How to identify it is gynecomastia or fat breast?

Doctor Answers 10

Do you have gynecomastia?

Gynecomastia is abnormal male breast enlargement. I am convinced that there are a tremendous amount of guys that have this and that it is a bit of a "little dirty secret" that is either under diagnosed or insufficiently addressed by the medical community at large. Guys with gynecomastia are affected because they feel self consious about the appearance of their chest. It can be mild or severe and the reaction is still the same. Most cases of gynecomastia simply happen without a known cause (idiopathic), while some have a real cause like hormonal imbalances caused by physiologic disorders, tumors or side effects from medicines. True gynecomastia will feel like a firm thickness when squeezing the breast tissue. It tends to look worse the more lean the guy gets through diet and exercise. for body builders it tends to hide the definition of the lower border of the pectoralis muscle. There is also pseudo-gynecomastia which is primarily due to fat. Losing weight in these cases will improve the appearance but most the time the guy cannot loose enough weight to be completely satisfied. The irony is that correction is fairly easy with a quick recovery and excellent chances of a permanent and complete correction. If you think you might have gynecomastia the best thing is to be evaluated by a surgeon who specializes in this type of surgery. Good luck.

Baltimore Plastic Surgeon
4.9 out of 5 stars 77 reviews

Who is a Gynecomastia Surgery Candidate

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 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.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

Fat vs Breast Tissue in Males

If you are unhappy with your breast size then you may want to consider corrective cosmetic surgery regardless of the cause, (fat vs breast tissue) especially if you are not planning on loosing weight. Gynecomastia simply means that your breasts are too big and has features of a women's breast. There are varying degrees of gynecomastia ranging from puffy nipple to severe breast enlargement and/or breast sag. The severity of the gynecomastia will determine which treatment option is necessary. In most cases, men suffer from standard gynecomastia, which can be surgically treated as an in-office procedure under local anesthesia. For more severe cases, it may be recommended that you have your procedure under general anesthesia at an outpatient surgery center. Your consultation will determine which option is best suited for treating your gynecomastia.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

Fat or breast

It is best to get a proper examination from a qualified surgeon.  Breast tissue (by the way, ALL men have breast tissue - not just those with gynecomastia) is more firm and generally localized behind nipple, and areola, and outward. Both fat and breast tissue create the "man breast" and  thus, should be managed together, ie.  lipo plus glandular excision. More Q and A on link.

Tim Neavin, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 42 reviews

Gynecomastia or Fat Breast?

Thank you for your question.

It is usually a mixed situation, that is both Fat and Gland Hypertrophy are present. The fat feels quite soft and the glands feels quite firm. Your Surgeon can easily tell the differences. If you have very low body fat then the likelyhood is that most of the swelling is because of the glands. 

All The Best !

Ajaya Kashyap, MD
India Plastic Surgeon
4.9 out of 5 stars 163 reviews

Gynevomastia as a fat or gland problem?

Hello.  Whether you are dealing with a male or female breast,  one component will be gland and one will be fat.  As a general rule,  fat is softer and more movable than gland.  Gland tends to feel more firm, dense,  and solid in one piece.  A physical exam with an experienced plastic surgeon should help give you an idea of whether your issue is mostly fat or mostly gland. Fat is usually easily removed with liposuction,  while glandular tissue often requires direct excision,  which means separate and often larger incisions. It is also usually more challenging to achieve an even and on target result with glandular excision because of the density and structure of the tissue left behind,  so I would recommend seeking out a plastic surgeon who performs these procedures on a regular basis. Good luck! 

Sophie Bartsich, MD
New York Plastic Surgeon
5.0 out of 5 stars 6 reviews


Unfortunately Gynecomastia  is permanent condition after a year..It is impossible to get rid of it without surgery.It is best to look for the right surgeon for exact diagnosis.

How should I choose a surgeon?
Selecting a surgeon is as important a choice as the decision to undergo surgery. Choose carefully. The decision is yours. What follows is some advice to assist in making your selection.
1. Experience matters. Choosing a surgeon who has performed over one thousand gynecomastia cases 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 a surgeon displays, the better. Pay attention not just to the number of pictures, but whether the surgeon is confident enough to show multiple angles of the same patient.
3. Reviews matter. Have patients reviewed your surgeon? Did those patients undergo the surgery you are considering?
4. Expertise matters. Is your surgeon recognized by the profession as an authority in the field? Are they certified by the American Board of Plastic Surgery? Have they authored books or medical journal articles regarding your surgery?
We hope these guidelines are of assistance when you are selecting your surgeon. When undergoing surgery, it is very important to be realistic about your expectations. Past results are not a guarantee of future results. Also, revision surgery tends to be significantly more difficult than initial surgery.

Mordcai Blau, MD
New York Plastic Surgeon
4.6 out of 5 stars 74 reviews

Is it gynecomastia or fat breast?

For all practical purposes there is nothing like just breast fat alone!!
there is always gland present and just the composition of the fat and gland varies.
more importantly the only indication for correction is if you are worried about the present shape of the chest.
most of the time the procedure is essentially the same.(liposuction and gland excision)
Best of luck

Karthik Ram, MRCS, DNB
India Plastic Surgeon
4.9 out of 5 stars 50 reviews


for practical purposes it does not really matter. If one is prepared to do the surgery most of us start by doing liposuction and then if there is gland it is removed.several of us in this area do it through a tiny incision in the armpit which is almost invisible, using liposuction and then a special instrument to grind up the gland tissue if its present and suction it out through that same little hole. this avoids the scars on the front of the chest.a consultation or two should put your mind at ease. Good luck with it.

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

Evaluation by a PS

Hello; by an physical examination with a PS and some images studies is possible to differentiate between gynecomastia (glandular compound) and pseudogynecomastia (fat compound). Treatment would be different so an differetation is helpfull.

Kemil Issa, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 12 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.