Credit the pandemic for many a man finding himself the proud owner of a new pair of man boobs. But if you’ve suddenly discovered C-cups under your T-shirt, we’ve got bad news: Although fat man boobs may all look the same, there are actually two main types. It’s a battle of gynecomastia vs fat, and physicians recognize these two as distinct silos with two distinct methods of resolving them. So, if you’ve found yourself uncomfortable at the thought of an upcoming pool party, we’ve tapped experts to provide a means of distinguishing which type of big man boobs you’ve got, plus the next steps to getting rid of your man titties. (If that’s what you want, that is. If you want to rock some male boobs, by all means, have at it!)
“There are two tissues that make up both male and female breasts — glandular tissue and fatty tissue,” says Norman Rowe, a New York City-based plastic surgeon. Glandular tissue produces and secretes some bodily products, including breast milk. Fatty tissue is, you guessed it, mostly made up of fat. “Gynecomastia is a proliferation of both of the types of tissue, whereas pseudo gynecomastia is an excess of fatty tissue.”
The “pseudo gynecomastia” kind of man boobs is what happens when you endure 12 months or more of pandemic gym closures. Translation: It’s the manifestation of lifestyle decisions. Luckily, they’re easy enough to deal with. In theory, the condition can be treated with liposuction. But going to the gym and eating right is a more practical (and less expensive) way to go when you’ve grown a pair of big ol’ biddies.
“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. (Think Meat Loaf in the David Fincher classic Fight Club.) Some men with this condition would also see results if they lost weight. But these guys also have extra glandular tissue to contend with, which comes from hormonal imbalances that can arise 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. 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 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 says. “In most cases, it can be attributed to gynecomastia. However, it should be mentioned that male breast cancer is a rare cancer that can form in the breast tissue of men.”