If, thanks to the coronavirus pandemic, you’re now the proud owner of a pair of man boobs, we’ve got even more bad news: They’re all not created equal. In fact, physicians recognize two unique types of man boobs—gynecomastia and pseudo gynecomastia. Although both may make men want to keep their shirts on, there are key differences between the conditions, and distinguishing between the two makes all the difference in getting rid of them.
“There are two tissues that make up both male and female breasts — glandular tissue and fatty tissue,” Norman Rowe, a New York City-based plastic surgeon told Fatherly. “Gynecomastia is a proliferation of both of the types of tissue, whereas pseudo gynecomastia is an excess of fatty tissue.”
The excess fatty tissue seen in pseudo gynecomastia is easy enough to deal with. This kind of man boobs are what happens when you pack on extra pounds and is usually the result of lifestyle decisions—eating a lot, exercising a little. In theory, it can be treated with liposuction. But going to the gym and eating right is a more practical (and less expensive) way to go. “This population of patients will be good candidates for liposuction, however, it is important to mention that liposuction is not the treatment for obesity,” plastic surgeon Victor Perez told Fatherly.
“Diet and exercise should be the primary treatment plan to reach a healthy weight first.”
But then there’s gynecomastia. Sure, some men with this condition would also see results if they would lose weight. But these men have additional glandular tissue to contend with, which comes from hormonal imbalances that can exist due to anabolic steroid or synthetic hormone use (and abuse), hormone blockers, antidepressants, thyroid problems, kidney failure, and just about any disease that interferes with a man’s estrogen levels. (Sound familiar? Think Meat Loaf in the David Fincher classic Fight Club.) Gynecomastia is more complicated to treat than pseudo gynecomastia because it requires not only surgical removal of the excess breast tissue, but also the treatment of the underlying hormonal imbalance.
The bottom line is that guys who have fat man boobs should speak with their doctors to ensure that the extra tissue there is only the evidence of a year-long COVID-19 lockdown and not a telltale sign of a hormonal imbalance — or something even worse. “Any changes in breast characteristics in men should be assessed by your physician,” Perez recommends. “In most cases, it can be attributed to gynecomastia, however, it should be mentioned that male breast cancer is rare cancer that can form in the breast tissue of men.”