Hello, I'm in my late teens, out of shape, and about 225 pound. I have distributed weight pretty evenley: mostly stomach, but also thighs, arms, back, chest. Feeling my chest, it seems that there is a large mass beneath both of nipples that makes up most of the mass between the muscle and skin. When i grab it, i kinda dig my fingers between the muscle and the lump and can almost pull it away. (some people say they have small lumps, these take up a good bit of the mass as stated, so i dont know what to make of that). It it somewhat solid, and seems to have a rough surface. When i lift my arms up they flatten out somewhat with a small gradual hump. I also read a a post that said, "all fat people think they have gyno" (encouraging, maybe fat people naturally have denser breast fat, if it is fat in my case) I will try to loose weight and then we will see, but if i could know now it would be great. The biggest sign seems to be the lumps, which does NOT feel like stomach fat, but maybe it is just feels different, i cant relly tell. BTW, i do have a few montgomery's tubercles (white looking pimples around the nipple) although i have not read these are liked with gyno. I can't tell if i'm grabbing a hunk of fat or not! Any help?
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 muscles can be a factor.
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. In your images, the abdomen contour suggests weight may be a significant issue.
Losing weight first, to something you are comfortable with and can maintain is typically a much better option. Weight loss is a coarse tool. Unfortunately, you cannot pick where weight comes from - nor can you pick where weight goes back on to. Gland that contributes to the breast shape is not helped with weight loss. Fingers of fat in the gland can become smaller, but the contour problem from gland does not go away.
After losing weight plastic surgery can help with localized fat, gland, and extra skin. After surgery remaining fat cells can put on more weight.
Hope this helps,
Michael Bermant, MD
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