Gynecomastia vs. Pseudogynecomastia: What You Need to Know and How Cosmetic Treatment Options for Each

Gynecomastia vs. Pseudogynecomastia: What You Need to Know and How Cosmetic Treatment Options for Each
Dr. Phillip Chang

Dr. Phillip Chang

Board Certified By The American Board of Plastic Surgeons.
Voted Top Plastic Surgeon in Loudoun, Virginia
Offices in Leesburg, Virginia.

Having large breasts might be a good thing for women but upsetting for men. The two common types of gynecomastia are true gynecomastia and pseudogynecomastia.

Gynecomastia is so prevalent that one out of three men has this breast issue. It has become a source of embarrassment and frustration for male adults, especially when they have to take off their shirts in front of other people.

The lesser-known pseudogynecomastia is still a real problem for men. So how do we know if it is gynecomastia or pseudogynecomastia? Though similar in appearance and symptoms, the difference lies in the cause of enlargement. 

For gynecomastia, the enlargement is due to the accumulated breast gland tissue, while for pseudogynecomastia, the cause is primarily due to fat. The good news? Both are treatable!

Let’s discuss each of the conditions in length and then draw their similarities and differences from another. We will also show you the best treatment options available for each breast condition.

What is Gynecomastia, and How to Treat It?

Let’s start with the more common gynecomastia. This refers to the condition when a male’s breast becomes oversized due to extra breast gland tissues due to hormonal changes and several contributing factors like smoking, alcohol, drugs, and the use of certain medications. This is what people refer to as the “true” gynecomastia.

How do you know if you have gynecomastia? There are some symptoms you need to observe and consult with an expert before you can say so. Some common gynecomastia symptoms include the following:

  • Asymmetrically-sized breasts
  • Excess breast gland tissue
  • Protrusion or swelling of nipples
  • Tender breasts

However, the above symptoms can be mistaken for pseudogynecomastia, so the best option is to consult a certified professional. 

The treatment options for gynecomastia are liposuction and mastectomy. This is the usual combination since enlargement is caused by both excess breast gland tissue and fats.

  • Liposuction: Since the excess breast gland tissue is usually accompanied by fat cells, liposuction will first be done before mastectomy to remove these excess fats. This can be administered for either gynecomastia or pseudogynecomastia.
  • Mastectomy: The surgeon then makes a small incision just below the areola after the liposuction has been performed. This direct excision is done to extract the non-fatty fibrous tissue behind the nipples. 

What is Pseudogynecomastia?

The term “pseudo,” which means “fake,” tells us that it’s not what it looks like. This is not the usual type of gynecomastia we are talking about here. For pseudogynecomastia, the leading underlying cause of the enlargement is fat and not tissue.

In the course of a man’s life, fats tend to develop around the chest. Unfortunately, when this fat piles up, it enlarges the breast and becomes pseudogynecomastia.

Pseudogynecomastia has similar symptoms to gynecomastia, so it would be hard to determine on a personal level the exact issue a person is dealing with. The best approach is to visit a medical professional and have it checked.

Since pseudogynecomastia is a matter of fat accumulating, the most straightforward remedy to this condition is diet and exercise. However, no matter how stringent the exercise is, the breast fat just won’t go away in many cases. If you tried doing body toning exercises, you would notice that the last ones to get toned are your breasts, especially if they are originally flabby.

The most effective method to remove breast fats is through liposuction. The area around the breast nipples is usually where the fats build up. The doctor will make one or two small incisions to suck out the fat.

Comparison of the Two

Gynecomastia or pseudogynecomastia? Let’s talk about the similarities between the two. Both of them are serious issues for men and have the same outward appearance. You can’t easily tell the difference – not unless you have yourself examined by a licensed professional. 

Again, the main difference between the two breast issues is the cause of enlargement. For true gynecomastia, the cause is excess breast gland tissue. For pseudogynecomastia, it’s fatty tissue. It is crucial to determine the specific type of gynecomastia first so that the exact treatment can also be identified.

Only pseudogynecomastia has a great chance to be treated through physical exercise and diet when it comes to treatment. Gynecomastia will have to be treated through surgery.

Both conditions require liposuction, although the incision depends on the volume of fat stored behind the breasts. Since pseudogynecomastia is more of a fat issue, liposuction will suffice. 

For gynecomastia, mastectomy is usually involved since the target is breast gland tissue. This procedure is considered a major surgery that entails severe risks and complications.

Recovery for the liposuction procedure may take two to three weeks, but it can take more than three weeks for the added mastectomy, depending on the level of surgery.

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For those wondering whether gynecomastia or pseudogynecomastia surgery might be the best cosmetic solution for you, we invite you to simply come in for a complimentary consultation with Dr. Chang or one of the cosmetic laser and injection nurses to explore whether you would make a good candidate. To find out more whether Aesthetica can help you, contact us online or at 703-729-5553 to arrange an appointment. Dr. Phillip Chang is a board-certified plastic surgeon in Northern Virginia near Leesburg, Virginia and an expert in a wide variety of cosmetic treatments.

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