Do I have gynecomastia? (Photo)

Question

Hey I’m 23 years old I’m a bit overweight but I wanted to ask y’all do y’all think I have gyno I’ve lost weight before and still had sagging boobs but I think I just needed to workout out the chest more after weight loss but can y’all help me

Stephen T. Greenberg, MD, FACS · Answer

Thank you for you question.  Looking at the pictures you have provided it does look like you have the components of gynecomastia.  Gynecomastia consists of 3 components, skin, fat and breast tissue. The procedure consists of your Surgeon liposuctioning the breast, removing the breast tissue and waiting on skin retraction.  If you don't get as much skin retraction as they expect then a secondary procedure maybe required to remove the extra skin.  I would suggest seeing a Board Certified Plastic Surgeon in person to evaluate you and discuss your options.

Ronald Schuster, MD · Answer

Yes you have gynecomastia. Much of it might be fat. The portion of gland can’t be determined from just a photo. You need a good exam. I recommend getting down to a weight that you can maintain fairly easily. Then you can deal with whatever is left over on your chest. Good luck.

Luis A. Mejia, MD · Answer

Dear nikolas14, thanks for sharing your pictures and concerns, after analysing your case your best option to give contour to your chest and end with this saggy area is to perform a gynecomastia. Make sure you go on consultation with a board-certified plastic surgeon. Hope this helps and best of lucks. Dr. Luis Mejia.

Daniel Barrett, MD · Answer

Dear nikolas14,it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Jayanthy Ravindran, MS, DNB, MRCS · Answer

Yes, as there is some look skin involved, it could be Grade 4 Gynecomastia.
The best way to find out is to get yourself checked by a dermatologist.
Gynecomastia is a common problem among men who take anabolic steroids. However, it is not uncommon for people to develop this issue without ever having taken steroids. Gynecomastia can occur at any age, although it most commonly affects young adult men between the ages of 20-40.
The cause of gynecomastia is unknown, however, some factors that increase the risk include:
• Obesity
• Alcohol consumption
• Hormonal changes
• Medications
• Certain medical conditions
• Smoking
• Stress
• Surgery
• Thyroid disease
• Testicular cancer
• Use of certain drugs
The following tests will determine if you have gynecomastias:
• Physical exam
• Breast examination
• Blood work
• Imaging studies
• Biopsy
We hope you found this information helpful. If you need further assistance, please contact us.

Prince HP, MBBS, MCh · Answer

Hi, you have gynecomastia. only thing to differentiate is whether its a true gynecomastia or pseudo gunecomastia. which can be done by clinical examination. better to consult a plastic surgeon• Botox

Anmol Chugh, MBBS, MS, MCh · Answer

Hi it looks like Grade 4 gynecomastia where there is loose skin involved. You can check out the results of one of my patient with similar grade as yours. Usually it requires removal of loose skin along with fat with re positioning of nipple.

Mats Hagstrom, MD (license on probation) · Answer

There are three variables to determine what the male chest looks like.
Those are subcutaneous fat, glandular breast tissue and skin laxity.
Each of them contribute and can be the cost of the appearance of gynecomastia or fullness in the chest.
With a history of weight loss skin laxity is most likely contributing to some degree.
To differentiate skin laxity put your skin and pectoralis muscle under tension by taking one arm at a time and stretching them behind your head. While doing this look in the mirror or have someone take a picture. With the skin and pectoralis under tension individuals who have excess glandular tissue or true gynecomastia will see it clearly projecting under the skin. To assess the thickness of subcutaneous fat push your finger against the skin while under moderate tension about 2 inches away from the nipple until you feel the underlying pectoralis muscle. When you feel the muscle that is the thickness of your subtitaneous fat. With your arm down in the skin in a dependent or relaxed position the fat thickness will seem three or four times thicker. This is how much skin laxity contributes to fullness in the chest.
In regards to surgery the operation should address the variables that are contributing to the problem. This means open excision of a glandular tissue when through gynecomastia is present, liposuction when excess subcutaneous fat is contributing and consideration of a Male chest lift if skin laxity is contributing enough to warrant the operation.
A chest lift operation is somewhat complex and requires some experience to get them to look good. There are a few different approaches to doing this including removing the nipple areola and replacing it as a free graft. If it comes to having that procedure it’s probably worthwhile consulting with a few providers until you find someone who has substantial skill and experience.
Gynecomastia surgery without a lift is a bit more straightforward but individuals who have skin laxity will most likely only have limited improvement because skin laxity contributed significantly to contour in this area.
To get a better assessment and better understanding of surgical options I suggest having a few in person consultations with local board-certified plastic surgeons.
When reviewing before and after pictures asked the provider to show as many pictures as possible of patients with similar body characteristics to your own to get a good understanding of what results may look like in your case.
Of the three variables skin laxity is probably the most difficult to deal with in regards to having what most people would consider quality results.
Best,
Mats Hagstrom MD

David E. Berman, MD (retired) · Answer

you can try losing weight and exercising but i would be very surprised if you did not end up needing surgery. It is a great surgery and really makes men feel better about taking off their shirts. i always do these cases in the operating room, under general anesthesia. i always place drains which are removed in about 5 days. 
Make sure that you see a board certified plastic surgeon that has a strong interest in gynecomastia. do not see a cosmetic surgeon - they are NOT plastic surgeons.

best of luck
david berman md, frcsc

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