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How do I know if I have Gynecomastia or Fat in my Chest (Pseudogynecomastia)?

April 21, 2020
May 2, 2024

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

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 do you know if you have gynecomastia?

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.

What is Pseudogynecomastia?

"Pseudo" means false or imitation, and is a result of 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. Interestingly, fat also causes your body to produce the aromatase enzyme, which can convert testosterone into estrogen and slow down 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 you know if it's fat in the chest (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.

Gynecomastia vs Pseudogynecomastia

Both conditions display similar physical traits, such as an enlarged, chubby 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 overdevelopment of glandular tissues and also excess fat tissues. Although hormonal imbalance is generally regarded as the main culprit for gynecomastia, in many cases, the cause of it is idiopathic. Glandular tissue is firm and fibrous and does not respond to diet changes, exercise, or non-invasive treatments such as fat freezing or low-energy laser. 

However, one clear sign that you have gynecomastia is you can feel a firm mound of glandular tissue around your areola area, which is sometimes painful to touch. For some, the nipple may even feel sensitive. But if it's pseudogynecomastia, the entire breast is evenly enlarged.

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 to get rid of unwanted tissues permanently but also to 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 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 incisions are made on the area to be treated and infiltrated with 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; it only targets fat tissues, preserving the health of nerves, blood vessels and other critical connective tissues. Therefore, post-treatment recovery is manageable with minimal downtime. Bruising and swelling are lesser with this procedure. As Vaser Liposuction is a form of liposuction, it 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 medicine, of which 17 years of clinical practice in aesthetic medicine, performing surgical body sculpting treatments.

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.


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