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

Doctor Answers 34

You Can Usually Do It Yourself!

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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

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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
4.8 out of 5 stars 123 reviews

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

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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 34 reviews

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

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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

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 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

Fattt Tissue or Breast Tissue Answer

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Gynecomastia is the most common thing I do in my practice and it takes nothing more than a grasp of the excess tissue in front of the pec major muscles to determine.  Fat is always soft and spongy whereas the glandular enlargement of gynecomastia is tough and at surgery it is like a hard white scar ball type of tissue.  This is also the reason why weight loss will have no effect on true gynecomastia.  I hope this has been helpful.

Robert D. Wilcox, M.D.

Robert D. Wilcox, MD
Dallas Plastic Surgeon
4.1 out of 5 stars 22 reviews

Feeling the Difference Between Fat vs Gland in Gynecomastia

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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. 

Alexander Ereso, MD
Mountain View Plastic Surgeon
5.0 out of 5 stars 12 reviews

Who is a Gynecomastia Surgery Candidate

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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.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

It's sometimes hard to tell

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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
4.6 out of 5 stars 49 reviews

Fatty or "true" gynecomastia

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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.

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.