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

This is a very interesting and important question. It can be very difficult to tell the difference between the two and I get a lot of referrals for revision of gynecomastia because it was thought to be fat only. Please see an experienced Plastic Surgeon who has a specialist interest in gynecomastia (male breast enlargement). They will be able to assess you and advice you what form of surgery you need. 

I agree with my colleagues below.  I think that most all patients that have "chest fullness" have a component of by fatty tissue and glandular tissue.  The glandular bud of tissue is usually more firm under the nipple, and the fatty tissue is softer.  Sometimes it can be difficult to tell exactly what proportion a patient has until the tissue is removed at the time of surgery.  In either case, in my opinion, the treatment is still surgery, so I would recommend getting evaluated by an experienced plastic surgeon that specializes in the treatment of gynecomastia and the male chest.  I hope this is helpful. Good luck!

Thanks for your question. Sometimes this is hard to tell as frequently, there is a component of both which contributes to the heaviness of your chest. As someone experienced in treating patient with gynecomastia, I can determine this thru a physical exam. What I try and palpate is the gland. I try and determine its size and extent. I do this by rolling the tissue between my fingers. I have the patient flex his pectoralis muscle so I know that I am only palpating skin, fat, and gland. You can try this by pinching your abdominal area and rolling the tissue between your fingers. Grab it in different areas and get an idea of what fat feels like. Then do the same in your lateral chest below your armpit. Usually, there is fat in this area but rarely any gland. Then keeping marching slowly towards the nipple and slowly pinch and roll the tissue. At some point around the nipple, you should feel a slight change in how the tissue feels. You may even feel a small rubbery mass if the gland is prominent. Usually the gland is centered under the nipple. Regardless, if you have concern, seek consultation with a board certified plastic surgeon with experience in treating gynecomastia. 

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.According to official statistics, 36% of adult young men and 57% of older #adult men in the United States have this medical condition in one of the four grades. About 200,000 to 3 million cases of #gynecomastia are being reported every single year. So if you have #breast #enlargement and you feel you're an exception, please understand that 1 in 3 young adult #men and 1 in 2 older adult men are just like you and have breast #enlargement.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.There are three types of surgical #treatment #options available that treat gynecomastia. Your board-certified plastic surgeon will recommend the type best suited for you. The most important decision to be made before performing any surgical procedure is determining whether you are an ideal #candidate.

The bottom line is that you need to see a plastic surgeon to know...and even then sometimes we plastic surgeons can't tell for sure until surgery.In general if it is fat the breast will have a soft and homogeneous feel, with no difference in consistency deep to the areola (where the gland would be) as compared to the rest of the breast.If there is true enlarged breast tissue there is usually a firm area deep to the areola.When there is enlarged breast tissue rather than just fat the nipple tends to be more puffy.  And those patients often will say that it looks better when their areola is cold and contracted - but that's not always the case.

True gynecomastia should feel very hard on exam. Gynecomastia due to fat will feel much softer. Sometimes it is hard to tell on exam only.

True gynecomastia will feel more firm than just fat.  Often, there is a combination of excess fat with excess breast in men with "breasts".  The treatment is the same regardless of core composition if weight loss and exercise doesn't do the trick (and it won't with gynecomastia).  Lipo plus gland excision is the best technique to treat the male "breast".

This can be determined by a physical examination performed by an experienced board certified plastic surgeon.

                  Gynecomastia
can occur in several forms. In some cases known as glandular gynecomastia there
may actually be growth of the breast tissue. In other cases there may be
diffuse fatty tissue and in some cases there may be a combination of both types
of gynecomastia.

                  The
differentiation of glandular gynecomastia from diffuse fatty gynecomastia is
extremely important for several reasons. Not only is the cause of these
conditions different, but they may require different treatments as well.

                  In
the majority of patients physical examination by a plastic surgeon can
differentiate these conditions. When glandular tissue is present, there is
firmness which is not present with fatty tissue. In rare cases, radiographic
studies, ultrasound or MRI studies may be necessary for this differentiation.
This is important because treatment may vary depending upon the specific type
of gynecomastia which is present. In some cases where there is a glandular
component, excision will be necessary. In cases where diffuse fatty tissue is
present, liposuction may be adequate. 

Usually it is a combination of both, the breast tissue feels firmer than the fat, but you might not be able to tell the difference. See a Board Certified Plastic Surgeon who specializes in gynecomastia for an evaluation. Good Luck.