No puffy nipples...

[DivineRadiance]

Hi I'm new here and I really hope that perhaps any professional or even someone with the same experience can answer my question. It's only been lately that I've actually taken notice of a possibility of myself having gynecomastia. I'm actually hoping it's only pseudogynecomastia though.

I've been fat probably ever since 5th grade and I was obese up to January of 2010. After that I made sure to cut down on my food intake. I lead a pretty busy life so I don't really have time to exercise. I weight at 239-242 lbs. It varies with our weighing scale and I'm 18 but I've been known to have a soft kid like voice so I'm probably sure I've got hormonal imbalance. Either that or I'm still in my puberty stages and I'm delayed. Is there any way to know?

Anyways, I don't have what people here call puffy nipples. Excuse my ignorance, I'm kinda new to this thing. I saw pictures of other guys with gynecomastia and compared em with mine. Mine look a little normal but yeah, they do stick out of my clothing and I do have fat at my chest and stomach area. I've gotten a little embarassed about it so I'm hoping someone could help me.

If I don't have puffy nipples, maybe just pointy ones, is it an immediate rule out that I don't have gynecomastia?

[DrBermant]

Hi I'm new here and I really hope that perhaps any professional or even someone with the same experience can answer my question. It's only been lately that I've actually taken notice of a possibility of myself having gynecomastia. I'm actually hoping it's only pseudogynecomastia though.

I've been fat probably ever since 5th grade and I was obese up to January of 2010. After that I made sure to cut down on my food intake. I lead a pretty busy life so I don't really have time to exercise. I weight at 239-242 lbs. It varies with our weighing scale and I'm 18 but I've been known to have a soft kid like voice so I'm probably sure I've got hormonal imbalance. Either that or I'm still in my puberty stages and I'm delayed. Is there any way to know?

Anyways, I don't have what people here call puffy nipples. Excuse my ignorance, I'm kinda new to this thing. I saw pictures of other guys with gynecomastia and compared em with mine. Mine look a little normal but yeah, they do stick out of my clothing and I do have fat at my chest and stomach area. I've gotten a little embarassed about it so I'm hoping someone could help me.

If I don't have puffy nipples, maybe just pointy ones, is it an immediate rule out that I don't have gynecomastia?

The Anatomy of Gynecomastia will consist of fat, gland, and skin.  All overweight mammals will have breasts, it is part of the contour of where fat goes on. Have you ever seen a Sumo Wrestler without breasts?

Galen coined the term gynecomastia. Although he was aware of the gland possible contribution, he described the fatty contour as gynecomastia. So yes, if it looks like a female breast on a male body it is gynecomastia. Some came up with the term Pseudogynecomastia, but if you look at that page you will see why this is just a poor word.

Weight loss is often the best first step for those who have fat as a major component of their contour problem. The fat will be a global body shaping problem. Losing weight is a coarse tool. You cannot pick where the fat comes from. Plastic Surgery is better reserved for refinement. As a good sculptor, I prefer to use the coarse tool first, then refinement second. Men tend to put weight on first on their chest and belly. We take the fat off those regions last. Early surgery cannot make an obese individual look thin, just an obese person with smaller breasts. It is compromise surgery. Contour the body, lose the weight, and if it comes off in the normal way, there will still be breasts!  I typically recommend getting to a weight / body fat a person is happy with before considering chest contouring.

No Surgery Body Shaping Compression Garments have been a fantastic temporizing measure for those wanting a better contour while working on stabilizing their problem.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[DivineRadiance]

Ahh so I guess it's not just a matter of puffy nipples? And that even though your nipples appear normal, it doesn't mean you're gynecomastia free?

[DrBermant]

Ahh so I guess it's not just a matter of puffy nipples? And that even though your nipples appear normal, it doesn't mean you're gynecomastia free?

Gynecomastia is a contour problem. If the chest says male, then there is not gynecomastia even if there is gland. All male mammals have gland. It is part of being a mammal. However, if the problem shows when the areola muscles relax, or on animation like flexing, then there is gynecomastia.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[Grandpa Bambu]

This thread should be a 'Sticky'...

GB...

[Paa_Paw]

Right again GB!

I agree entirely with what Dr. B said as well.

It should be pointed out that either fatty or glandular would not seem to often exist without some of the other.

Since the impact upon the man is emotional rather than physical and it is the same either way, calling one true and the other pseudo seems a bit foolish.

[Grandpa Bambu]

Gynecomastia:  Gyne (Woman-like) Mastos (Breasts)

If one has 'Woman-like Breasts', then they have Gynecomastia ... regardless of the gland/adipose tissue ratio...

GB...

[DivineRadiance]

Hi again. I have more questions. Let's say that if one's nipples look normal, is it possible that nipples will become puffy if one has reduced chest fat?

And take for example someone who has a flat chest, no manboobs at all, but then he becomes fat and has manboobs, when he loses weight will they return to their normal appearance, no fat or anything?

[Dr. Elliot Jacobs]

Obesity is a double whammy.  When you are fat, there is added fat in your chest area.  But obesity itself predisposes to production of more estrogen, which then stimulates your innate breast tissue to grow. The result is enlarged breasts in an overweight person which always has both fat and breast tissue.

If you were to lose sufficient weight to be in the normal range, what will happen is that the fat tissue in your breasts will diminish, but the breast tissue will remain.  The breast tissue actually concentrates together as the fat tissue shrinks between the layers of breast tissue.

After weight loss, surgery will usually consist of removal of excess tissue plus attention to loose, lax skin and possible need to re-position the nipples to a more normal location.

Dr Jacobs

[DrBermant]

Hi again. I have more questions. Let's say that if one's nipples look normal, is it possible that nipples will become puffy if one has reduced chest fat?

And take for example someone who has a flat chest, no manboobs at all, but then he becomes fat and has manboobs, when he loses weight will they return to their normal appearance, no fat or anything?

The Anatomy of Puffy Nipple Gynecomastia consists of fat, gland, and skin. The contour of the normal male chest will also have all three component. Weight loss can help with the fat component and can unmask remaining gland tissues.

Manboobs is slang for gynecomastia. When weight goes on, men tend to put it on their chest and belly first. We take it off those regions last. So with weight loss, the contour problem can now be from remaining gland, fat, and now also skin. In addition, obesity itself seems to generate more gland component, it is in the chemistry of the fat cells themselves and may have something to do with multi-potential cells converting to gland. So the gland component can enlarge and become a bigger factor when weight is put on.

I have seen so many different variations:

Weight loss and a flat chest,
weight loss with residual fat and trivial gland,
weight loss with residual fat gland,
weight loss with residual fat, gland and skin.

Such issues are just not predictable.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[DivineRadiance]

So I'm guessing that the nipples may become puffy because of the gland if one chooses to lose weight? Not just so sure...

And is it possible that if one has been obese ever since he was a little kid and loses weight during his late teenage years, is it possible for him to still get a flat chest without surgery? I'm thinking maybe the estrogen stuff has already produced too much already so I'm guessing it's impossible but I just need to ask and confirm.