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

Doctor Answers 31

You Can Usually Do It Yourself!

In most cases, you should be able to have a good idea if you have fatty breasts (Pseudo-gynecomastia) or "True" gynecomastia simply by examining yourself. 

With Pseudo-gynecomastia, the breast feels soft and homogenous throughout, much like a similar sized female breast.   In contrast, "True" gynecomastia will feel like a firm, well defined disk of tissue, directly beneath the areola and surrounding skin.

The majority of patients I see in the Pacific Northwest actually have a combination of Pseudo and True  gynecomastia.  In this case, you would feel both a soft, fatty, female type breast along with a firm, almost rubbery subareolar disk of tissue.  If your breast is large, it might be difficult to feel this firm tissue however. 

Remember, if you notice any type of mass, bleeding from the nipple, unexplained pain, particularly in one breast, you should seek medical attention in order to avoid missing some other type of serious condition.  

I hope that answers your question.

Gynecomastia Fat or Breast Tissue

Gynecomastia can be fat, glandular, or a combination of both. An experienced plastic surgeon can tell you what you have. Your plastic surgeon can put a unique surgical plan together for you that will address your concerns while leaving as few visible scars as possible.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
5.0 out of 5 stars 97 reviews

Male breast fatty tissue or glandular tissue requires a consultation to sort out.

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

Mathew C. Mosher, MD
Vancouver Plastic Surgeon
4.5 out of 5 stars 25 reviews

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

By going for an examination by a boarded plastic surgeon. Over the internet impossible to advise without that touchy feely experience. From MIAMI Dr. Darryl j. Blinski

Gynecomastia Usually Comprised of Both Fatty & Glandular Tissue

 90% of the cases of the cases that I see of gynecomastia have elements of both excess fat and glandular tissue.  For that reason my treatment  ususally is both excision and liposuction.  Occasionally only one of these elements is present.  Consultation with a qualified plastic surgeon should provide your answer.

John Whitt, MD (retired)
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

It's sometimes hard to tell

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.

Steven Teitelbaum, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 42 reviews

Fatty or "true" gynecomastia

A "true" gynecomastia results from excessive glandular tissue under the nipple and areola. It will feel firm, like a "knot" or a "disk" under the nipple area. It may change over time, sometimes feeling larger and firmer and more tender, and other times, not as much. Gynecomastia due to fat is softer, tends to be more consistent in how it looks and feels, and is accompanied by a higher percent body fat overall. People with true gynecomastia can be very lean, but may also have a higher percentage body fat. The two - fatty and "true" gynecomastia can also exist together in the same person.

True gynecomastia vs pseudo gynecomastia

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.

Fat Versus Gland

Hi Amauri,

Thank you for the post. Glandular tissue typically feels firm and in some cases can be tender. Fatty tissue feels softer and less distinct. The best advice I can give you is to be evaluated by a board-certified plastic surgeon who is experienced in gynecomastia surgery. The distinction is important as it will dictate the surgical procedure that should be performed.


Dr. Dadvand

Babak Dadvand, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 32 reviews

Male breasts

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".

Tim Neavin, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 29 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.