Distinguishing Between True Gynecomastia and Chest Fat

Not all chest enlargement in men is caused by fat. In many cases, it’s a condition called gynecomastia, which involves glandular tissue (not just weight gain).

At West Houston Plastic Surgery, Dr. Alfonso Barrera and Dr. Eric Ruff help patients distinguish between true gynecomastia and pseudogynecomastia. Dr. Barrera is double board-certified and has practiced in Houston since 1985. Dr. Ruff brings advanced training from top Texas institutions and a strong background in body contouring. Together, they offer in-depth evaluations and surgical care.

What Is True Gynecomastia?

True gynecomastia happens when there’s an increase in glandular breast tissue in men. This isn’t fat. It’s real breast tissue that forms under the nipple and can feel firm or rubbery to the touch. 

The cause is usually hormonal, and it may develop during puberty, due to certain medications, or as a result of conditions that affect hormone levels. In many cases, even very fit men can develop true gynecomastia.

What Is Pseudogynecomastia?

Pseudogynecomastia, on the other hand, is related to fat buildup in the chest. It’s more common in men who carry extra weight and tends to feel softer than glandular tissue. 

You may be able to improve it with exercise and weight loss, but fat in this area can be stubborn. It doesn’t always go away completely, even with significant lifestyle changes.

How Can You Tell the Difference?

You can’t always tell just by looking, which is why a physical exam with a doctor is important. True gynecomastia typically causes a firm lump directly beneath the nipple, while fat tends to be more spread out. In some cases, imaging studies like ultrasound may be used to confirm what type of tissue is present.

Treatment will be different depending on the cause. True gynecomastia usually requires surgical removal of the glandular tissue. Pseudogynecomastia can sometimes be treated with liposuction alone. 

In both cases, surgery is highly individualized and should be performed by a board-certified plastic surgeon with experience in male chest procedures.

Experienced Care in Houston

Gynecomastia isn’t always obvious from the outside. A proper exam is the only way to know what’s causing the volume and how it can be corrected. For an experienced surgical opinion in Houston, call 713-468-5200 to schedule a consultation with Dr. Barrera or Dr. Ruff.