I am obese, but I'd like to know if this is true gynecomastia or not, and who to consult about this (Photo)

Im 18 and had this problem for a while. Nipples are puffy and chest looks very awkward. I dont feel any thing under the nipple, no hard substance, but its still puffy. Any remedies for this?

Doctor Answers 4

I am obese, but I'd like to know if this is true gynecomastia

Thank you for the question and picture. Accurate diagnosis would necessitate physical examination. It IS important to differentiate gynecomastia ( excess breast tissue) from lipomastia ( otherwise known as pseudo-gynecomastia or excess adipose tissue of chest wall). Treatment will differ depending on diagnosis. In most cases, gynecomastia is treated with resection of the excess breast tissue; peripheral chest liposuction may also be helpful.

My best suggestion: get into the "shape" you want to be physically; In other words, achieve your long-term stable weight prior to make any decisions. Then if your chest wall is still of concern, seek consultation with board-certified plastic surgeons who can demonstrate significant experience achieving the types of outcomes you will be pleased with. You may find the attached link helpful to you as you learn more. Best wishes.

San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

Obesity and Gynecomastia

Obesity is an issue that affects over 51% of the population. As with other males, obese men may also have gynecomastia. There are however some variations with the type of gynecomastia seen in males who are obese.A majority of males with gynecomastia have a glandular component. This is breast tissue that is centered underneath the areola. There is usually also a variable amount of fatty tissue that surrounds this breast tissue as well. Men who are obese may have this form of gynecomastia. This is due to the increased conversion of androgens to estrogens by tissue aromatase. However, more often obese males have an excess of fatty tissue with little or no excess in glandular tissue. The distinction is important because it may respond to diet and exercise. In men with excess fatty tissue who do not show a response to diet and exercise liposuction is an effective technique to correct the problem. Another issue with obese men is that they may have a degree of breast ptosis (droopiness) or even skin excess. The treatment for these patients will involve skin excision, areolar reduction, breast lift, or a combination of the three. These cases need to be addressed on an individual manner and the resultant scars and risks need to be explained fully to the patients.The best thing to do at this point would be to schedule a consultation with a local board certified plastic surgeon to fully diagnose your case and determine which treatment option(s) would be best for you. I wish you the best!

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews


You may have answered your own question. This certainly sounds like it is weight related. Before you even think of surgery or even getting a consultation make every effort to get down to your proper weight. This is the kind of thing that Might well improve enough and avoid surgery. 

Sherwood Baxt, MD
Paramus Plastic Surgeon
3.8 out of 5 stars 25 reviews

Is this true gynecomastia?

Healthy male patients with excess breast tissue or unwanted breast development who have no underlying breast disease.Men who desire improved physical and aesthetic appearance should have realistic expectations based on their condition and the procedure performed. You should meet with a board certified plastic surgeon to be able to get a formal diagnosis and to be able to decide on a course of treatment if necessary.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 157 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.