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Gynecomastia and pseudogynecomastia are two terms used to describe the enlargement of male breast tissue. While both can result in similar physical and psychological manifestations, they have distinct underlying causes and require different approaches to diagnosis and treatment. In this blog, we’ll explain the difference between gynecomastia and pseudogynecomastia, if diet and exercise can help, and the treatments available to correct these conditions when they can’t.

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What Is True Gynecomastia?

In the age of Zoom meetings and online dating, appearances are more important to many than ever. Gynecomastia refers to the benign enlargement of male breast tissue, resulting in a feminine or glandular appearance of the chest. This condition typically occurs as a result of hormonal imbalances, specifically an increase in estrogen levels relative to testosterone. Gynecomastia can manifest unilaterally (affecting one breast) or bilaterally (affecting both breasts) and may be accompanied by tenderness or sensitivity in the breast tissue.

Common causes of gynecomastia include puberty, hormonal fluctuations during adolescence or aging, certain medications (such as anabolic steroids or antiandrogens), underlying medical conditions (such as hypogonadism or liver disease), and lifestyle factors (such as excessive alcohol consumption or marijuana use).

What Is Pseudogynecomastia?

Pseudogynecomastia, or lipomastia, refers to the accumulation of excess fat deposits in the chest area, resulting in a breast-like appearance in males. Unlike gynecomastia, which involves glandular tissue enlargement, pseudogynecomastia is primarily a result of excess adipose tissue (fat) accumulation.

This condition is often associated with weight gain, obesity, and a poor diet, as well as a sedentary lifestyle. Pseudogynecomastia may present bilaterally or unilaterally and is typically characterized by soft, compressible tissue without the firmness or tenderness associated with true gynecomastia.

How to Distinguish Between Gynecomastia and Pseudogynecomastia

While gynecomastia and pseudogynecomastia both present with breast enlargement in males, there are key differences in their characteristics and the underlying causes. If you are experiencing enlarged male breast tissue, the following are the best ways to distinguish between these conditions

  • Physical Examination

A thorough physical examination is often the first step in distinguishing between gynecomastia and pseudogynecomastia. Gynecomastia typically presents as firm, rubbery tissue beneath the nipple-areolar complex, whereas pseudogynecomastia is characterized by soft, fatty tissue without glandular prominence.

  • Hormonal Assessment

Gynecomastia is commonly associated with hormonal imbalances, such as elevated estrogen levels or decreased testosterone levels. Blood tests may be performed to assess hormone levels and rule out underlying endocrine disorders contributing to gynecomastia. In contrast, pseudogynecomastia is not typically associated with hormonal abnormalities but rather with excess adiposity.

  • Imaging Studies

In cases where the distinction between gynecomastia and pseudogynecomastia is unclear, imaging studies such as ultrasound or mammography may be utilized to evaluate breast tissue composition and identify any underlying glandular enlargement characteristic of gynecomastia.

Treatment Response

Your response to treatment can also provide valuable insights into the underlying cause of breast enlargement. Depending on the severity and underlying etiology, Gynecomastia may respond to hormonal therapy, surgical excision, or liposuction.

In contrast, pseudogynecomastia is typically managed through lifestyle modifications, including diet and exercise interventions designed to reduce excess body fat.

Key Facts About Gynecomastia and Pseudogynecomastia

Gynecomastia and pseudogynecomastia are two distinct conditions characterized by the enlargement of male breast tissue. Gynecomastia involves the expansion of glandular tissue, while pseudogynecomastia is primarily attributed to excess fatty tissue.

While both conditions can present with similar physical manifestations, a thorough evaluation, including physical examination, hormonal assessment, imaging studies, and treatment response, can help distinguish the two and guide you to the appropriate management strategies.

Crucial visible characteristics that differentiate these conditions:

  • True gynecomastia involves both fat and glandular breast tissue
  • Pseudogynecomastia is characterized by a concentration of fat behind and around the areolas and nipples

A qualified healthcare provider can help you understand the differences between gynecomastia and pseudogynecomastia, order the appropriate testing to get answers, and recommend the best treatments to correct this condition and optimize your outcome.

Gynecomastia Specialist in San Francisco, CA

Gynecomastia.org is more than a plastic surgery website. It is a community for men who are currently struggling with gynecomastia or have undergone treatment for excess breast tissue.

In adult men with true gynecomastia, the standard of care is typically male breast reduction surgery. Dr. Miguel Delgado is a leader in the treatment of gynecomastia and can help you achieve a more masculine chest with natural-looking results.

Call our Bay Area gynecomastia specialist at 415.898.4161 with your questions and get on the path to a manlier chest.



Dr. Delgado Bio


Dr. Delgado, MD is a world-recognized plastic surgeon and specialist in the treatment of male breast enlargement, also called gynecomastia. He has developed new techniques and owns and operates gynecomastia.psstage.com, which has become the largest gynecomastia forum in the world. Dr. Delgado holds the two most coveted credentials; the certification by the American Board of Plastic Surgery and membership in the American Society of Plastic Surgery.