Gynecomastia Surgery Options/Finding out about gland

[prasadanwar]

I've attached some pictures of my Gyno, I'm 19 and I've researched online and multiple sites say to feel if there is a gland which should be hard. Most of the time when my nipples are puffy, both will be. Just wondering if it would be true gynecomastia if i can't seem to feel the 'hard' gland. And how would I go about finding out whether or not it is (would an ultrasound on the chest show?) as I feel that the plastic surgeons in my area would firstly say that I should do the surgery.

Any help would be greatly appreciated, thanks for taking this time

[Dr. Schuster]

Gynecomastia, whether purely glandular, fatty (pseudogynecomastia, or mixed, is really more a clinical diagnosis based on history and examination. Most of he time it is termed idiopathic, meaning "it just happens without an underlying known cause". Sometimes there can be some underlying disorders or conditions. A good gynecomastia surgeon or endocrinologist can help sort that out. But again most of the time it will be simply a cosmetic issue. Unless somehing is seen on an examination, additional test such as ultrasound, mammogram or MRI are not needed. Occaisionally bloodwork is done to rule out any other cause. Your photos would suggest that you indeed have gynecomastia. An experienced gynecomastia surgeon should be able to help you to understand your conditions and options. Good luck.

[Dr. Elliot Jacobs]

The presence of gynecomastia is not determined by a patient feeling "hard" tissue beneath the areolas.  In fact, oftentimes, the breast tissue is soft.

What determines a diagnosis of gynecomastia is whether there is excess tissues (no matter how hard or soft it may feel) beneath the areola and extending outwardly.  Self diagnosis is oftentimes misleading.

Best to check things out with a plastic surgeon with extensive experience in gynecomastia surgery.

BTW, if you have puffy nipples, the only cause for this is breast tissue -- it is never just fat alone.

Dr Jacobs

[Michael Law, M.D.]

All boys and men have a small mass of fibrous breast tissue immediately below the areolas. This small mass of breast tissue does not become apparent externally unless it grows in size to a point where the nipple-areola complexes begin to bulge outward, hence the term ‘puffy nipples’. 
You may not feel hard or firm tissue behind the nipple. In some cases, puffy nipples in teens can change, and become less pronounced after puberty. By age 19, it is unlikely that the area will change at this point. 
Some of my happiest patients are men who elected to have surgery as young adults, or even as teens with the consent of their parents. This surgery can be truly life changing. You are in a great place to start finding a plastic surgeon with a real passion for, and expertise in gynecomastia surgery.