I'm a 20yo college student and I'm almost positive that I do have gynecomastia. I've been aware for several years now and i've gotten clever at hiding it. But i'm tired of having to hide it. I'm interested to know what you guys think, like how severe or mild it is, and if surgery would be a good option? I've lost some weight recently hoping that it would help but it only made it more prominent I think, one side is definitely bigger than the other. Comments are appreciated, thank you!
How Severe or Mild or Rate My Gynecomastia are common questions on this forum.
There are many such grading systems, all fail. When I lecture about Gynecomastia, I spend almost 5 minutes describing how all of the systems break down. Galen who first coined the phrase was talking about fatty breasts. When posters here ask Rate My Gynecomastia, any such rating has little value. It is a question of how much it affects the owner than a public comment for a number.
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. Check out the
Anatomy of Gynecomastia to see typical composition.
Pseudo Gynecomastia
Pseudogynecomastia 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.
When a girl starts growing female breasts and has small buds, I wonder if that same doctor would inform the child she does not have real breasts because they are too small!
Puffy Nipple Gynecomastia is a variant of a small female breast. For a young male or
Bodybuilder with Gynecomastia even such a small contour issue can lead to teasing, stress, and major emotional concerns.
Weight loss only helps with the fat component and can unmask the remaining gland. Major weight loss can also result in loose skin issues.
To determine if surgery is a good option there needs to be a much more detailed exchange of information and details. This is normally done during a consultation or a
Preliminary Remote Discussion (which is what our patients use coming from a distance and wanting to minimize travel to Virginia). Looking at photos alone would not assess issues like risks for a patient with bleeding disorder, unstable blood pressure, and many other medical factors that can come into play for a detailed discussion of risks, benefits, and alternate methods of care.
Hope this helps,
Michael Bermant, MD
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