Bermant Gynecomastia Male Breast Reduction Plastic Surgery
Bermant Pseudogynecomastia definition and treatment

Pseudo Gynecomastia or Pseudogynecomastia - Definition, Diagnosis, Pictures, and Treatment Options

Explore the problem of big male breasts with fat as a major component.

Michael Bermant, MD
Board Certified by the American Board of Plastic Surgery

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Definition of Pseudogynecomastia

Pseudo Gynecomastia (pseudogynecomastia) is supposed to be fat only gynecomastia. The problem with that "classification" is that in almost every case of gynecomastia that Dr. Bermant has seen there is some component of gland. This gland can be very small, but it is present almost all the time. So do you have Pseudo gynecomastia when there is a 1%, 10%, 50%, or 90% deformity from fat? Reality just does not work that way.

pseudogynecomastia medium gland pseudogynecomastia minimal gland Here the contour is all fat, the gland is very small
pseudo gynecomastia small gland Gland is still small, with most of the contour fat.
pseudogynecomastia medium gland Fat is still significant, but the gland is larger.
large gland pseudo gynecomastia Here, most of the contour problem is gland.

Move cursor over smaller drawings to see a larger or smaller gland component (in white). Pseudogynecomastia would be fat gynecomastia but at what percentage is that?

fat david male body fat and pseudogynecomastiaFat, Gland, and or Skin?

Determining if the male breast contour is mainly fat or gland by male breast examination can be difficult at best. Fat tends to be soft, gland tends to be firm. Fingers of gland often dissect between fingers of fat. You can see this relationship in the Anatomy of Gynecomastia or the Anatomy of Male Puffy Nipples. However, gland can be soft and fat firm confusing the picture. Gland tends to be located under the nipple and pinching pressure can sometimes tether to the nipple pulling it in. You can see the denser gland tissues on a Male Mammogram, X-rays of the male chest. However unless your doctor is concerned about possible specific pathology, such x-rays are an unnecessary expense and exposure to radiation. That is why Dr. Bermant evolved his Dynamic Technique to manage whatever he finds during gynecomastia chest surgery.

Men with excessive fat do tend to have certain contour issues. Typical fat distribution in men is first on the chest and abdominal bands. The fat on the chest is usually only part of the problem: look at your belly, love handles, under arms, and around the back.

After major weight loss, diminished muscle mass, or aging, excess chest skin can result in drooping / sagging that can be managed with male mastopexy chest lift.

Treatment of Pseudogynecomastia

rodin balzac male fatWith pseudo gynecomastia, fat is the major factor. Weight loss before surgery is typically better than weight loss after surgery. As a sculptor, Dr. Bermant prefers to use a coarse tool first, then the finer. Losing weight is a coarse tool of body shaping. Unfortunately, you cannot pick where weight comes from - nor can you pick where weight goes back on to. Plastic Surgery is better for refinement. You can see the major changes that weight loss can have on the fat component of gynecomastia. The remaining gland and fat were then managed with surgery.

Losing weight first, to something you are comfortable with and can maintain is typically a much better option. However, you do not want to lose more than you are able to maintain. After surgery, remaining fat cells can put on more weight (pseudogynecomastia recurrence).

It is not just losing weight. A high Body Mass Index (BMI) coupled with a high Body Fat Percentage indicate that fat is a significant component. The BMI alone does not account for bone or muscle component. That is why using Body Fat Analysis is important. Losing excess fat can improve much more than just pseudogynecomastia. Patients tell Dr. Bermant how much better they feel after weight loss.

While dieting can help with global fat, it will not help with the glandular component. The gland may even show more as surrounding fat resolves. Bodybuilding is great for building muscles. However, whatever fat and gland sits on top of the muscles can get pushed further out.

Plastic Surgery is not a good alternative to losing weight. Compromise contouring can help to a degree. To look lean and fit, dieting and exercise are better options.

Excessive Fat Does Not Look Good in Men.

Fat collects first on the belly and breasts in men. Galen first coined the phrase gynecomastia. Although aware of the gland component, his description was of the fatty male breast. Pseudogynecomastia can create a great deal of emotional stress. This chest contour just does not say male.

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This page last updated on: January 10, 2013

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