How do I determine if I have lipomastia or gynecomastia?
Is there anything I can do at home to self-diagnose my issue? Or do I need to go to a doctor to tell? I am 28 years old and only started to get man boobs 2 years ago after I packed on a few too many pounds. I am average height and weight about 200 lbs. I used to weigh around 170 all through my early 20s. Would 30 lbs of fat cause this lipomastia?
While the weight gain might certainly be responsible for your gynecomastia, it’s definitely not the only possible cause. Prescription drugs, hormone disorders, anabolic steroids and tumors all increase your chances of developing gynecomastia.
It’s probably not that important to make the distinction between lipomastia and gynecomastia. Although lipomastia may feel slightly softer and gynecomastia harder, they both present in enlarged male breasts and are treated in more or less the same way.
However, I do have to advise against relying on self-diagnosing, as it’s difficult – if not impossible – to make an accurate diagnosis based on feel alone. Your doctor will use a mammogram or ultrasound for a more thorough evaluation.
You have a few different options when it comes to treatment. Medication such as clomiphene is sometimes prescribed to treat gynecomastia, while some people have found tamoxifen to be effective at reducing overall breast volume. Older men have also experienced positive results with testosterone replacement therapy, but it may not be effective for you given your age (assuming your testosterone levels are normal). Unfortunately, most drugs are unable to completely resolve gynecomastia.
For most people with gynecomastia, the most effective treatment option is plastic surgery. Thanks to recent advances in technology, more and more cosmetic surgeons are able to perform male breast reduction surgery using liposuction. This approach involves removing excess fat deposits and glandular tissue to contour the chest into a more natural shape. For more severe cases of gynecomastia, your doctor may recommend tissue excision. This procedure enables the surgeon to extract a larger amount of glandular tissue. Both approaches have an immediate impact on the appearance of your chest and should help you feel more confident about your body.
If you’re considering liposuction or tissue excision, I suggest you visit a board-certified plastic surgeon (preferably one with a lot of experience in male breast reduction surgery) for a formal evaluation and to discuss your options.
It’s quite likely that your excess breast tissue is associated with the weight gain, but it’s worth noting that there are a number of factors that could potentially be responsible. For example, hyperthyroidism, testicular tumors, and other health conditions that affect your body’s hormonal system can increase the risk of developing gynecomastia. There are also many pharmaceutical drugs that are linked with gynecomastia, including anti-androgens, diazepam, certain anti-ulcer medications, and more. To isolate the underlying cause of your “man boobs”, I recommend visiting your GP or booking an appointment with a surgeon who specializes in gynecomastia.
Self-diagnosing any condition is a risky endeavor, and for gynecomastia I think it’s even more difficult because you generally need an ultrasound or mammogram to fully understand what you’re dealing with. I strongly recommend pursuing professional medical advice rather than attempting to diagnose yourself.
With that being said, it is possible to perform a rudimentary self-examination as a basic first step. True gynecomastia is the result of having excess glandular tissue that typically presents beneath the nipple as a hard lump. In some cases, the tissue may slightly extend away from the areola, depending on how much tissue is there.
To do a basic test yourself, just lightly pinch the affected area, and if it’s hard there’s a reasonable chance that you may have gynecomastia. In contrast, lipomastia (often referred to as pseudogynecomastia) is typically softer and may develop under the entire breast.
While there are some minor differences between gynecomastia and lipomastia, in my opinion, it doesn’t really matter which condition you have as the end result is the same (enlarged male breasts) and the treatment options are similar. If you’re concerned with the aesthetic appearance of your chest, you should consider seeing a board-certified plastic surgeon to discuss which course of treatment best suits your specific needs.
Dr. Jonathan Heistein has 2 Gynecomastia Reduction before & afters:
If you are determined to self-diagnose, you may be able to feel a firm disc of breast tissue beneath the nipple. This disc is the mammary gland. Keep in mind however that your issue is likely a combination of both excess fat and some glandular tissue. There is no way to know from self-examination what the ratio of mammary gland to excess chest fat is.
In my experience, drawing a distinction between "true gynecomastia" and "lipomastia" isn't particularly productive. (The latter is simply a form of gynecomastia.) The presentation in either case is enlarged male breasts.
Whether the condition is caused by breast glandular tissue or chest fat makes little difference. If the condition bothers you, we can treat it.
In the event that the issue is caused by fat alone, breast reduction can be achieved with basic liposuction.
In the event that there is some enlarged glandular tissue, the tissue can be removed with a relatively basic surgical procedure.
I encourage you to arrange a consultation to review the options that are best for you. Gynecomastia is a very common complaint and gynecomastia surgery is simple and straightforward.
Dr. Neil Zemmel has 3 Gynecomastia reduction before & afters:
The question of "is it gynecomastia or pseudogynecomastia" comes up frequently. As you noted, your "man boobs" may be due to excess adipose tissue and your weight gain may indeed be partly to blame.
Too much body fat can lead to a build-up of fatty tissue in the male breast. However it is rare for enlarged male breasts to contain fat alone.
While there are some rudimentary self-examinations you can do to feel for an enlarged mammary gland, I would encourage you to seek a professional examination. Some doctors will use ultrasound or a mammogram on male patients which can provide a clearer picture of the source of the breast growth. Regardless of what's causing enlarged breasts, the condition is easily treatable with liposuction or surgical excision.
As you probably know, chest fat can be extremely difficult to lose with traditional weight loss methods. The chest and belly are often one of the last areas where fat is shed.
We have had excellent results with cosmetic surgery to eliminate gynecomastia and restore a well-contoured male chest.
I suggest a professional consultation to discuss which options make the most sense for you. Remember to contact a board-certified plastic surgeon.
Gaining weight is a double edged sword. Surely some of the weight will go to your chest. But then there is an increase in production of estrogen as well, which will then stimulate growth of breast tissue. And this growth is a one way street. If you were to lose the same amount of weight, the fat cells would shrink but the newly grown breast tissue will remain, leaving you with residual enlarged breasts.
Trying to self-diagnose fat vs breast tissue is a fool's errand. Even the most experienced doctors' hands cannot tell the percentage of fat vs breast tissue. Just realize that ALL men's breasts have some combination of fat and breast tissue.
I have written on this subject and would recommend you read: https://www.gynecomastia.org/smf/index.php?topic=27922.msg201443#new
For further info, consult my website which is exclusively devoted to gynecomastia: www.gynecomastianework.com
Elliot Jacobs, MD, FACS
New York City
Elliot Jacobs has 3 Gynecomastia reduction before & afters: