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Pseudogynecomastia : Causes, Diagnosis & Treatment Options

An A-Z guide about pseudogynecomasia covering causes, diagnosis and treatment options.

Pseudogynecomastia : Causes, Diagnosis & Treatment Options2019-03-04T06:17:05-05:00

What Is Pseudogynecomastia ?

The word pseudogynecomastia is a combination of two words: pseudo and gynecomastia. Pseudo means false or masking something else. So pseudogynecomastia means false gynecomastia or something that masks itself as gynecomastia but is not gynecomastia. In the case of pseudogynecomastia, the look and feel of gynecomastia is not as a result of excess breast tissue but stubborn pectoral fat accumulation [1]. How a male chest will look in the case of gynecomastia and pseudogynecomastia is more or less the same.

what is pseudogynecomastia

Gynecomastia has its own underlying etiology and definite characteristics [2]. It is recommended that you have a clear understanding of gynecomastia to know about pseudogynecomastia as they are inter-connected [3]. This is required because, treatment of pseudogynecomastia is different from that of gynecomastia [4,5]. If you haven’t read the definitive guide to gynecomastia, then I recommend you read that first and come back here to continue reading about pseudogynecomastia.

Pseudogynecomastia Or Lipomastia Or Adipomastia

Pseudogynecomastia is the commonly known name for breast enlargement in men due to chest fat. The appropriate clinical terms are lipomastia or adipomastia [1,6]. When men find out that they have unusually larger chest mass than other men of their age and size, probably the first thing that comes to their mind is gynecomastia. However, not all breast enlargement in men are caused as a result of excessive breast tissue growth or gynecomastia and it can be caused by chest fat as well. For the sake of clarity, medical science classifies pseudogynecomastia and gynecomastia as the two distinct types of breast enlargement in men. However, in practice, most cases of gynecomastia has some chest fat as well, with the two combining to form breast enlargement.

How Many Men Have Pseudogynecomastia

incidence of pseudogynecomastia

The incidence of pseudogynecomastia must be seen in conjunction with the rise in the number of men who are obese. Let’s take a look at the numbers. As per latest available statistics from the The National Institute of Diabetes and Digestive and Kidney Diseases, 1 out of 3 adults are obese and 1 out of 20 are considered to be extremely obese [7]. Chest and abdomen are two of the most fat prone areas of our body and this fat accumulation will for sure reflects the growing number of men with chest fat. So translating these statistics, 1 out of 3 adult men will have above normal levels of chest fat and 1 out of 20 adult men will extremely high levels of chest fat. Click here for the latest statistics.

Of Men Have Some Pseudogynecomastia
Of Men Have Severe Pseudogynecomastia

What Causes Pseudogynecomastia

There is a simple superficial answer and there is a complex answer that explains the root cause and process that results in pseudogynecomastia. The simple answer is that there is an excess intake of fat into the body and it stores the excess fat behind and around the areola (nipple). This gets built up over time since the chest is one of the least kinetic part of our body.

cause of pseudogynecomastia

The root cause of pseudogynecomastia is a little complex and the main factors that come into play are high estrogen levels, low testosterone levels and low metabolism [8]. Whenever there is a concentration of body fat in the chest among men, there is the inseparable aspect of high levels of estrogen. It is commonly agreed in the medical world that there is a direct correlation between body fat and estrogen in men [9]. When you have high levels of estrogen in your body, it predisposes the body to retain more fat in the chest. This is because estrogen being the female hormone signals the body to retain more fat and store it in the chest [10,11].

the negative feedback loop that causes gynecomastia

The stored chest fat also produces an enzyme called aromatase and it converts even more testosterone to estrogen [12]. The process of conversion of male hormone testosterone to female hormone estrogen is called aromatization [13]. By producing the enzyme aromatase, chest and abdominal fat also acts as a secondary gland that produces estrogen. When you have excess estrogen, it also leads to even less production of testosterone and low metabolism. All of this becomes a negative feedback loop creating even more estrogen and this estrogen dominance signals the body to develop feminine features like breast tissue and fatty deposits in the chest.

Pseudogynecomastia VS Normal Male Breast Anatomy

The illustration below shows the difference in anatomy and appearance of a normal male chest and someone with very high deposit of pectoral fat. By normal chest, I am implying a chest make up with low or no fat deposit.

An illustration showing the difference between pseudogynecomastia and normal male chest

Difference Between Pseudogynecomastia & Gynecomastia

The illustration below shows the anatomical difference between breast enlargement caused by breast tissue growth as well as chest fat. If you look at the outward appearance, you can see that no matter what the underlying matter is, it looks pretty much the same and that is why it is very important to find out the underlying matter.

An illustration showing difference between gynecomastia and pseudogynecomastia

Breast Enlargement In Majority Of Cases

The classification of breast enlargement into gynecomastia and pseudogynecomastia are primarily theoretical and for the sake of clarity.  In majority of cases, breast enlargement is caused by a combination of chest fat and breast tissue [14]. This happens because of the negative feedback loop between high estrogen and fat [15]. High estrogen causes the body to retain excess fat in the chest and this excess fat then produces the enzyme aromatase that converts testosterone to estrogen [16]. This excessive production of the female hormone estrogen then causes development of feminine features and one of which is breast tissue [17]. This is why majority cases of breast enlargement in men is a mix of breast tissue and chest fat [3].

mixed gynecomastia

First Things First

diagnosis of pseudogynecomastia

The main difference between pseudogynecomastia and gynecomastia is the underlying mass that leads to the feminization of the male breast. In the case of gynecomastia, what leads to the feminization of male breast is the growth of excessive breast tissue. However, if it is pseudogynecomastia, the underlying mass is not breast tissue but chest fat [1]. So if you think that you have gynecomastia just because you have a chubby chest, the first thing that you should make sure is that it is in fact gynecomastia. It is recommended that you consult with a doctor who specialises in male breast reduction for accurate diagnosis.

Diagnosis Of Pseudogynecomastia

One of the common misconception that you may have is that all breast enlargement is gynecomastia or breast tissue. The first priority should be to understand what is causing it. If you can, you should always consult a doctor who specializes in the treatment of breast enlargement in men and he/she should be able to tell you what the composition (how much of it is breast tissue and how much is fat) of the underlying matter behind the areola (nipples). Your family doctor can also diagnose it but if possible, seek the help of a surgeon who specialised in breast reduction surgery [18].

An image of a doctor diagnosing pseudogynecomastia through physical examination

The classic approach to diagnosing the underlying matter that is causing enlargement of the chest and areola (nipple) is through physical examination. Imaging tools like scanning are usually done when physical examination does not lead to a definite conclusion.

The patient lies flat on his back with his hands clasped beneath his head. Using the separated thumb and forefinger, the examiner slowly brings the fingers together from either side of the breast. In patients with true gynecomastia, a rubbery or firm mound of tissue that is concentric with the nipple–areolar complex is felt, whereas in patients with pseudogynecomastia, no such disk of tissue is found.

Physical Examination Findings

 Gynecomastia Pseudogynecomastia
A mass under the nipple area of the breast with or without pain when touched or squeezed. Breast enlargement involves the both breasts equally and evenly, without pain during palpation.

How To Get Rid Of Chest Fat

Treatment options for pseudogynecomastia depends on factors like how fast you want the results, how much you are willing to pay etc. I am using the word treatment in the broadest sense here and this includes options that may not come under the purview of medical or clinical treatment in the strictest sense.

Workouts To Lose Chest Fat

How To Do Workouts To Lose Chest Fat

Since pseudogynecomastia is caused by fat accumulation in the chest and especially behind and around the nipples, one relatively cost effective way to get rid of it is to incorporate workouts that target the upper chest into your routine at the gym. One thing that is worth and relevant mentioning here is that we are looking at fat loss and NOT muscle building. So the key with these workouts are that they have to be less/low weight and more/high frequency. All of the below workouts are for the upper chest and they are designed to pull up and burn fat from the lower chest and to flatten and  shape the chest. Below are some workouts that you can do at home and in the gym. You do not have to do all of them and a few of them can be done at home with a pair of dumbbells [23].

Dumbbell Pullover

A man performing dumbbell pullover workout to lose chest fat

Incline Bench Dumbbell Press

A man performing incline bench dumbbell press workout to lose chest fat

Incline Bench Barbell Press

Incline bench barbell press workout to lose chest fat

Smith Machine Incline Bench Press

A man performing smith machine incline bench press workout to lose chest fat

Decline Push Ups

A man performing decline push ups workout to lose chest fat

The dedicated page for workouts for pseudogynecomastia has animated illustrations of how to properly perform these workouts along with detailed instructions. It also has a frequently asked questions section that covers all aspects of workouts to lose chest fat.

Workouts To Lose Chest Fat

Compression Shirts

compression shirts for pseudogynecomastia

Gynecomastia shirts for men are another option to temporarily hide the visual effects of pseudogynecomastia [17,19,24]. If you have an event coming and you are concerned or does not have the time to workout in the gym or try the pills or cannot afford surgery, compression shirts are the logical solution. They also help you feel, though temporarily, what it is like without pseudogynecomastia or gynecomastia even before you workout, take the pills or go for surgery [17,19]. I always recommend my readers on this site to buy a compression shirt and realize the instant change and boost in self-confidence that they can get. offers absolutely free shipping and free returns on a wide variety of gynecomastia shirts and take a look at the selection if you are interested. Click here to browse the selection.

An image of a man wearing a compression shirt to hide pseudogynecomastia
  • Compression shirts are ideal if you want a fast yet temporary result.

  • Ideal for formal use or any event where you do not have to take your shirt off.

  • By using a compression you can see how it looks like if you lose your chest fat without actually losing it.

  • Compression shirts are affordable and you can get a branded compression shirt for less than $30.

  • Their main disadvantage is that the effect is only temporary and also, you cannot use it anywhere you have to take your shirts off as that will only attract even more attention.

Browse Compression Shirts @ Zappos

Supplements Custom Developed For Chest Fat

One of the fastest growing segments in the supplement industry are speciality natural supplements that are developed to burn off chest fat. There are a number of products that have come to the market but only two have survived the test of time. Currently, Gynexin and Gynectrol are the market leaders in supplements to burn off chest fat. Both supplements have almost the exact same ingredients. The main difference is that Gynexin’s formula and ratio of ingredients is proprietary and Gynectrol’s formula is open to the public. Below are the main ingredients.

No Ingredient What It Does
1 Sclareolides May suppress adipogenesis and lipogenesis activity, improve sexual function
2 Guggulsterone May increase the function of thyroid gland, which may increase lipolysis
3 Theobromine Cacao May modulate the immune response and has anti-inflammatory and anticarcinogenic properties
4 Caffeine Enhances focus and provides energy [25]
5 Chromium Reduce insulin resistance and to help reduce the risk of cardiovascular disease and type 2 diabetes [26]
  • Custom Developed To Burn Chest Fat

  • Balances Estrogen

  • Can Be Used Individually Or Stacked With Other Cutting Supplements

  • Natural & Safe Ingredients

  • Is a nutrient and not a therapeutic agent and therefore will only be of benefit to those whose problems are due to suboptimal intake of ingredients.

A-Z Guide To Supplements

Pseudogynecomastia Surgery

pseudogynecomastia surgery

Surgery is another way to get rid of pseudogynecomastia [1,18]. The procedure is fast and the effects are instant when done by a surgeon specialised in breast reduction surgery [16]. One of the issues that pulls people back from undergoing surgery is the cost [20] because surgery for pseudogynecomastia is considered as cosmetic and is not covered under medical insurance. However, there are a number of companies that finance cosmetic surgery and you can have your dream chest now and pay for the surgery later in small monthly instalments. Read the breast reduction surgery for men page for more information.

  • Pseudogynecomastia surgery is the most personalised treatment you can get.

  • You will get the individualised care and surgery planning and the surgeon will discuss with you what to expect after the surgery.

  • The surgeon will carefully analyse your physique and chest contour and will make sure that the overall contour of your chest after the surgery matches with the overall contour of your body.

  • You are looking at anywhere between $4000-7000 for pseudogynecomastia surgery and this can be a financial burden for some.

  • Pseudogynecomastia surgery is considered as cosmetic and as such is not covered by medical insurance.

an image of a gynecomastia surgeon

Pseudogynecomastia surgery and gynecomastia surgery follows more or less the same pattern and costs almost the same [20]. The only difference is in the procedure used to take out the underlying fat. The procedure used for pseudogynecomastia surgery to remove excess pectoral fat is called liposuction [21,22]. The procedure used to cut and remove excess breast tissue for gynecomastia surgery is called excision. In medical parlance, breast reduction surgery in general is called is called reduction mammoplasty. For more information about other aspects of surgery, take a look at the dedicated page for breast reduction surgery.

Learn More About Surgery

CoolSculpting (Future Technology)


Coolsculpting is a new and emerging procedure for burning fat by means of controlled cooling [27,28]. According to its inventors, coolsculpting is effective in even burning off the stubborn fat that have stayed even after diet changes and rigorous workouts [27]. It is not currently cleared for pectoral fat but is something that holds immense potential for those with pseudogynecomastia once it is cleared by the FDA for pectoral fat.

Difference Between Gynecomastia And Pseudogynecomastia

Pseudogynecomastia and gynecomastia looks pretty much the same and there are also some other similarities between them. Compression shirts are also the same for gynecomastia and pseudogynecomastia. Surgeons that perform breast reduction surgery be it gynecomastia or pseudogynecomastia, are also the same. However, there are some significant differences between aspects of gynecomastia and pseudogynecomastia. I will list them in the table below for clarity.

Difference Gynecomastia Pseudogynecomastia Or Lipomastia Or Adipomastia
Definition Excessive growth of breast tissue behind and around the areola (nipple). Excessive accumulation of pectoral fat behind and around the areola (nipple).
Cause Excess estrogen. Excess fat stored as pectoral fat.
Visibility Depends on grade. See grades of gynecomastia for more information. Depends of how much fat has been accumulated.
Underlying Matter Breast tissue. Fat or pectoral fat to be specific.
Diagnosis Your family doctor can but best done by a surgeon specialising in gynecomastia surgery. Your family doctor can but best done by a surgeon specialising in breast reduction surgery.
Surgical Technique The surgical technique used is called excision. Surgical technique used is called liposuction.
Treatment options Compression shirts, supplements and gynecomastia surgery. Compression shirts, workouts that specifically targets chest or pectoral fat, speciality chest fat burners and pseudogynecomastia surgery.

Medical Review Team

Medical reviewer at Gynecoma.comThe content of this page was fact-checked and medically reviewed by Dr.Sergii Vasyliuk MD on October 22, 2018. You can read more about Dr.Sergii Vasyliuk MD and his credentials at our about us page.

The content of this page was fact-checked and medically reviewed by Dr.Marija Petkovic MD on December 19, 2018. You can read more about Dr.Marija Petkovic MD and her credentials at our about us page.



Suggested Further Reading

a-z guide to breast reduction supplements for men

compression shirts for men with gynecomastia

a definitive guide covering everything on gynecomastia surgery cost

an image of a doctor explaining the different available gynecomastia treatment options

a detailed guide about causes of gynecomastia

what is man boobs

the best workouts to lose chest fat for men

a-z guide to gynecomastia surgery

causes and frequently asked questions about gynecomastia in teenagers

a-z guide to breast reduction supplements for men

a comprehensive guide to post cycle therapy to get rid of gynecomastia

the main requirements to get insurance coverage for gynecomastia surgery

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