There are three tissue variables that determine what the Male chest looks like. The problem can be skin laxity from weight loss, excess subcutaneous, fat, or gladder breast tissue. Often it’s a combination of two or all three. To differentiate which variable is contributing the most it’s important to get a good history. If you’ve had significant weight loss(more than 30 pounds) then skin laxity may be contributing. To take skin laxity out of the equation, put the skin and pectoralis muscle under tension by putting your arm straight up in the air like your scratching your upper back. In the picture, your arm is halfway up. Try to pull your arm up and back as far as it’ll go then have someone take pictures or look in the mirror. It’s better to have someone else take pictures or use the timer on your camera. Avoid taking pictures using mirrors. If you have excess glandular tissue, it’ll stick out like a golf ball when the skin and pectoralis muscle are under tension. If everything looks perfect with the skin under tension, the skin laxity is the major component. If there is overall thickness without a significant bulge under the nipple, then subcutaneous fat maybe the primary Ideology.Most likely skin laxity is contributing and so is subcutaneous fat. You may have mild gynecomastia, but I think the other variables are contributing significantly. In regards to treatment subcutaneous fat is best removed with liposuction. Glandular breast tissue requires and direct open excision. Skin laxity is by far the hardest variable to treat. I’m guessing your weight has fluctuated because it looks like you have slight skin laxity. You’re also a little chubby, so fat is definitely contributing. The question of how much glandular tissue is best determined by an examination or you can try what I described above. It’s much each year to assess the chest with the skin and pectoralis muscle under tension. You can also visualize yourself how much skin laxity and fat is contributing by watching the change of your chest as you move your arm in a down position. Gynecomastia will stand out with the skin under tension. It is absolutely key to differentiate which variables are contributing because it determines the exact outcome from surgical intervention. If skin is contributing, significantly like those who’ve lost a lot of weight or older men than Liposuction and glandular excision aren’t going to do that much. Of all the variables skin is the only one we don’t have great treatments for. A chest lift is kind of brutal and more than most guys want to go through. Glandular, tissue and subcutaneous fat are pretty easy to treat. History of weight fluctuations is key in getting an accurate assessment. Best, Matt Hagstrom, MDA History of weight fluctuations is key in getting an accurate assessment. Best, Mats Hagstrom, MD