Pure breast tissue gynecomastia, or just fat? Are there any non-surgical solutions to my problem? (Photo)

I was very overweight throughout elementary school and up until high school. In eighth grade, however, I wanted to lose weight, and underwent a crash diet (in hindsight, I understand how dangerous that is, but at the time I didn't understand that). Before I lost the weight, I had large puffy nipples and moderately sized breasts, but afterwards I kept them as well. It has been four years since then, and I am still having this problem. Are there any non-surgical solutions to my problem?

Doctor Answers 12

What is Gynecomastia

The male breast is composed of glandular tissue and fatty tissue. An excess in either type of tissue can cause the chest to take on the look of gynecomastia. Gynecomastia can affect men of all different body types. There are different types of #gynecomastia.
Particularly, Normal Gynecomastia is usually apparent in males between the ages of 12 to 15 years old. It is also common for older men 65 years old or more who experience a drop in their testosterone levels. #Normal Gynecomastia takes approximately one to two years to naturally regress on its own.
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 with #Adolescent 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.

"Puffy Nipple Areola Complex" is among the most common forms of gynecomastia. This gland and/or adipose tissue accumulation can be located under the areola or can be slightly extended outside the areola, causing the areola to appear dome shaped.This form of #Gynecomastia can be found in all age groups but is more common in young adults.

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.

Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews

Non surgical options

The only medicine that might work for Gynecomastia would be for male breast enlargement caused by an endocrine disorder. You would need to see an endocrinologist for a work up if this involves you - tyically this would occur in late childhood/adolescence but could occur later (from a Pituitary tumor producing prolactin - a hormone that makes breasts enlarge for example)

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

Pure breast tissue gynecomastia, or just fat? Are there any non-surgical solutions to my problem?

Thank you for the question and pictures. 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. 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.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

Treatment of gynecomastia

You have done a great job losing weight. It appears from your photographs that the residual tissue is likely primarily glandular breast tissue.Treatment for gynecomastia depends on the extent of the condition. Sometimes the excess tissue is relatively small and concentrated under the nipple areolar complex. In this case simple excision intended to recontour the breast is sufficient. If the excess tissue is more fatty in its consistency liposuction may be a good option. Very often a combination of direct excision and liposuction is employed. If the breast enlargement is quite large it may be necessary to re-tailor the overlying skin envelope.

John J. Edney, MD
Omaha Plastic Surgeon
4.8 out of 5 stars 117 reviews

Gynecomastia--breast tissue or fat?

You have lost weight (good for you, and good that you now recognize that "crash dieting" is unhealthy), and what remains is likely mostly glandular tissue, requiring surgical excision.

External treatments (RF, laser, ultrasonic, Cool Sculpting, or other) are designed to work with fatty tissues, and many of these treatments have mild results. They will all be ineffective for glandular or mixed fat/glandular gynecomastia. Skilled plastic surgery by an experienced ABPS-certified plastic surgeon who does lots of gynecomastia surgeries is the only solution.

There are no pills or creams or magical herbal "fat burners" that can resolve this either, especially since fat is NOT the primary component of your residual gynecomastia after weight loss. Schedule consultations with one or more ABPS-certified plastic surgeons. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

True gynecomastia or not?

Thanks for your photo and your question.
Non surgical options-- first some teaching...

True gynecomastia is a proliferation of male glandular breast tissue. This tissue lives under the nipple and is rubbery and firm. It does not come out with liposuction (any kind) and is usually removed by an incision under the areola.

Pseudo-gynecomastia is proliferation of the male breast fatty tissue. This fat tends to be more fiberous than fat in other parts of the body so many plastic surgeons use  power assisted or ultrasonic liposuction to remove it.

The vast majority of male gynecomastia is actually a combination of true and Pseudo gynecomastia. Therefore a common approach is to perform liposuction as well as direct excision.

In your case, only a physical examination by a plastic surgeon can tell you if you have predominantly fatty or glandular tissue.

If it is mainly fatty tissue, liposuction alone may suffice. Unfortunately, non -invasive liposuction such as cool sculpt could help, but I don't think it does as good a job on this fiberous fat as more traditional liposuction. If there is glandular tissue it will not decrease it.

You would need to be formally evaluated, but from your pictures it looks as though your skin tone is good making all options possible, but I suspect you have mainly glandular tissue ( because of where I see the prominence)  making excision your best option.

I know this may not be what you were hoping to hear, but I hope it makes sense and is of help to you in your decision making.

Best wishes.

Adam Tattelbaum, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 105 reviews


From your photos you do appear to have a standard form of gynecomastia. This will likely not resolve. Smartlipo through a needle puncture in the armpit area will treat this nicely. This is an office procedure and you do not have to undergo general anesthesia. The recovery is quick (about a week) and gives you a permanent correction.

Franklin D. Richards, MD
Bethesda Plastic Surgeon
4.8 out of 5 stars 133 reviews

Male breast reduction

Your treatment would depend on what is present, whether it is fat alone, or some gland with fat.  Usually both are present to some degree.  If the breast if mostly fatty, we have had good success with CoolSculpting which is an office procedure.  So have it checked out in person.  Be sure to see only a board certified plastic surgeon (by ABPS - The American Board of Plastic Surgery) who is a member of ASAPS (The American Society for Aesthetic Plastic Surgery) and or a member of ASPS (The American Society of Plastic Surgeons). All the best, Dr. Joe

Joe Gryskiewicz, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 278 reviews

True Gynecomastia

The surgery you need to remove the gynecomastia is excision of the gland.Any form of liposuction alon will do very little. Vasershape is not the best answer to your problem. 

Mordcai Blau, MD
New York Plastic Surgeon
4.6 out of 5 stars 76 reviews

Pure breast tissue gynecomastia, or just fat? Are there any non-surgical solutions to my problem?

Appears as glandular/fat gynecomastia. Only surgical intervention will allow a correction for you. Best to seek IN PERSON opinions. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 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.