Gynecomastia is common among adolescent boys and middle-aged, including older men. Hormonal imbalance, medication side effects and declining testosterone levels are the usual suspects.
Pseudogynecomastia, on the other hand, can happen to men regardless of age group. This condition is usually brought on by the presence of excess fat primarily in the chest area. However, due to their similarity in appearance – the best method of confirmation is via a doctor’s assessment.
What is Gynecomastia and Pseudogynecomastia?
Gynecomastia is caused by hormonal imbalance, which is the result of excess estrogen being produced. Changes surrounding sexual development in teenage boys and health issues such as thyroid problems common among men in their 50s and above are some of the causes of this hormonal imbalance. The side effects of some medications can also potentially be a cause.
In men, the fat tends to accumulate in the chest and abdomen areas. Fat amassed around the chest area usually results in a puffy or swollen appearance clinically known as lipomastia, adipomastia, or pseudogynecomastia.
Low Metabolism and Body Fat
Poor dietary habits and lifestyle choices easily contribute to a host of issues, including weight gain and the accumulation of excess fat. Excess fat often results in slower metabolism and testosterone levels and the production of aromatase. The aromatase enzyme converts testosterone to estrogen.
Men produce estrogen, albeit at a lower level compared to women. When a man’s body produces excess estrogen, the more the likelihood that excess fat will be stored. An area where this excess is usually more prevalent would be that of the chest or breast. This is what commonly causes pseudogynecomastia.
When the body produces excess estrogen, the more the likelihood that excess fat will be stored. Fat also causes the body to produce the aromatase enzyme. This enzyme converts testosterone into estrogen and is responsible for slowing down metabolism, which slows down the body’s ability to burn fat – you will lose fat but in lesser amounts. If not addressed, this can lead to more fat being stored causing an imbalance to the body’s hormone level.
An increased estrogen level in men also results in loss of muscle mass, fatigue and mood swings.
Low Testosterone
Low testosterone levels cause an increase in fat storage as the body’s fat-burning capability is reduced. This results in weight gain and the production of excess estrogen. One common sign of low testosterone sign is a decrease in libido. Frequent fatigue is also a sign in men.
What is the difference between Gynecomastia and Pseudogynecomastia?
Both the male and female breasts are made up of glandular and fatty tissue. In gynecomastia cases, it is a proliferation of both types of tissue. As for pseudogynecomastia, it is usually the case of excess fatty tissue.
Do I have Pseudogynecomastia?
There are simple self-check methods that one can carry out. For example:
Appearance: Does your chest area look evenly enlarged?
Excess fat: Is your exercise or workout routine not addressing the excess fat around the chest?
Pain: Is it painful or does the area around the areolas when touched? (this could be a sign of gynecomastia)
The above list is not confirmation indicators. A trip to the doctor’s for a qualified assessment is highly recommended. Do take note that it is possible for an individual to suffer from both gynecomastia and pseudogynecomastia.
Pseudogynecomastia treatment options
There are options to select from, and these include:
Weight loss and exercise: Adopt a comprehensive programme that promotes both weight loss and healthy eating habits. These may consist of resistance training and a caloric deficit diet
Compression wear: Compression garment in the form of tops, for example, does help in terms of appearance and according to some, improving blood flow. Improved blood flow has been known to increase fat oxidation.
Liposuction: Liposuction is currently the proven clinical treatment for treating pseudogynecomastia. During this procedure, excess fat cells are removed. It is only to be performed by a qualified gynecomastia doctor. The costs may vary, depending on the patient’s clinical condition and complexity of the surgery.
Gynecomastia 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. Pseudogynecomastia, on the other hand, can be rectified without surgical intervention.
What is pseudogynecomastia?
“Pseudo” by definition means false or imitation, and when one considers what pseudogynecomastia is, it makes sense. Unlike gynecomastia, which is the result of excess breast tissue, pseudogynecomastia is the accumulation of stubborn pectoral fat. Physically, they may look the same, and although it may be called pseudogynecomastia, it is still a real problem for men.
Pseudogynecomastia vs gynecomastia
In pseudogynecomastia, the primary cause of chest enlargement is fat as opposed to tissue. The fat is usually stored behind and around the nipple area. For gynecomastia, the cause of the condition is excess glandular male breast tissue. This occurs as a result of hormone imbalance. Glandular tissue is firmer and fibrous than fat tissue and it does not respond to diet changes or exercise.
What can be done?
The first thing to do is to get the right diagnosis by a qualified doctor. For those suffering from pseudogynecomastia, compression vests are ideal, but it does not get rid of the underlying issue. As it is caused by excess fat, a full fat and weight loss programme could relieve patients of the condition. Specific exercises that improve the chest’s appearance and contour are also recommended. Fat removal procedures such as liposuction also help to remove excess fat in the problem areas.
Gynecomastia, on the other hand, can’t be treated with exercise or diet. Gynecomastia surgery is still the best option to relieve sufferers of the condition. Despite its intimidating name, gynecomastia surgery is considered as an outpatient treatment, and patients can go home after the procedure. During the procedure, the glandular tissue and excess skin are excised resulting in a flatter, contoured chest. If excess fat is present, it is removed via liposuction.
As with women, men also face appearance issues that are 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.
Affecting at least 60% of all men at some time in their life is the development of female-type breasts, which is caused by a condition known as gynecomastia. The most prevalent time this occurs is the adolescent years as young men pass through puberty and experience hormonal changes. As their hormones are changing and the estrogen level is temporarily high, they may have what is referred to as “puffy nipples.” Fortunately for most, their gynecomastia will resolve on its own without any intervention. However, for some, if their chest is not back to normal after two years, it may be permanent, with gynecomastia surgery as the only effective option.
Gynecomastia Causes
Overall, there are many different factors that can cause gynecomastia or breast enlargement in males. The most common cause is a hormonal imbalance with estrogen levels being higher than testosterone levels, while certain medications may also lead to male breast enlargement. Anabolic steroids can also lead to gynecomastia, which is common among the bodybuilding community.
True Gynecomastia and Pseudo-Gynecomastia
True gynecomastia occurs when there is excess glandular tissue in the male breasts along with excess male breast tissue resulting in enlarged male breasts. Surgical treatment is often the best solution for true gynecomastia.
It is important to note that true gynecomastia should not be confused with false gynecomastia, or pseudo gynecomastia, which results in enlargement of the male breasts due to weight gain, excess fat, and fatty tissue on the body. The main cure for pseudo-gynecomastia is often weight loss.
Gynecomastia Grades
Gynecomastia can be divided into different grades to determine severity. These grades include:
Grade I: severity is mild with enlargement centered around the areola. At this grade, gynecomastia is usually not noticeable with clothing.
• Grade II: enlargement is moderate without excess skin past the areola. At this stage, gynecomastia can still be concealed with loose clothing.
• Grade III: enlargement is moderate with excess skin. At this point, the swelling of the breast tissue is moderate to severe, and is highly visible.
• Grade IV: significant enlargement with feminine-type breasts and excess skin. This is the most severe stage of gynecomastia.
The severity of the gynecomastia will determine how the male breast reduction surgery is to be performed. It is imperative to select a board-certified plastic surgeon that has extensive experience with gynecomastia.
For patients with mild to moderate gynecomastia, the less invasive “pull-through technique” procedure may be an option. For those with more severe gynecomastia, a “Two Stage Procedure” may be necessary in order to reduce the excess skin.
Schedule a Consultation
If you are tired of living with the symptoms of gynecomastia and are ready to make a change, contact Dr. Delgado in San Francisco today! Your first step will be to schedule a one on one consultation appointment to discuss your concerns and gynecomastia treatment options.
Gynecomastia in San Francisco FAQs
What is the most severe grade of gynecomastia?
The most severe grade of gynecomastia is grade 4, which involves severe levels of excess breast tissue and glandular tissue. This excess tissue will create a noticeable condition regardless of whether the patient is wearing a shirt.
What is the best treatment for Gynecomastia?
Gynecomastia surgery is often the best way to treat gynecomastia. This surgical procedure is performed to correct moderate breast enlargement through the removal of excess glandular and fatty tissues.
Do all adolescent males experience gynecomastia?
No, not all adolescents will experience gynecomastia symptoms. However, most males do experience gynecomastia during their teen years as this is when their hormones are fluctuating.
Does gynecomastia cause breast pain?
For some males, gynecomastia can cause the breasts to be tender or painful to the touch.
