Gynecomastia or Pseudogynecomastia? (photos)

Question

As per the attached does it look like I'm suffering from Gynecomastia, which will therefore require surgery and gland removal etc... Or does this look more like Pseudogynecomastia, and therefore weight loss would suffice... Thanks in advance!

Larry S. Nichter, MD, MS, FACS · Answer

Healthy male patients with excess breast tissue or unwanted breast development who have no underlying breast disease.Men who desire improved physical and aesthetic appearance should have realistic expectations based on their condition and the procedure performed. You should meet with a board certified plastic surgeon to be able to get a formal diagnosis and to be able to decide on a course of treatment if necessary.
#gynecomastia #malebreastreduction

Jed H. Horowitz, MD, FACS · Answer

Gynecomastia
is the excessive growth of the gland or breast tissue causing enlargement of
the male chest. In the United States 57% adult men and 36% young adult
men have gynecomastia. There are several types of the condition and it is
characterized by excess breast skin, excessive glandular tissue development and
excessive localized fat. Unfortunately, the appearance of large breasts in men
can cause a negative impact on self-confidence.

Types of Gynecomastia:

1- Normal Gynecomastia – This type is
usually apparent in boy between the ages of 12 to 15 years old and older men 65
years old or more who experience a drop in their testosterone levels. This type
of Gynecomastia takes about one to two years to regress on its own.

2- Pure Glandular Gynecomastia – This particular type of gynecomastia
is seen more commonly in body builders and is caused by steroid use. Surgical
removal of the gland is required for treatment.

3- Adult Gynecomastia – Fat deposits are apparent in the
glandular tissue. This type of gynecomastia is the most common. Doctors may
recommend surgery for treatment of the condition.

4- Adolescent Gynecomastia – This type is hereditary and usually
appears in 30% to 60% of boys between the ages of nine to fourteen. Many cases
of adolescent gynecomastia resolve on its own as the boy grows into adulthood.
Some may choose to undergo surgery to correct the situation, this usually
happens at the age of 18 or above. In severe cases in young boys, the physician
and child development specialists will need to speak to the parents regarding
the severity of the gynecomastia and if surgery is an option before the age of
18.

5- Assymetric or Unilateral
Gynecomastia
– This type of gynecomastia appears in either one or both breasts at different
degrees. In many cases one breast appears larger than the other. Surgery is a
common treatment for this type of gynecomastia.

6-
Pseudo-Gynecomastia – It is composed of adipose tissue instead of glandular
tissue. This type of gynecomastia can be treated with diet, liposuction or
surgery

7- Severe Gynecomastia – This type of gyencomastia commonly
affects those who have lost skin elasticity at an older age and those who have
been obese or overweight at one point in their life and lost weight may have
saggy skin and breasts that are severely enlarged. Surgery is the recommended
treatment for severe gynecomastia.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  Your pictures appear to demonstrate more of a pseudogynecomastia appearance, but without an in-person evaluation of your tissues it is impossible to tell.  Oftentimes there is a small amount of gynecomastia with pseudogynecomastia with most patients benefitting from liposuction and direct glandular excision.  See an ASPS board certified plastic surgeon in consultation, they can offer you the best treatment option.

Sean Doherty, MD, FACS · Answer

The easiest way for you to answer that question is to lose the excess weight and then see if you like the look of your chest. If not, schedule a consultation with a board certified plastic surgeon to be examined in person and discuss your options. Best of luck.

Michael Law, MD · Answer

My suggestion to men considering gynecomastia surgery is do all they can with diet and exercise before surgery. In some cases, that alone will provide the result they are hoping for. If changing their diet and fitness program doesn't result in the changes they are hoping to achieve, they will still fare better after surgery by being in the best shape possible. Most of my gynecomastia patients have worked very hard to change their shape prior to surgery. Too often, men blame themselves for something they cannot control.  Gynecomastia surgery often results in the most significant change in confidence level of any patient. men will often be more active after surgery as they feel more confident.

Scott Barr, MD · Answer

Thank you for the question.  You would need a consultation so that the tissue on your chest can be examined.You likely have a combination of the two.It is a straightforward procedure that can be done in about 90 minutes. The combination of UAL and direct gland resection will permanently remove all of the fullness in the chest area.  The incision usually heals so well that you will be back taking your shirt off in the gym within 2 to 3 weeks. Please see a board certified PS in your area that is a member of ASAPS / CSAPS for a formal consultation and examination.Do it sooner rather than later.  I see many older men in my practice for this procedure and they always comment that they wish they had done it years before.  Gynecomastia has a significant impact on social activities and all this is corrected with an expertly performed surgical procedure.All the best,Scott K. M. Barr, MD, FRCSC, Plastic Surgeon.barrplasticsurgery.com

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the question and though an examination would suffice, you are a better candidate for surgery with reduced body fat so lose some body fat either wayDr Corbin

David E. Berman, MD (retired) · Answer

Despite the promise of liposuction, i have found in almost all cases, i can get a much flatter look with direct excision in the operating room. I am a huge fan of Smartlipo normally, but in most cases the men are very self conscious and want to be as flat as possible  - and this is better achieved with direct excision. It is less important if it is true gynecomastia or not since surgery can correct both.david berman md

Gynecomastia or Pseudogynecomastia? (photos)

Answers (8)

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