26yr old, do i have gynecomastia? possible to hide with hard gym work?

[christango]

See the attached pics.

I am 26 and fairly active, i have always been skinny and a little feminine in the face.  up until recently discovering Gynecomastia i thought it was just down to how i was meant to be.  I went to my doctors and she said she could feel a little tissue and may send me to a specialist.  Mean while i wanted someone elses opinion.... i recently started going to the gym in an effort to tone up the relaxed chest area... but i read trying to tone up breast tissue can make it even worse since your now adding muscle mass to the breast tissue....

as you can see in the pics linked below i have barely any fat tissue around my stomach and it tears me to bits to think that i have breast tissue on my chest knowing i have a perfectly beach worthy stomach.

Ultimately the 3 questions i would love feedback on....
1) do you think i have the condition?
2) do you think going to the gym will lessen the condition if i tone my chest? im under no disillusion that the condition will disappear completely using this method but is it possible to tone my chest to something like this with a lot of hard work? http://www.gynecomastia-surgeon.com/wp-content/uploads/2010/02/healthy-chest-216x300.jpg
if i could tone my chest to get rid of some of the sagginess than i am completely happy with that.
3) can meds help at this stage?

[DeeDubStyle619]

Yes, you do have gynecomastia.
Yes, it could help hide it, but for best results, surgery is needed.

[kwl04]

Yes, I would say you have it.

From what I've read, muscle and fat push the tissue out and give you that appearance. I think you'll always have the puffy nipples regardless of how much you exercise, but a doctor is obviously more qualified to tell you what's really going on.

If you exercise and don't like the way you look, you could always take up a bad diet and sit on the couch. I'd say exercise like heck and get your surgery if it bugs you that much.

Best of luck!

[ddh]

IMHO I don't think you'll be able to change the contour of your chest with just exercise. Nor will medications change it's shape.

You are very slim and probably look just fine in any type of shirt, but if the contour of your chest really bothers you, I think surgery is the only option.

[DrBermant]

See the attached pics.

I am 26 and fairly active, i have always been skinny and a little feminine in the face.  up until recently discovering Gynecomastia i thought it was just down to how i was meant to be.  I went to my doctors and she said she could feel a little tissue and may send me to a specialist.  Mean while i wanted someone elses opinion.... i recently started going to the gym in an effort to tone up the relaxed chest area... but i read trying to tone up breast tissue can make it even worse since your now adding muscle mass to the breast tissue....

as you can see in the pics linked below i have barely any fat tissue around my stomach and it tears me to bits to think that i have breast tissue on my chest knowing i have a perfectly beach worthy stomach.

Ultimately the 3 questions i would love feedback on....
1) do you think i have the condition?
2) do you think going to the gym will lessen the condition if i tone my chest? im under no disillusion that the condition will disappear completely using this method but is it possible to tone my chest to something like this with a lot of hard work?
if i could tone my chest to get rid of some of the sagginess than i am completely happy with that.
3) can meds help at this stage?

http://img202.imageshack.us/i/20101008003902.jpg/
http://img526.imageshack.us/i/20101008003849.jpg/
http://img403.imageshack.us/i/20101008003810.jpg/
http://img69.imageshack.us/i/20101008003703.jpg/

When there are breasts on a male chest, it is gynecomastia by definition. During the evaluation of patients, however, I am also looking at more than the chest alone. The Red Flags that can merit an endocrinology evaluation include female body fat distribution, hair pattern, voice, facial features, among many other factors. Check out some of such issues in this patient labeled male on his birth certificate, male on his driver's license, living as a man, but was a Congenital Adrenal Hyperplasia Gynecomastia XX female. It was the mixed sexual characteristics during my clinical exam missed by years of other doctors that started the evaluational for the diagnosis. That is why picking an experienced doctor who spends time evaluating the patients before rushing into surgery is so critical. His previous surgeon was not as careful resulting in the recurrence that the patient then saw me about.

Your images are not sufficient for an evaluation, posting Standard Gynecomastia Pictures can better help other understand your concerns. If there is sagging or drooping, then Male Chest Lift Pictures will show loose skin issues.

Hope this helps,

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

[henry 41]

You do not have gynecomastia. I see no woman-like breasts. Your problem is that you're out of shape from lack of exercise, and since there is little muscle, it looks a little like what's there could be hinting at breasts. The nipples are a little bigger than average, but you do not have gynecomastia. If you were to get yourself into shape with a vigorous daily military-style calesthenics regimen, your body would tighten up, and within a year, the nipples will probably atrophy (shrink a little) due to the increased testosterone produced by muscle. Why scar your chest with surgery for nothing?

[christango]

ok i have tried to take better pictures, and DrBermant, the doctor i saw examined my testicles and asked the usual male questions, yes i shave daily, i have hair under my arms as you can see...(sorry for that!:P), my testicles are fine, i have a high sex drive and my voice is deep and everything occured at the normal times.

i hope this new pics show it a little better, it is hard to take the pics on your own! surgery is indeed the last resort for me henry, i dont want to risk anything if i can avoid it.  I am also asking questions on a body building forum to see their advice on the matter too, many say if i bulked up the rest of my body the condition would be far less noticeable.  of course i would fully trust the answer of a trained doctor over some forum bods but the opinions are nice to have.

If the pics are still not sufficient to diagnose my body then i will ask someone to take the pictures for me.  thankyou again in advance....

ps. clicking the thumbnail once then once again while on imageshack zooms into the full size image...

[George Pope, M.D.]

You appear to have classic gynecomastia, but not a severe case.  Your areolar diameter is quite large, presumably from breast tissue pushing against the areolar skin, causing it to spread out.  If you do have gland tissue present, aggressive working out your pec muscles will most likely aggravate the problem, as the increased muscle bulk will push the gland tissue out further.

Removal of the gland tissue in a classic gyne surgical procedure will most likely help to shrink the diameter of the areolae.

Dr. Pope, MD

[christango]

if that is the case is surgery the only option for my chest? if so i read that it can take weeks to recover, is that estimated time based on a more severe case of gyno? if so is there an estimated time for a case like mine?

[gyneco_1001]

It depends on what you mean by recover, you should be 'functional' by about a week (can't lift things etc.).. up and running by about the 3-4 week mark... any residual swelling/scars should subside between 6-12 months

[George Pope, M.D.]

Recovery time is not determined by the severity of the gynecomastia.  Recovery from surgery is in some ways individual, but as a general rule, bruising should resolve within a couple of weeks, but swelling will take a good 2 to 3 months to completely resolve.  I tell my patients to refrain from aerobic activity for about 3 weeks and avoid heavy lifting, refrain from upper body weight lifting for about 6 weeks.  That's my instruction to patients, but surgeons vary in how they manage patients postop.

Dr. Pope, MD

[DrBermant]

ok i have tried to take better pictures, and DrBermant, the doctor i saw examined my testicles and asked the usual male questions, yes i shave daily, i have hair under my arms as you can see...(sorry for that!:P), my testicles are fine, i have a high sex drive and my voice is deep and everything occured at the normal times.

i hope this new pics show it a little better, it is hard to take the pics on your own! surgery is indeed the last resort for me henry, i dont want to risk anything if i can avoid it.  I am also asking questions on a body building forum to see their advice on the matter too, many say if i bulked up the rest of my body the condition would be far less noticeable.  of course i would fully trust the answer of a trained doctor over some forum bods but the opinions are nice to have.

If the pics are still not sufficient to diagnose my body then i will ask someone to take the pictures for me.  thankyou again in advance....

The new images do not show the unusual fat distribution you demonstrate in this earlier photograph:

http://img403.imageshack.us/i/20101008003810.jpg/

but in addition the extra detail, point out the limitations of online forum discussions. Actually this is a dynamic process of evaluation / question asking that just does not happen online nor in emails. I prefer to start out with a detailed questionnaire in conjunction with an examination or Standard Gynecomastia Pictures. The give and take of a phone call or face to face just do not happen enough for an "email consultation" to be effective. Even the phone call sometimes is inadequate as in the example I posted above. Sometimes only an in office real hands on exam and face to face discussion is necessary for that next step.

It depends on what you mean by recover, you should be 'functional' by about a week (can't lift things etc.).. up and running by about the 3-4 week mark... any residual swelling/scars should subside between 6-12 months

if that is the case is surgery the only option for my chest? if so i read that it can take weeks to recover, is that estimated time based on a more severe case of gyno? if so is there an estimated time for a case like mine?

You have not cleared up if there are other issues going on, before jumping into a possible surgery. Understanding if you are in a stable condition is the first step, then evaluating your medical condition are all critical steps before saying surgery is appropriate.

Recovery After Gynecomastia Surgery does indeed depend on the original problem, what is done, how much damage the surgery creates, skill of the surgeon, After Surgery Compression, aftercare, and many other factors. Bigger operations like Male Mastopexy Chest Lift are more extensive, and longer to recover than a typical gynecomastia surgery. Revision Gynecomastia Surgery is often more complex and difficult with a longer recovery than primary surgery. That is why those sections are split off from my gynecomastia surgery to demonstrate such issues and collect the various types to better see differences. Even variations in the degree of gynecomastia can change recovery.

The more Bruising and Swelling After Gynecomastia Surgery, the greater the injury of the surgery, the slower the recovery, the longer the return to activities. My patients typically have minimal bruising and swelling. The swelling peaks in the operating room and typically decreases after as documented on my examples. What little swelling / bruising gradually then diminishes over time.

My patients are typically back to light activity the day after surgery. That means using a keyboard is fine, walking around is fine. Lifting the arms or bouncing is too much. I advise my patients, it is like recovering from a sprain. You cannot effectively put a time period on such an injury, but instead gradually phase back into it. Imagine telling someone with a sprain that they will be good to go in x days or y weeks!

Comfort after Gynecomastia Surgery is another factor. If there is enough discomfort or need major pain medication, then not working makes perfect sense. Although we give our patients a prescription for strong pain medication, they tell me that plain Tylenol alone is more than enough. When they achieve this typical comfort many are able to return to work or drive long distances the next day after surgery.

What you see on my examples are typical for my patients. Each surgeon has his / her own methods and what you see in my examples are typical for my patients. For other doctors, often you need to search forums to find early after surgery examples.

Hope this helps,

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

[christango]

thankyou for the very detailed reply!, when you comment on the fat distribution of my earlier pic i assume you mean the fact my chest is a little saggy yet my stomach is quite defined and the rest of my body is very slim and not very typical of a male in his 20's?

i would never rush into surgery, its the last thing i want to do hence why i am asking the questions about recovery so i know my options should it come to that, i understand it is your profession but the main thing i want to know is if i could in your opinion change my appearence of my upper body by training my upper body at a gym? if that is a question you can't answer because of not knowing the answer of a potential medical conditition i may have then i will take your opinion onboard.  I also understand that training my lower chest may push the breast tissue out further due to the newly formed muscle taking up space too which is why i would adapt my training routine to avoid that as much as possible.

I guess i am a little confused about the whole Congenital Adrenal Hyperplasia Gynecomastia XX female.  How would i find out if this is the case? I have all the male signs in my body other than the chest in question.  I live in the Uk and my doctor said they may be able to refer me to a breast specialist on the NHS.

Thankyou again and i apologise if i sound a little ignorant, this is a new realm of knowledge for me.

[thetodd]

There's no way of hiding gyne, despite what some people say about weightlifting its a load of crap. The guy you posted in that pic would probally take 2 years of constant 5 day full on weightlifting (and probally a cocktail of steroids). Theres just no way of a guy of your build achieving huge pectoral muscles. Although you do definatley have gyne i think the NHS will turn you away when you go and see the specialist. My doc reffered me to the breast clinic for them to tell me there is no such thing as gynecomastia surgery and the only people they do it on is elderly men with hormone issues and they remove the breast itself (so no gland at all, so i presume that means no nipples). And with all the cutbacks in the NHS at the minute its going to be even tougher to pass through the board.


Dont put all your eggs in one basket with the NHS, ive seen so many dissapointed lads on here who have had dealings with them. And if you are refused then the only option left is really to pay £4ishk for surgery you have to balance up whether thats a price your willing to pay.

[DrBermant]

thankyou for the very detailed reply!, when you comment on the fat distribution of my earlier pic i assume you mean the fact my chest is a little saggy yet my stomach is quite defined and the rest of my body is very slim and not very typical of a male in his 20's?

i would never rush into surgery, its the last thing i want to do hence why i am asking the questions about recovery so i know my options should it come to that, i understand it is your profession but the main thing i want to know is if i could in your opinion change my appearence of my upper body by training my upper body at a gym? if that is a question you can't answer because of not knowing the answer of a potential medical conditition i may have then i will take your opinion onboard.  I also understand that training my lower chest may push the breast tissue out further due to the newly formed muscle taking up space too which is why i would adapt my training routine to avoid that as much as possible.

I guess i am a little confused about the whole Congenital Adrenal Hyperplasia Gynecomastia XX female.  How would i find out if this is the case? I have all the male signs in my body other than the chest in question.  I live in the Uk and my doctor said they may be able to refer me to a breast specialist on the NHS.

Thankyou again and i apologise if i sound a little ignorant, this is a new realm of knowledge for me.

There are many possible issues I help my patients explore during a consultation. Body fat distribution is one factor  for a Red Flag warranting endocrinology evaluation. My comments about the CAH is that there was an individual who had a problem missed by doctors' evaluation for decades. It takes an experienced clinician performing such examinations and why, when I find Red Flags, I mandate an Endocrinologist for continued assessment.

Loose skin issues are another completely different factor that is part of my evaluation and discussion for my patients.

If you are interested in learning more, forums are not sufficient for such details. We are glad to help patients explore such issues during consultations or our Preliminary Remote Discussion

Hope this helps,

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