who do you see about gyne

[indyadam]

Wanted to know if a plastic surgeon is the only doctor that can diagnoes wether my man boobs are due to an enlarged gland or just fat.  Was thinking of just asking my family doctor on my next visit, but didn't want to waste the time if a general practicing doctor doesn't know what to look and feel for.  Sorry for the bad spelling.

[Dr. Elliot Jacobs]

Most of the time, family docs may know the term "gynecomastia" but that's about it.  They will usually pat you on the shoulder and urge you to "wait it out -- it will go away."  Sometimes, they may send you to an endocrinologist for an evaluation.  They usually cannot diagnose fat vs gland -- except in rare circumstances.

If you think you have gyne, then the best choice is to go to a plastic surgeon for an evaluation -- preferably one with demonstrated interest and large experience in gyne.  He will guide you as to diagnosis and also review your medical history to try to determine the cause -- oftentimes a cause cannot be found.  And if he is suspicious, he may refer you to an endocrinologist for an evaluation.  But he is also able to describe any anticipated surgery for you.

Good luck!

Dr Jacobs

[DrBermant]

Wanted to know if a plastic surgeon is the only doctor that can diagnoes wether my man boobs are due to an enlarged gland or just fat.  Was thinking of just asking my family doctor on my next visit, but didn't want to waste the time if a general practicing doctor doesn't know what to look and feel for.  Sorry for the bad spelling.

The Anatomy of Gynecomastia consists of fat, gland, and skin. All male mammals with have a gland component. Clinical Examination of the Male Chest, even when done by an experienced Plastic Surgeon does not differentiate between fat and gland. Although gland tends to be firm and fat soft, fat can be firm and gland soft. You can see my before surgery estimates of what I thought was gland in my markings and the resulting glands on the chest after surgery as a demonstration of my exams. 

What doctor to chose depends on many factors. When someone is obese, it does not take a Plastic Surgeon to have to say there is a global fat component contributing to the gynecomastia. When the problem is subtle, the more experienced gynecomastia surgeon is often a better place to start. For the individual with painful growing breasts, the Endocrinologist is often the best starting point. That is why a number of Endocrinologists many years ago helped me evolve my Red Flag System of evaluation to determine just where a patients should start.

Hope this helps,

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