Gynecomastia Versus Chest Fat: Which do I have? Austin Gynecomastia Center

Gynecomastia is the appearance of female-like breasts in a male. For a gynecomastia specialist such as myself, determining who has it and who doesn't is straightforward. If you suspect you have gynecomastia, what can you do to determine if you have it with certainty?

There is no single test to establish the diagnosis of gynecomastia. The diagnosis is made on visual appearance. The "normal" male chest has flat, small nipple-areola complexes and a chest that is defined by the pectoral muscles. There isn't a lot of tissue on top of the muscle nor the appearance of "puffy" nipple-areola complexes.

People are confused by the medical profession today regarding the diagnosis of gynecomastia. They are told to obtain blood tests to check their hormones and even undergo scans to determine if they have "gynecomastia tissue." Unfortunately, almost all lab results will be normal, and the scans, at best, will tell you what you already know—you have tissue excess on your chest. There is no need to walk into the doctor's office with a bunch of lab tests and scan results, all you need to do is look at your chest objectively in the mirror and grab the tissue at your nipple areola complexes.

If there is any exacting feature that defines gynecomastia, it is the appearance of "puffy nipples." Puffy nipples are dome-shaped and not flat, and they are very obvious when wearing a shirt (think headlights). Gynecomastia tissue growth starts under the nipples and spreads in a circular shape. The nipple area is "ground zero," so if you have puffy nipples, this is gynecomastia. The tissue herniates through the skin, causing the dome-shaped nipple-areola complex.

What can I tell you about this relationship between chest fat and gynecomastia? We would all like to believe that the appearance of gynecomastia is just fat because fat is something we can make disappear with weight loss. This is something you can control. Pseudogynecomastia is a fancy name for a fatty chest. The term needs to be abandoned as it confuses patients and gives them false hope that always ends in disappointment. Don't get me wrong, I cherish weight loss in anyone who needs to lose weight because it's healthier, but it simply won't cure your gynecomastia.

It's never just chest fat. It's called gynecomastia. Go ahead and lose some weight if you need to, but don't be surprised or disappointed if your gynecomastia doesn't go away. The great news is treatment is very effective, safe, and reliable. This is one of the legacies of the Austin Gynecomastia Center.