What is Gynecomastia Tissue Made Of?

Layer of soil undergroundWhat is the difference between normal chest tissue and gynecomastia chest tissue?

It’s important to be aware that the term gynecomastia refers to the appearance of the chest area: it’s not determined by examining the tissue composition of the chest. There is no specific test to diagnose gynecomastia, but simply put, it is the appearance of a female-like chest in a male due to excess tissue. Each case is unique: some men may have obvious breasts while many others may have hard tissue they can feel but the appearance may otherwise be “normal” to most observers.

I have operated on many gynecomastia patients over the years and I can tell you that there are three tissue varieties that can exist singularly or in combination — fibrofatty, fibroglandular and glandular tissue.

I can remove the fibrofatty and some of the fibroglandular tissue with only liposuction, but I cannot remove the glandular tissue, which is most common in men who have used hormones or prohormones. Probably 95% of patients that I see at the Austin Gynecomastia Center have some glandular tissue. For these patients, I usually recommend a small incision around the areola to remove this tissue, which, if left behind, can lead to puffy nipples and a palpable mass.

It is easy to believe that if you have mostly fibrofatty or fibroglandular tissue, you can lose weight or exercise to shrink your gynecomastia, but this is not the case. You may be able to make a small difference but rarely does this guarantee satisfaction. In fact, I have had skinny patients lose a lot of weight only to make their gynecomastia appear more pronounced.

The fact remains that gynecomastia is gynecomastia, and that the type of tissue you have should be of little importance to you as a patient. (After all, you just want it gone.) It matters to me though, as I often adjust my approach to the best treatment based on what I think I will find during your consultation, what I find during the procedure and my vast prior experience with other patients. This is the “art” of gynecomastia.

And don’t be disappointed if I don’t find a lot of glandular tissue in your case: at the end of the day, be happy that your chest has been expertly contoured and that you no longer have gynecomastia.

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Robert Caridi, MD
Diplomate of the American Board of Plastic Surgery
Fellow of the American College of Surgeons (FACS)
Member of the American Society of Plastic Surgeons (ASPS)
Member of the American Society for Aesthetic Plastic Surgery
Founder of the Austin Gynecomastia Center