Pseudogynecomastia or True Gynecomastia

[Ptl2011]

Wasup everyone. I have been dealing with this issue for couple yrs now . I don't have the typical case of puffy nipples or true female looking breast but my breast under the areola feels very soft. Tried pretty much everything but I can't get rid of the fat that runs along the armpit and if I wear a light colored shirt it is very prominent.  I have tried the pinch test and don't feel much glandular tissue. Can I get away with just liposuction in my case? Please critique. Thanks

[Ptl2011]

Another view

[Paa_Paw]

For our purposes the generally accepted definition of Gynecomastia is any surplus of tissue in the breast area of a male.

The distinction between "True" and "Pseudo" Gynecomastia makes no sense at all.  The surplus could be an excess of Adipose (fatty) tissue, Glandular tissue, of sometimes skin. It does not matter which and since the enlargement usually involves all three kinds of tisue to some extent it really does not matter what the relative amounts are of each kind of tissue.

The effects of Gynecomastia are not physical, but psychological. so physical differences mean nothing.

The only measure of Gynecomastia is that relly matters is: "How much does it impact your personal life." Some guys with large breasts are coping very well so for them it is not bad. Some guys with very small breasts have trouble socializing and experience diminished sense of self worth; for them it is bad.

[xelnaga13]

I would attempt to drop body fat and see if that helps. In some cases the chest fat comes off, in other cases gyne fat can be the last to go. Similar to a women who loses a ton of weight but still has breast fat.

[George Pope, M.D.]

It looks to me like you're in very good physical shape but are carrying some extra body fat.  If you lose some weight you'll probably be fine.  If you don't feel solid "gland" tissue when you pinch your chest, you may just have some extra chest wall fat over well-developed muscle.  Try losing some weight to see if that takes care of it.  Overall, you look great. 

Dr. Pope, MD