What is it?

Pseudogynecomastia is a condition in which fat accumulates in the chest region, creating enlarged male breasts similar to those found in patients with gynecomastia. However, it does not have the significant breast gland tissue involvement that is seen in true gynecomastia.

gynecomastia vs pseudogynecomastia - figure

This diagram illustrates the differences between true gynecomastia and pseudogynecomastia. Note that even with pseudogynecomastia, a small amount of glandular breast tissue is normally present.

What causes pseudogynecomastia?

Pseudogynecomastia typically appears in boys and men who experience weight gain—whether they are slightly overweight or obese.

Distinguishing gynecomastia from pseudogynecomastia can be challenging; but in general, with pseudogynecomastia, the excess weight is distributed fairly evenly throughout the body, with a large amount of accumulation in the chest.

medical conditions male breast - figure

This diagram illustrates the increased size of the male breast due to fat accumulation.

What causes gynecomastia?

There is no medical reason or disease process that causes pseudogynecomastia other than weight gain. However, true gynecomastia has well-established causes, including these more common ones:

  • An imbalance of hormones at puberty, often termed adolescent gynecomastia
  • Anabolic steroids
  • An underlying medical condition
  • Recreational drug abuse, such as marijuana and alcohol

Treatment for pseudogynecomastia

Weight loss

The first line of treatment for pseudogynecomastia is healthy weight loss through a sensible diet and exercise. While weight loss has been shown to decrease the size of the breasts, it does require a high level of self-discipline and willpower, making losing weight extremely difficult for some men. 

Surgical treatment options

Oftentimes pseudogynecomastia cannot be improved through diet and exercise, and surgical correction is the next logical step.

before and after treatment pseudogynecomastia with liposuction

Pseudogynecomastia before and after treatment with liposuction

Liposuction, also known as lipoplasty or suction-assisted lipectomy yields excellent results. It is a cosmetic surgery performed to remove the unwanted deposits of fat from under the skin that have been resistant to reduction by diet or exercise. The fat is permanently removed from under the skin with a suction device.

The issues that can make pseudogynecomastia more difficult to treat include skin laxity (breast sagging) from aging, weight loss, or loss of muscle mass. In this case, liposuction alone will not address this issue, and a mastopexy or other skin lifting procedure is required.

Also, with liposuction alone, some breast enlargement is known to return after the procedure for some patients, regardless of whether they had pseudogynecomastia or gynecomastia prior to the procedure.

Some surgeons treat both gynecomastia and pseudogynecomastia with liposuction only. However, this is not adequate treatment for true gynecomastia, because the breast gland tissue cannot be removed with the liposuction device. Although sharp liposuction instruments have been devised to break the gynecomastia gland down and suction the remains. This approach does not work adequately either. Performing liposuction around the gland can make it appear more obvious and unnatural.

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