How do I Tell if my Gynecomastia is Caused by Fatty Tissues or Breast Tissues?

Enlargement of the male breast known as "gynecomastia" is most often a combination of both glandular tissue and extra fatty tissue. An examination  by a Plastic Surgeon can usually sort this out but occasionally imaging studies such as ultrasound, Xray or MRI can be useful. If you have a very lean body with firm or nodular tissue directly behind the nipple only then chances are this is mostly glandular tissue. By far the majority of men who we help with this condition have this glandular tissue as well as a disproportionate amount of fatty tissue on the chest.

The first step in correcting this is to be near your ideal weight and rule out any medical issues that may be treatable without surgery. Medically reversible causes of gynecomastia are uncommon so the best treatment then becomes surgery. Results from surgical management done by a Plastic Surgeon are highly successful and satisfying for most patients. Good Luck!

Dr. Mosher

Hi @Amauri - Thanks for the question!
Man Boobs (aka Gynecomastia) affects up to 65% of men! I guess it’s one of those things we don’t talk about but there’s some really easy options to get this taken care of permanently. 
There are typically two types of surgically correctable gynecomastia. The first, is the result of excess fat accumulation in the chest. This one feels like an even-filled squishy breast. Almost like a female breast. The second, is more excess breast glandular tissue and less of a fatty component. This one feels large but usually you can pinpoint a defined ball or hard/firm area beneath the fat. Oftentimes, it’s a combination of these two and there are some really great options to manage these.

If it’s mainly fat, we have a couple options the first is wide awake flash recovery liposuction which is very well tolerated, doesn’t require going to sleep (but you can if you want to) and the second is a non invasive option like CoolSculpting or CryoLipolysis which is freezing the fat cells.These are both great options for patients which primarily fatty gynecomastia or pseudogynecomastia. 

The other group of patients we typically see, which is the majority, will have some fat but also a rubbery, more firm glandular component which tends to be centralized under the nipple area. For these patients, I like to use the Pull Through Technique along with liposuction. This involves a tiny incision away from the breast, concealed in an area of natural shadow, and through that incision we first liposuction all the fatty tissue and then use that same incision to remove the rubbery glandular tissue from behind the nipple. The scars are imperceptible and heals great. 
Both of these options lead to a masculine and flat chest surface that won't show through sweaters or shirts which is usually the main complaint I hear from patients with gynecomastia.
Thanks,
Dr. Karan Chopra
Plastic & Reconstructive Surgeon
Johns Hopkins Trained 
Body & Face Expert

Although it is not always clear if a specific patient’s gynecomastia is due to excess breast tissue or fatty tissue, typically excess fatty tissue feels softer to touch. Unfortunately, gynecomastia is a stubborn condition, which is resistant to diet and exercise. The only way to have a handsome, masculine chest is for the patient to undergo the gynecomastia procedure. This is a quick procedure that I frequently perform in my New York City practice. Most importantly, I am able to perform this surgery without putting the typical scar on the nipple/areolar complex. For best results, please visit a board certified plastic surgeon who specializes in gynecomastia surgery.