It's it possible to have gynecomastia (Excess glandular tissue) without visibly puffy areola? (photos)

Since I am obese, could the puffy areola be masked by fatty tissue? Even when I was extremely low bodyfat many years ago, I felt like there was a gynecomastia issue.

Doctor Answers 10


Thank you for your picture.  Yes you have gynecomastia.  You should seek evaluation by several board certified plastic surgeons for treatment options


You will get a better result from gynecomastia surgery if you can get close to your ideal body weight, or the weight that you are comfortable with.  Not all gynecomastia patients have a puffy areola.  Best wishes!

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 62 reviews

It's it possible to have gynecomastia (Excess glandular tissue) without visibly puffy areola?

Yes it is possible.
Issues of concern are why you may have glandular hypertrophy(enlargement), and treatment of any symptoms of glandular enlargement or hormonal imbalance. Also 1% of all breast cancers are in men; typically give unilateral(one sided symptoms). Otherwise, adipose excess can be treated purely aesthetically.

Hope this helps 

Andrew Kornstein, MD, FACS
New York Plastic Surgeon
4.6 out of 5 stars 17 reviews


Either way, it looks like you need a reduction of the volume and perhaps skin excision as well.  Good luck

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews


"Gynecomastia" I considered to be a relative term. Even with that I'm pretty sure everyone would consider what you show in the photos to be gynecomastia. Before you even consider surgery you want to think about getting down to your lowest possible weight. Good luck with it.

Sherwood Baxt, MD
Paramus Plastic Surgeon
3.8 out of 5 stars 25 reviews

Gynecomastia or fat?

I appreciate your concern, but physical exam would be helpful. However, your photo demonstrates probable Gynecomastia with fatty component which is usually treated by liposuction alone, or liposuction with skin excision. The scars are small and well hidden. Insurance may or may not cover it, depends on your policy. Check out the link below to an article I wrote about Gynecomastia, as you may find it helpful. Seek out a board certified plastic surgeon in your area, good luck!

Robert M. Tornambe, MD
New York Plastic Surgeon
5.0 out of 5 stars 31 reviews

It's it possible to have gynecomastia (Excess glandular tissue) without visibly puffy areola

Yes ,
the photos that you  have posted is one
gynaecomastia is a condition which includes various shapes of the chest , nipple and areola  complex which are out of shape 
the best way to correct them is surgery(liposuction and gland excision)

Karthik Ram, MRCS, DNB
India Plastic Surgeon
4.8 out of 5 stars 54 reviews

About Gynecomastia and Puffy Nipples Complex

The male breast is composed of glandular tissue and fatty tissue. An excess in either type of tissue can cause the chest to take on the look of gynecomastia. Gynecomastia can affect #men of all different body types. There are different types of #gynecomastia. Several common factors can cause gynecomastia including excessive levels of #estrogen, natural #hormone changes, use of recreational drugs or alcohol, medications and their associated side effects, and, various health conditions. Also, there are different types of #gynecomastia.

"Puffy Nipple Areola Complex" is among the most common forms of gynecomastia. This gland and/or adipose tissue accumulation can be located under the areola or can be slightly extended outside the areola, causing the areola to appear dome shaped.This form of #Gynecomastia can be found in all age groups but is more common in young adults.

As each case is different, it is vital that you consult with a board certified plastic surgeon who is experienced in male breast surgery. The surgeon should determine if you are a suitable candidate for male breast reduction by liposuction or glandular excision. It is also crucial to have a plastic surgeon who is well-versed in the gynecomastia condition can determine if there is firm breast tissue beneath the areola that is causing the nipples to project (which is often the case), and if so, how much of this glandular tissue can be removed to create a flat appearance.

Also, men who suffer from large #areolas may notice that after breast surgery, the skin of the chest muscles will tighten, causing the areolas to tighten and diminish in size. This is a result of the removal of glandular and/or adipose tissue.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews

Yes, but..

Based on your description, there is probably excess glandular tissue, too. Liposuction alone may not get the job done.  A good start is a consult from a board certified plastic surgeon. More information is available in the link attached.

Tim Neavin, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 46 reviews

Gynecomastia Boston MA

If it bothers you ,you can see a real specialist.
How should I choose a surgeon? Choose carefully.
The decision is yours. Advice to assist in making your selection.Only a board certified plastic surgeon 1. Experience matters. Choosing a surgeon increases the likelihood that they have seen a case similar to yours in the past. Selecting a surgeon whose practice is focused on gynecomastia exclusively is also an indicator of experience. 2. Results matter. The more before-and-after pictures, the better. Pay attention whether the surgeon is confident enough to show multiple angles of the same patient. 3.Only gynecomastia Reviews matter. 4. Expertise matters. Is your surgeon recognized by the profession as an authority in the field? Have they authored books or medical journal articles regarding your surgery? Be realistic about your expectations. Also, revision surgery tends to be significantly more difficult than initial surgery.

Mordcai Blau, MD
New York Plastic Surgeon
4.6 out of 5 stars 76 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.