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How Do I Know if I Have Gyno or Just Fat In My Chest (Pseudogynecomastia)?

April 21, 2020
July 1, 2024

Gynecomastia is sometimes confused with pseudogynecomastia. Learn about the differences between gynecomastia vs. typical fat chest today.

How Do I Know if I Have Gyno or Just Fat In My Chest (Pseudogynecomastia)?

Table of Contents

How do I know if I have Gynecomastia or Pseudogynecomastia?

It's natural for men to worry if their breasts seem to become enlarged or swollen. They'll turn to the Internet to search for their symptoms and land on articles on gynecomastia: a condition caused by excessive tissue growth.

However, this isn't the only cause. In some cases, it's caused by excess chest fat. Let's look at gynecomastia and pseudogynecomastia and what you can do in either situation.

What is Gyno?

As discussed on the condition of enlarged male breasts or gyno or gynecomastia, the nipples on a normal male chest are small and flat, and you can see the pectoralis muscle move whenever you flex the area. However, men with gynecomastia will have more rounded breasts and the nipples seem swollen or puffy. Your breast will also feel tender and may feel more uncomfortable with each passing day.

Gyno is a real issue for men. In fact, one out of three men suffers from this condition of swollen glandular tissue, which can be physically embarrassing and sometimes painful. It affects 40-60% of adolescent males, making it a relatively common condition. Despite being so, it is not an openly discussed issue for the most part due to its "embarrassing nature" – a stigma that often overshadows its true and, at times, urgent medical condition. Individuals should not feel discouraged from seeking help, as it can be a much-needed relief.

Gynecomastia Causes

An imbalance of hormones triggers gynecomastia. All men produce some estrogen, but when you produce more than the "normal" amount, that may lead to the development of excess breast tissues. This affects 1 out of 2 teen boys and 2 out of 3 men above 50 years old. 

There are a variety of reasons that contribute to gynecomastia. Ageing, medication side effects, hormonal imbalance and a dip in testosterone level are common culprits for the condition. While gynecomastia symptoms are common during puberty due to hormonal changes, if they do not go away when one reaches adulthood, surgical intervention would be the answer to counter the condition.

Other factors that could trigger the onset of gynecomastia include using steroids for bodybuilding, malnutrition and starvation, medical conditions such as kidney or liver failure, or Klinefelter's syndrome.

One interesting fact to remember is that gynecomastia is not associated only with an obese person. Any male with predispositions, such as genetics and consumption of certain types of medication, is susceptible to the condition.

Gynecomastia Grades

There are FOUR grades in gynecomastia classification, with the mildest being just a local swelling around the nipple area and the most severe showing a pronounced rounded appearance similar to a female breast.

Possible Gynecomastia Symptoms

The main gynecomastia symptoms include enlargement of the glandular tissue in the breasts and tenderness experienced around the breast and the nipple. Other possible gynecomastia symptoms include nipple discharge in one or both breasts.

How to know if I have gynecomastia? How do I test myself for gyno?

Pain or tenderness, which may increase over time and swelling are just two possible telltale signs of gynecomastia. To the touch, it feels like a rubbery, firm mound of lump under the nipple affecting one or both. Indicative appearance includes a resemblance to that of a woman's breasts.

Often, gynecomastia is confused with pseudogynecomastia, particularly among overweight young men. Hence, an accurate diagnosis and conclusion are best left in the hands of a qualified doctor.

When to see a gynecomastia doctor?

For an accurate diagnosis, the only way to be completely sure of your medical condition is to undergo a physical examination by a doctor who has experience in treating gynecomastia cases. During the clinical evaluation, the doctor will assess the severity and grade of your gynecomastia and recommend an appropriate approach.

Seek immediate professional help should you experience pain, tenderness and swelling in the chest area.

What is Pseudogynecomastia?

"Pseudo" means false or imitation, resulting from the accumulation of chest fat, unlike gynecomastia, which results from breast tissue proliferation. Physically, they may look the same, and pseudogynecomastia equally poses a real problem for men.

Genetically, men tend to accumulate fat in the chest and abdomen area. When chest fat builds up, the chest appears puffy and swollen. This is clinically known as lipomastia, adipomastia, or pseudogynecomastia. The more estrogen you have, the more your body stores fat. Fat also causes your body to produce the aromatase enzyme, which can convert testosterone into estrogen and slow your metabolism.

Unfortunately, a lower metabolism will also mean you burn less fat, which triggers a vicious cycle where you store more and more fat in your chest area.

How Do I Know if it's Just Fat (pseudogynecomastia)?

When this excess chest fat accumulates, it renders a puffy and swollen appearance. Surprisingly, pseudogynecomastia is actually less common than gynecomastia! Dr Ivan Puah, our Medical Director who has treated many male patients, observed that "most men who came in with complaints of pseudogynecomastia were shown to have true or mixed gynecomastia after medical assessment." This reiterates the essential need to seek qualified assessment and help.

Does Pseudogynecomastia go away?

In theory, chest fat can be improved with exercise and weight loss. However, in many patients, the fat tissue fat can be rather resistant to these methods, so losing weight may not lead to significant improvement.

How Do I Know if I Have Gyno or Just Fat? Gynecomastia vs Pseudogynecomastia

Both conditions display similar physical traits, such as an enlarged, puffy chest. The difference lies in what's underneath.

In pseudogynecomastia, the primary cause of chest enlargement is fat instead of glandular tissue. Only your doctor can confirm what you really have through a clinical assessment.

For gynecomastia, the cause of the condition is caused by the enlargement of male breast tissues.  Although hormonal imbalance is generally regarded as the main culprit for gynecomastia, in many cases, the cause of it is idiopathic. Glandular tissue does not respond to diet changes, exercise, or non-invasive treatments such as fat freezing or low-energy laser. 

Here is a table comparison for Gynecomastia vs Pseudogynecomastia

Gynecomastia Pseudogynecomastia
Definition Enlargement of male breast tissue AKA fake gynecomastia, pseudogynecomastia often appears as fat buildup without an increase in glandular tissue and is most commonly seen in obese men.
Cause Hormonal imbalance, Idiopathic cause, side effects of certain medications, some medical problems or disease, use of anabolic steroid or illegal drugs and starvation. Excess chest fat
Appearance A disc of firm tissue centered around the nipple and areola Fat around the area under the nipple
Symptoms Pain, soreness, tenderness to the touch, and sensitive nipples when rubbed against clothes and nipple discharge. No discomfort or pain.
Types True gyno: Only enlargement of glandular tissues

Mixed gyno: Enlargement of both fat and glandular tissues
None
Grade and Severity Grade I, II, III and IV. The gynecomastia grading considers breast tissue size and loose skin condition. No grading scale is available
Treatment Medication, counselling and gynecomastia surgery Exercise and weight management as the first line of treatment. If there is no improvement, liposuction is recommended.
How Do I Know if I Have Gyno or Just Fat In My Chest (Pseudogynecomastia)?

What can be done for gynecomastia?

The only clinically proven treatment to date for gynecomastia is gynecomastia surgery, which involves the permanent removal of excess glandular and fatty tissues. What is also important when considering gynecomastia surgery is the surgical experience and results the doctor achieves. A skilled and experienced doctor will be able to not only help you get rid of unwanted tissues permanently but also contour your chest, making it look defined and sculpted.

Gynecomastia can't be treated with exercise or diet. Hence surgery is still the best option to relieve sufferers of the agony that this condition inflicts. Despite its intimidating name, gynecomastia surgery is a day surgery procedure, meaning the patient can be discharged the same day after the surgery. During the procedure, the affected glandular tissues are excised, resulting in a flatter, contoured chest. If excess fat is present, it is removed via liposuction.

What can be done for pseudogynecomastia? ‍Can Vaser Liposuction get rid of pseudogynecomastia successfully?

Both gynecomastia and pseudogynecomastia won't hurt your health, but they can affect your self-confidence and damage your pride. Men are very self-conscious about their chest and, in severe cases, may be bullied or ridiculed by others for having "man boobs."

You may try to get rid of it through chest exercises or a diet, but that rarely works. If you have gynecomastia, no amount of exercise will get rid of that. You could even be perfectly fit and still have a pronounced chest.

The first thing to do is to get the right diagnosis from a qualified lipo doctor. For those suffering from pseudogynecomastia, fat removal procedures such as liposuction will effectively remove excess fat in the problem areas.

Vaser Liposuction, a tissue-selective fat reduction and removal procedure, is the treatment for those suffering from pseudogynecomastia. During the process, small strategic incisions are made on the chest area to facilitate the infiltration of anaesthetic fluid. Subsequently, a probe transmits ultrasonic energy to the targeted fat tissues to emulsify the stubborn fat. Once the fat cells are liquefied, Dr Ivan Puah will remove the fat via suction.

Vaser Liposuction is tissue-selective, meaning it only targets fat tissues, preserving the health of nerves, blood vessels and other critical connective tissues. Post-treatment recovery is fast and manageable, with minimal downtime, bruising and pain. Vaser Liposuction is a form of liposuction that can only be performed by doctors trained in liposuction and accredited by the Ministry of Health (MOH) Singapore.

It is a proven clinical treatment for pseudogynecomastia; many men have benefited from its results! While this is undoubtedly good news for those afflicted, remember to practise due diligence in one's research when seeking help.

As with women, men also face appearance issues beyond mere vanity. But with the available treatments to safely and effectively address them, conditions such as pseudogynecomastia and gynecomastia can now be a thing of the past for many men.

That's undoubtedly a massive load off their chests!


Dr Ivan Puah, medical director of Amaris B. Clinic, is certified to perform Vaser Liposuction and accredited by the Ministry Of Health Singapore to perform liposuction. He has more than 20 years of clinical practice in aesthetic medicine and performing surgical body sculpting treatments such as liposuction, hi-definition lipo, laserlipolysis, gynecomastia surgery, fat grafting, etc.

Whether you are suffering from gynecomastia or pseudogynecomastia, treatment options are available at Amaris B. Clinic. To learn more, call 6536 5211, WhatsApp +65 9152 4140 or leave us a message.

Reference

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