Gland behind nipple?

[wassilyk1]

I'm a 20 year old male, fit (pretty skinny actually), with a little fat on the chest and stomach. I've only noticed my larger, puffier nipples since a few months ago, when I went from being skinny to putting on a little muscle and, at the same time, a little fat on the chest/stomach.

I've noticed a hard round substance beneath one or both of my nipples before (sometime in the past 2 years) but it only surfaced a couple of times for a period of about a week or less. I didn't know what it was and wasn't really concerned. No longer do I feel it. Now it sounds like it could be glandular, but it's gone now and I haven't felt it in a long time. But my nipples are still a bit puffy. They poke out a bit and ruin the masculine contour I'd hoped for when I started working out.

Still not sure if it's fat/muscle, but it seems that if it truly is gynecomastia, there would be an obvious enlarged gland behind my nipple puffiness. I don't know what to feel for. Can anyone explain what exactly the gland feels like, how deep it can be in various cases, etc. to help me confirm that it's a glandular issue, not just fat or something?

[DrBermant]

I'm a 20 year old male, fit (pretty skinny actually), with a little fat on the chest and stomach. I've only noticed my larger, puffier nipples since a few months ago, when I went from being skinny to putting on a little muscle and, at the same time, a little fat on the chest/stomach.

I've noticed a hard round substance beneath one or both of my nipples before (sometime in the past 2 years) but it only surfaced a couple of times for a period of about a week or less. I didn't know what it was and wasn't really concerned. No longer do I feel it. Now it sounds like it could be glandular, but it's gone now and I haven't felt it in a long time. But my nipples are still a bit puffy. They poke out a bit and ruin the masculine contour I'd hoped for when I started working out.

Still not sure if it's fat/muscle, but it seems that if it truly is gynecomastia, there would be an obvious enlarged gland behind my nipple puffiness. I don't know what to feel for. Can anyone explain what exactly the gland feels like, how deep it can be in various cases, etc. to help me confirm that it's a glandular issue, not just fat or something?

Unfortunately, it can be difficult to distinguish just what is causing the problem.  Gynecomastia male breasts can be fat, gland, or most commonly a combination of both.  Sometimes skin and sagging tissues can be a factor.  Pseudo Gynecomastia is supposed to be fat only gynecomastia.  The problem with that "classification" is that in almost every case of gynecomastia I have seen there is some component of gland.  This gland can be very small, but it is present almost all the time.  So do you have Pseudo gynecomastia when there is a 1%, 10%, 50%, or 90% deformity from fat?  Reality just does not work that way.

Defining the problem with photographs sometimes can help.  However, it is impossible to tell from photographs if the deformity is from fat or gland. The dynamic images, of my standard set of images can show a region that compresses differently.  Even clinical examination differentiation can be difficult.

Fat tends to be soft, gland tends to be firm.  Fingers of gland often dissect between fingers of fat.  Look at this drawing and move your mouse over the arrows.  However, gland can be soft and fat firm confusing the picture.  Gland tends to be located under the nipple and pinching pressure can sometimes tether to the nipple pulling it in.

Men with excessive fat do tend to have certain contour issues.  Check out this link about Sumo Wrestlers.  Men tend to carry excessive weight in their chest and stomach.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture