Publicado por Dr. Miguel Fernández Calderón: 10/02/2022
How to know whether I have gynecomastia or it is just fat
Blog of Aesthetic News, Tips and Care
One of the procedures men most often ask us for at Sculpture Clinic is gynecomastia surgery in Madrid. They often come in with breasts that are unusually enlarged for a man and wonder how to know whether I have gynecomastia or it is just fat. It is common for them to want to reduce their size safely and effectively, which can be achieved thanks to today’s surgical techniques.
What is gynecomastia and how does it differ from chest fat?
Gynecomastia is a medical condition that affects many men and is caused by the growth of glandular breast tissue. It can occur in one or both breasts.
The causes of gynecomastia are related to hormonal imbalances. That is, an increase in oestrogen or a decrease in testosterone. Taking certain medications and drugs can also play a part, as can some medical conditions.
It is not usually a serious health problem, but it can cause discomfort and low self-esteem in men with this condition.
Gynecomastia is often confused with the accumulation of fat in the chest; however, it should be made clear that they are different conditions.
What is pseudogynecomastia?
Enlargement of the chest in men caused by the accumulation of fat is known as pseudogynecomastia. In this case there is no growth of glandular breast tissue.
Pseudogynecomastia is more common in men who are overweight or obese.
Key differences between gynecomastia and fat
There are some key differences that can help make a correct diagnosis as to whether it is gynecomastia or pseudogynecomastia.
In the case of gynecomastia, it tends to be concentrated around the nipple and, on feeling underneath it, you notice firm, rubbery tissue. In addition, gynecomastia is associated with greater tenderness in the area.
Pseudogynecomastia, on the other hand, gives the sensation of soft, fatty tissue spread across the whole chest. In this case, the man feels no pain.
Causes of gynecomastia and fat accumulation
Hormonal imbalances and gynecomastia
Hormonal changes are the underlying cause of gynecomastia. In newborns and adolescents there may be a reduction in testosterone which, over time, tends to settle down.
More than 65% (approximately 8 out of 12) of 14-year-old boys experience a build-up of tissue in their chest during puberty, so this growth is normal and will return to normal within a year.
Likewise, in older adults there may be a reduction in the male hormone, which causes gynecomastia.
Being overweight and pseudogynecomastia
Men who are overweight or who have had sudden weight changes can have an increase in chest volume. In these cases it is pseudogynecomastia and the treatment used is different.
Other factors: medication and lifestyle
Some drugs, such as anabolic steroids and antidepressants, among others, can alter hormone production. As a consequence they cause gynecomastia. Likewise, alcohol consumption and some drugs can upset the hormonal balance.
Hypothyroidism, kidney failure and other medical conditions can also give rise to gynecomastia.
How can I tell whether I have gynecomastia?
1. Look at your hormonal changes
Changes in hormone levels can be natural, but that does not mean you have to accept them. If you are no longer an adolescent and have male breasts, it could mean you are overweight or obese. This is because your body accumulates fat in various areas, the chest included.
If you are over 30 and have mood swings, loss of sexual appetite, general weakness and this comes with an increasingly fatty chest, it could be down to hormonal changes.
2. Examine yourself
At first glance, breast fat and gynecomastia seem to be the same thing, but there is a subtle difference that can be established with a self-examination.
If they are fat cells, they will feel soft to the touch and will look slack. Pseudogynecomastia is a condition in which the breasts are enlarged, but they are slack and not as firm as in the case of gynecomastia.
Does that sound like a self-examination women should do to check for breast cancer? Yes, it does. And it works for men too. It may be a little uncomfortable standing in front of the mirror feeling your chest, but it is proven to be an effective method.
3. Look for lumps in the chest
Feel the breast area; if there is a small lump under the nipples, you will feel it. If there is a lump, you should see a doctor immediately. It could be gynecomastia, but it could also simply be breast cancer.
This part of the check can be frightening, but it is very rare for men to have breast cancer. The lump you feel is most likely just gynecomastia, and it is better to know either way.
4. Feel for any tender spots
As you continue the breast self-examination, use your hand to feel for any tender spots. Fat deposits do not feel noticeably different, but the tenderness of gynecomastia does feel different.
The tenderness is generally felt near the nipples. If you feel anything out of the ordinary, book an appointment with your doctor.
5. Check the nipples
To know whether your chest is fatty or you have gynecomastia you need to examine it. If it is swollen, erect and tender, these are signs of a gynecomastia problem.
If you notice the nipple is erect, you are more likely to have gynecomastia. We should not buy any medication, treatment or supplement until we verify your conclusions at the clinic.
Pain or tenderness and swelling are only two of the possible signs of gynecomastia. To the touch, the lump feels like a rubbery mass under the nipple. A visual sign is the resemblance to a woman’s breasts.
Often, gynecomastia is confused with the expected presence of fatty tissue, especially among young overweight men. Therefore, it must be a qualified doctor who makes the diagnosis and reaches a conclusion.
Besides gynecomastia, another procedure that is common among men is rhinoplasty.
Professional diagnosis: when should you see a specialist?
To get a proper diagnosis of whether what we have is gynecomastia, from an increase in breast and fatty tissue, or pseudogynecomastia, that is, only an increase in fatty tissue, it can be done at the appointment in two ways.
The first way is a physical examination. Normally any experienced breast surgeon, such as those who form part of the Sculpture Clinic team, can give the appropriate assessment.
Physical examination by a surgeon
If you experience enlargement of the breast tissue, pain, tenderness or nipple discharge it is advisable to consult a doctor. The main reason for seeing a specialist is to rule out any cause other than gynecomastia.
During the appointment a physical examination will be carried out, in which the doctor feels the breast tissue. They will also look for signs of inflammation, tenderness and any other abnormality.
Ultrasound: the definitive diagnosis
After the physical examination an ultrasound scan will be performed which will help confirm the presence of glandular breast tissue, assess its size and rule out other conditions. In some cases additional tests will be necessary.
The ultrasound can be done at the same appointment. This way, we make an accurate diagnosis through physical examination and ultrasound and know which procedure to use in each case, whether liposuction or breast tissue reduction surgery.
Available treatments for gynecomastia and chest fat
The most appropriate treatment for gynecomastia will depend on making a proper diagnosis. There are times when the breast enlargement comes from an increase in fatty volume, and others when the increase in breast volume is rather due to an increase in breast tissue. This latter cause is what is strictly known as gynecomastia.
Non-surgical options: diet and exercise
Diet and exercise can help remove adipose tissue, so they can be effective for pseudogynecomastia. In the case of gynecomastia, foods that raise testosterone levels could be included in the diet.
Another non-surgical option is to review the medication the patient takes. Because some medications alter hormone levels, the possibility of changing the treatment could be considered. It is the treating doctor who can modify the treatment.
Gynecomastia surgery: liposuction and mastectomy
When the increase in breast volume is down to fat, the most appropriate medical treatment will always be liposuction. This condition is called pseudogynecomastia, since no increase in breast tissue is involved.
If, on the other hand, there is breast enlargement with breast tissue, in the vast majority of cases this is corrected with surgery. An incision is made through the areola and the excess tissue is removed.
If you have doubts about how to know whether you have gynecomastia or it is just fat, the best thing is to consult a doctor; get in touch and book an appointment with our specialists.
The Sculpture Clinic Team
Together we are stronger
Dr. Miguel Fernández Calderón
Plastic, reconstructive and aesthetic surgeon
Dr. Irene Otero
Anaesthetist
Dr. Juan Godoy
Plastic, reconstructive and aesthetic surgeon
Dr. Estefanía Alonso
Plastic, reconstructive and aesthetic surgeon
