A few days ago another member of gynecomastia.org asked a question we have heard many times: are my man boobs made up of fat and breast tissue or just fat?

Sometimes the debate is framed using the terms “pseudogynecomastia” (breasts comprised of fat alone) vs. “gynecomastia.” No matter what words are used, in our view it’s not useful to spend time and money worrying about this.

That said, from the conversations we’ve had with thousands of New York gynecomastia patients, we’ve come to understand the psychology behind the question. Men seem less able to deal with the notion that they have excess breast tissue present than the idea that they have fat on their chest. Many don’t want to think that they have “female” attributes. Others believe that if the problem is related to fat alone, they will be able to conquer it with diet.

In our opinion, any excess tissue on a male chest should be considered gynecomastia (the same way that any amount of tissue, fat or gland, on a woman is called a breast no matter what).When a man has moobs, there is always breast gland present as well as fat. The ratio of each type of tissue varies from individual to individual. There’s no way a doctor can examine a male chest and determine how much gland there is or what the ratio is. A layperson has even less chance of figuring this out.

Some doctors will order a mammogram or ultrasound to determine how much breast tissue is present.But this look inside the breast does not change the surgical approach one bit (though it may change the budget available for surgery). Most often a combination of liposuction and gland excision is needed.

Know that no amount of diet or exercise can solve a gynecomastia challenge.The gland component isn’t affected at all, and though the fat component of gynecomastia may diminish somewhat with extreme weight loss, it’s never enough. When a man puts weight on, the first places it goes is the chest, the abdomen and the love handles.As most guys will attest, these are the last areas where fat is lost – if at all.

We feel the term “pseudogynecomastia” is misleading in more than one way. Not only are moobs containing fat alone non existent, the “pseudo” prefix implies that perhaps the condition is not real or worth solving. Nothing could be further from the truth. No matter how much gland tissue vs. fat lies under the skin, gynecomastia is gynecomastia. If you have it, and it bothers you, it’s worth addressing.

We would be delighted to meet you and discuss this and any other topic related to gynecomastia in New York in our Park Avenue offices, online or by phone.

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