I'd just like to know if I have pseudo gynecomastia or gynecomastia. (Photo)
Doctor Answers 11
Pseudo-Gynecomastia vs. Severe Gynecomastia
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
I'd just like to know if I have pseudo gynecomastia or gynecomastia.
Kenneth Hughes, MD
Los Angeles, CA
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Gynecomastia or Pseudo Gynecomastia
‘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.
Gynecomastia or Pseudogynecomastia?
You have gynecomastia
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.