Posted by Dr. Miguel Fernández Calderón: 20/06/2025
Having enlarged breasts is a rather uncomfortable condition for men who experience it. Although at first glance it may look the same and you cannot differentiate what the cause is. If you are going through this situation, you have surely asked yourself How to tell if I have gynecomastia or if it’s fat? Keep reading to find out the answer.
How to tell if I have gynecomastia or if it’s fat?
Have you looked in the mirror and noticed that your chest area looks swollen as if you had female breasts? Would you like to know if it’s an excess of fat, perhaps caused by being overweight, or if you truly suffer from gynecomastia?
As experts in gynecomastia in Madrid, we will now discuss 4 aspects that can help you determine if what you see in your body is due to gynecomastia or if it is fat.
Pay attention to hormonal changes
During adolescence hormonal changes are normal. And in a large percentage of young males, it is normal to see an increase in chest size. These changes in the body will reverse on their own after one or two years.
But if you are in your 30s and 40s, and your breasts are a size you consider abnormal, then you should pay attention if you have experienced mood changes, felt weak, or lost your libido. It is possible you are going through hormonal issues.
Examine yourself
A self-examination can help you determine which of these two conditions you have. By touching your chest in front of a mirror you will notice how it feels.
If it feels soft and flabby, these characteristics are associated with fat deposits. On the other hand, if it feels firm, it is most likely gynecomastia.
This self-examination is performed similarly to the one women do to detect breast cancer.
In that same self-examination we just discussed, you should take the opportunity to feel if you have any lumps in that area. If you find a small lump near or under your nipple, it is a sign of gynecomastia. Although that lump could also be breast cancer, the reality is that this condition is rare in men.
The difference between gynecomastia and breast cancer is not obvious, so the most recommended thing, if you feel something unusual, is to undergo a medical checkup.
Tender spots
Touch your chest looking for areas where you feel sensitivity. Gynecomastia can cause your skin to have some sensitivity, especially in the area near the nipples. Fat produces no sensation when touched.
Check your nipples
If you are trying to determine if you have excess fat or gynecomastia, your nipples can give you clues. When it comes to gynecomastia, nipples may be swollen and rigid. Flabbiness remains a sign of the presence of much fat.
Male nipples can also produce discharge. Whether you observe fluid in one or both nipples, this can be a sign of gynecomastia, but it can also be a sign of breast cancer or low testosterone.
If you notice that your nipples are discharging any fluid, consult your doctor immediately.
This is a small guide that can help you understand what is happening in your body, but if you have doubts the best thing is to book your free assessment so you can be seen by one of our specialists. After the evaluation, they will address your concerns and can give you a diagnosis.
Differences between gynecomastia and fat
To understand the difference between gynecomastia and fat in the chest, let’s first discuss both concepts.
Gynecomastia is an excessive growth of breast tissue and glands in men, which gives the appearance of having female breasts. For this reason, it is also known as “male breasts.”
It does not look the same in all cases. In some men only small masses of breast tissue appear around the nipples, but in others the growth of tissue is much more evident and looks more like female breasts. This can be quite uncomfortable physically and psychologically.
On the other hand, fat in the chest refers to the accumulation of fat deposits in the male chest area. This accumulated fat is also known as pseudogynecomastia, and is the result of obesity or excessive weight gain.
One way to know how to differentiate gynecomastia from fat is with a physical examination, like the one we mentioned before. By palpating the area, gynecomastia feels different from fat, because breast tissue feels firmer than fat. Fat in pseudogynecomastia is soft to the touch and is present throughout the pectoral area.
Another difference between pectoral fat and gynecomastia is that gynecomastia hurts and is sensitive when touching the area, fat does not. Fat causes the male breast to look more flabby, while gynecomastia in the chest area looks firmer.
In patients with excess fat, a healthy diet and exercise can work to improve the condition. In contrast, those who suffer from gynecomastia will not achieve any changes, even if they adopt healthier habits.
A specialist is the most qualified person to recognize the difference between gynecomastia and pseudogynecomastia in each patient. By performing the necessary examinations and evaluations they can provide a diagnosis and offer the best treatment.
Definitive Diagnosis
To determine whether a patient’s condition is gynecomastia or pseudogynecomastia, the physician can perform a physical examination, but there are cases where imaging procedures or blood tests may be necessary.
When Ultrasound is Necessary
If the physician suspects gynecomastia, an ultrasound is one of the tests used to reach an accurate diagnosis. Through an ultrasound, breast tissue can be visualized, making it possible to differentiate whether male breast enlargement is due to fat accumulation (pseudogynecomastia) or is caused by an increase in breast tissue (gynecomastia).
Medical Assessment: What Tests Are Used
To diagnose gynecomastia, in addition to an ultrasound, the physician may order a mammography or magnetic resonance imaging. Mammography allows the specialist to rule out other conditions that may be causing male breast enlargement, and MRI may be necessary when gynecomastia is deep.
Additionally, blood tests can measure hormone levels, which can help identify hormonal imbalances, as well as the presence of tumor markers.
Treatments According to Type
Options for Gynecomastia
Once the physician makes a diagnosis of gynecomastia, they may prescribe medications to control hormone levels or block the effects of estrogen on breast tissue.
Another option is surgery. This may be a mastectomy to remove excess glandular breast tissue. In some cases, mastectomy can be combined with liposuction.
There is a surgical procedure to eliminate gynecomastia. This is usually the most recommended solution, but each patient is different, so medical guidance should be followed.
Options for Pseudogynecomastia
Since pseudogynecomastia forms due to fat accumulation in the male chest, it is possible to reduce it with diet and exercise. With a healthy eating plan and an exercise routine, it is possible to eliminate the accumulated fat, especially in patients with obesity.
In cases where exercise and diet are not effective, the physician may recommend liposuction, through which, using small incisions, a very thin cannula is introduced, allowing the surgeon to remove all excess fat and reshape the chest area.
If you’ve reached this point looking for an answer to whether I have gynecomastia or if it’s just fat, we believe the best way is to schedule a medical consultation. Here we explain some ways to examine yourself and what signs you may find, but that will only be an assumption until a specialist evaluates you and can provide the correct diagnosis.
