I'd just like to know if I have pseudo gynecomastia or gynecomastia. (Photo)

Doctor Answers 11

Pseudo-Gynecomastia vs. Severe Gynecomastia

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Among the different types of #gynecomastia there are two in which you may be experiencing. Pseudo-Gynecomastia is composed of adipose tissue instead of glandular tissue. This type of gynecomastia can be treated with diet, liposuction or surgery.
Severe Gynecomastia 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. To better distinguish the category your condition may be within, it's necessary to consult in-person with a plastic surgeon.

Also, 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. Weight, and more specifically body mass index (BMI), need to be considered when deciding. Consulting with a board-certified plastic surgeon is highly suggested in order to determine if you are a surgery candidate and what treatments are best for you.

True or pseudo gynecomastia

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Pseudogynecomastia is excess fat while true gynecomastia is excess glandular tissue. Your surgeon can check which you have in a physical examination. Generally, this involves pinching the skin on your chest. Fat is far softer than glandular tissue.

I'd just like to know if I have pseudo gynecomastia or gynecomastia.

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I would have to examine you to give you the best recommendation. Look at reviews and before and after pictures as well as credentials to select your surgeon.

Kenneth Hughes, MD

Los Angeles, CA

Gynecomastia or Pseudo Gynecomastia

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Pseudogynecomastia is a term used to describe enlargement of the male breast area by excess fat only, while gyneocmastia refers to enlargement of the male breast area by the proliferation of fibrous breast tissue (and fat as well in most patients).
‘Pseudogynecomastia’ occurs primarily in patients who are overweight or obese. The term implies that the breast area is enlarged purely by fatty tissue, but in my experience most of these patients are found to have some excess fibrous breast tissue as well when gynecomastia surgery is performed. All men have some breast tissue behind the areola. Excess body mass in the form of fat has the ability to convert androgens (male sex hormones) to estrogens (female sex hormones), so it is not surprising that the breast tissue proliferates in many of these patients, even if it is a secondary response to obesity.

Patients with ‘pure glandular’ gyneocmastia have only excess breast tissue – there is no fat to remove. Patients with ‘mixed’ gyneocmastia, the most common form of gynecomastia, have both excess fibrous breast tissue and surrounding excess fatty tissue.

Patients with pseudogynecomastia and mixed gyneocmastia are both treated by liposuction, and then any excess fibrous breast tissue is removed by a variety of means (arthroscopic shaver excision and/or ‘pull-through’ technique). So from a surgeon’s perspective, there aren’t really significant differences between the two. Mixed gynecomastia patients have more fibrous breast tissue to remove while pure gynecomastia patients have less, but the approach to surgical treatment is essentially the same.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Gynecomastia or Pseudogynecomastia?

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It is hard to tell from a picture as they can look the same. If you have pseudogynecomastia (fat only), you can try losing weight to see if it makes a difference. See a Board Certified Plastic Surgeon that specializes in gynecomastia for an evaluation and to determine your options. Good luck!

Gynecomastia diagnosis

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Based on the photo, you appear to have a small degree of gynecomastia. Consult in person with 3 experienced and expert board certified plastic surgeons to verify you are a candidate, understand your options, and determine the best treatment plan for you.

Gynecomastia Appearance

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From the photos it looks like you have a small amount of gynecomastia or possibly fat below your nipple area , both which are easily corrected with surgery. If there is a firm mass this is most likely gynecomastia. Consult a plastic surgeon for the correct diagnosis and see what options there are for your condition. In my practice you would undergo a day surgical procedure and be able to return to work in 2-3 days.


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You look like you have gynecomastia, but hard to tell with just a photo. At any rate this can be resolved with surgery if you wish. See a plastic surgeon who does this type of work. Good luck.

You have gynecomastia

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Your photos are consistent with gynecomastia.  Surgery will benefit you.  If it bothers you you should see a plastic surgeon in your area.


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Thanks for writing,

As it appears you know, pseudo-gynecomastia is the surrounding fat of the breast that also become enlarged with the true glandular tissue of the breast (gynecomastia). Based on your photos it appears as though you have true gynecomastia. I have found the with management of gynecomastia some degree of liposuction help to ensure a more even contour of the surrounding tissue to give a smoother more uniform look.

Hope this helps

Stephen M. Davis, MD,FACS
GreenHill Plastic Surgery

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.