In the medical community, Fatty Gynecomastia is called Pseudo-Gynecomastia. The terms are interchangeable. Gynecomastia primarily caused by excess fat is defined as Pseudo-Gynecomastia.
Men with fatty gynecomastia tend to be no the heavier side, so weight loss is usually recommended before pursuing surgical options. However, in some cases, diet and exercise is not enough. This is frequently the case when men have "love handles," as well as fatty gynecomastia, because the combination of these two areas do not respond well to weight loss. Even when a man is at an ideal body weight, the body can still accumulate excess fat in these areas. Weight loss is still the recommended first option prior to pursuing surgical options.
Frequently Asked Question
Will liposuction alone work or do I need to have breast tissue removed?
This is one of the most common questions heard from men with gynecomastia. The answer will vary from surgeon to surgeon. Some surgeons will tell you liposuction alone will take care of the problem. Others believe that breast tissue removal is also necessary. The answer is "It depends!"
View the pictures and explanation below to better understand what determines the best course of treatment.
In the above pictures, the main differences between Classic Gynecomastia and Fatty Gynecomastia are diagramed. The right side of each picture looks the same (outside view). Look at the cut-out view on the left side of each chest. Notice the Fatty Gynecomastia has much more fatty tissue (shown in yellow) than Classic Gynecomastia. You will also notice more glandular tissue (shown in white) with Classic Gynecomastia compared to Fatty Gynecomastia. You can see that although the overall shape appears to the same, the underlying causes are not identical. This is the reason some types of gynecomastia can only be determined at the time of surgery, which in turn determines what surgical approach should be used.
Liposuction alone works well to eliminate Fatty Gynecomastia, but leaves excess breast tissue behind, which causes Classic Gynecomastia. Removing excess fat from Classic Gynecomastia may turn the chest into a smaller chest with Puffy Nipples. This is why it’s important to seek out an experienced gynecomastia surgeon. If the gynecomastia is not treated appropriately, it could result in continued issues after surgery.
Classic Gynecomastia is represented on the left. Notice the amount of fatty tissue in yellow. After liposuction you will see a dramatic decrease in the amount of fat, however now the breast tissue is exaggerated. This is now creating a “Puffy Nipple” appearance as shown on the right. The better option for optimal correction would be removal of both the fatty tissue and glandular tissue.
Notice in the image to the right that Fatty Gynecomastia has very little, if any, breast tissue. Liposuction alone can at times be effective in treating this type of gynecomastia, but it must be done properly. Fatty tissue is fibrous and quite difficult to remove. The fatty tissue in the chest area is much more resistant to removal than other areas of the body. There are various techniques available for fat removal: Traditional Tumescent liposuction, ultrasconic liposuction, and manual hand dissection.