Gynecomastia / Pseudogynecomastia

[morneaumadness]

I was just wondering if there was a way to determine if I had one of those conditions or the other without having to go to the doctor.

Pseudogynecomastia is the condtion in which the male breast has "Fat tissue," and Gynecomastia is the condition in which the male breat has "fat tissue" and "breast tissue."

I'm a 19 year old male who believes I may have Gynecomastia. Since Gynecomastia (in most cases) is supposed to go away 2 to 3 years after hitting puberty and its been 4+ years since then, I have to question what may be going on. Over the years I've lost lots of weight by running and consider myself to be an athlete, yet I dont think i've lost any fat around my pectoral (male breast) region. As I've burned fat everywhere else around my body I feel as though Gynecomastia is making me look even more disproportional (maybe I just think that, who knows?)

So if anyone has any insight with gynecomastia / Pseudogynecomastia or has any other suggestions I would greatly appreciate it.

[Paa_Paw]

I do not like the distinction between Gynecomastia and Pseudo-Gynecomastia becaust there is usually both fatty and glandular tissue. Sometimes, even a skilled surgeon cannot be sure of what there is and how much of each until after the surgery is done.

[DrBermant]

I was just wondering if there was a way to determine if I had one of those conditions or the other without having to go to the doctor.

Pseudogynecomastia is the condtion in which the male breast has "Fat tissue," and Gynecomastia is the condition in which the male breat has "fat tissue" and "breast tissue."

I'm a 19 year old male who believes I may have Gynecomastia. Since Gynecomastia (in most cases) is supposed to go away 2 to 3 years after hitting puberty and its been 4+ years since then, I have to question what may be going on. Over the years I've lost lots of weight by running and consider myself to be an athlete, yet I dont think i've lost any fat around my pectoral (male breast) region. As I've burned fat everywhere else around my body I feel as though Gynecomastia is making me look even more disproportional (maybe I just think that, who knows?)

So if anyone has any insight with gynecomastia / Pseudogynecomastia or has any other suggestions I would greatly appreciate it.

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 tissues can be a factor.  Pseudo Gynecomastia is supposed to be fat only gynecomastia.  The problem with that "classification" is that in almost every case of gynecomastia I have seen there is some component of gland.  This gland can be very small, but it is present almost all the time.  So do you have Pseudo gynecomastia when there is a 1%, 10%, 50%, or 90% deformity from fat?  Reality just does not work that way.

Defining the problem with photographs sometimes can help.  However, 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.

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
Learn More About Gynecomastia and Chest Sculpture

[Mr_Nip]

Great post, Dr. Bermant. 

It should be required reading for everybody who's doctor says they're just fat and only need liposuction.
Thanks for the knowledge you regularly contribute.