Do I have gynecomastia , pseudogynecomastia , or is this just excess chest fat ? (photos)

Question

I've been noticing extra puffy nipples lately and im wondering what the cause is. I dont necessarily feel a hard lump behind my nipple but then again its hard to tell. Is there a way to know for sure? Im 6'0 175 so im not exactly overweight but i have gained about 5-6 pounds in a month from eating unhealthy but i also think i have low testosterone levels as well (very little sex drive, occasional ED, and im always tired

Jed H. Horowitz, MD, FACS · Answer

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. There are several common factors which contribute to gynecomastia. These include 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.Normal Gynecomastia is usually apparent in boy between the ages of 12 to 15 years old and older men 65 years old or more who experience a drop in their testosterone levels. This type of Gynecomastia takes about one to two years to regress on its own.Pure Glandular Gynecomastia is seen more commonly in body builders and is caused by steroid use. Surgical removal of the gland is required for treatment.Adult Gynecomastia – Fat deposits are apparent in the glandular tissue. This type of gynecomastia is the most common. Doctors may recommend surgery for treatment of the condition.Adolescent Gynecomastia is hereditary and usually appears in 30% to 60% of boys between the ages of nine to fourteen. Many cases of adolescent gynecomastia resolve on its own as the boy grows into adulthood. Some may choose to undergo surgery to correct the situation, this usually happens at the age of 18 or above. In severe cases in young boys, the physician and child development specialists will need to speak to the parents regarding the severity of the gynecomastia and if surgery is an option before the age of 18.Assymetric or Unilateral Gynecomastia appears in either one or both breasts at different degrees. In many cases one breast appears larger than the other. Surgery is a common treatment for this type of gynecomastia.Pseudo-Gynecomastia is composed of adipose tissue instead of glandular tissue. This type of gynecomastia can be treated with diet, liposuction or surgerySevere 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. There are three types of surgical treatment options available that treat gynecomastia. The doctor will recommend the one that is best suited to each individual case.

Tim Neavin, MD · Answer

You may have some gynecomastia.  I can't tell from the photos.  The relationship between gyn and testosterone isn't that clear.  A good start is a consult from a board certified plastic surgeon. You will need to be properly evaluated.  More information is available in the link attached.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Thank you for your picture. Based on the pictures I don't believe you have or suffer from gynecomastia.

Robert M. Tornambe, MD · Answer

I appreciate your concern, but physical exam would be helpful. However, your photo demonstrates possibly mild Gynecomastia which is usually treated by liposuction alone. The scars are small and well hidden. Insurance may or may not cover it, depends on your policy. Check out the link below to an article I wrote about Gynecomastia, as you may find it helpful. Seek out a board certified plastic surgeon in your area, good luck!

Babak Dadvand, MD · Answer

Hi cameronconner39,Thanks for the post and photos. In some of the photos you appear to have puffy nipples, which with your build will not be due to fat, but rather excess breast tissue. I recommend you see not only a plastic surgeon who specializes in gynecomastia, but also an endocrinologist to evaluate your concerns of low testosterone. You can read more about gynecomastia in the link below.Sincerely,Dr. Dadvand

Tom J. Pousti, MD · Answer

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 surgery may also be helpful.

My best suggestion: 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.

Elliot W. Jacobs, MD · Answer

Yes, you have puffy nipples, which means that you have some excess breast tissue just behind the nipples. Don't try to feel for that tissue with your own hands -- oftentimes breast tissue feels soft.  There may also be additional excess fat and breast tissue on your chest, but that cannot be determined without an in-person physical examination.Treatment for puffy nipples can be tricky for if too much is removed, there can be an indentation of the nipples created (we call this a crater deformity).  Be sure to do your research and find a plastic surgeon who has demonstrated interest and expertise in treating gynecomastia.You can read more about this on my website (captioned below) which is specifically devoted to gynecomastia.Good luck!Elliot W. Jacobs, MD, FACSNew York City

Mordcai Blau, MD · Answer

You probably have a mild gynecomastia..How should I choose a surgeon?Choose carefully. The decision is yours. Advice to assist in making your selection.Only a board certified plastic surgeon1. Experience matters. Choosing a surgeon increases the likelihood that they have seen a case similar to yours in the past. Selecting a surgeon whose practice is focused on gynecomastia exclusively is also an indicator of experience.2. Results matter. The more before-and-after pictures, the better. Pay attention whether the surgeon is confident enough to show multiple angles of the same patient.3.Only gynecomastia Reviews matter. 4. Expertise matters. Is your surgeon recognized by the profession as an authority in the field? Have they authored books or medical journal articles regarding your surgery?Be realistic about your expectations. Also, revision surgery tends to be significantly more difficult than initial surgery.

Sherwood Baxt, MD (retired) · Answer

Slightly noticeable in some pictures but not others. Pretty much a variation of normal. Find yourself a good board certified plastic surgeon and do some talking as to your options. Is there any chance you've been taking any over the counter " supplements"? That might be the cause. In any case if you do treated it can be done through a tiny almost invisible incision inside your armpit but my guess is you'll decide to leave things as they are. Good luck with it in either case.

Do I have gynecomastia , pseudogynecomastia , or is this just excess chest fat ? (photos)

Answers (9)

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