Hi Dr. Bermant,
I'm the original poster of the query.
Situations unchanged - still haven't bitten the bullet and commited to a gym routine out of fear that it'll make the gland appear more pronounced. Visited a GP (Family Doctor) who told me it was a normal chest shape and he didn't feel anything out of the ordinary, but I can definitely feel the gland marble beneath my nipples. What else would explain the shape of my chest?
Would working out make them look worse - I mean my lower chest in particular is non-existant so might help create a more rounded appearance.
Is it definitely gynecomastia? If so, what surgery would it require - an incision to remove gland or liposuction.
Any help you can offer would be so helpful, I'm at my wit's end and just want to do something proactive about it.
This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.
Welcome to our forum. Thank you for posting your images.
The most critical views for evaluating subtle Puffy Nipple Gynecomastia
would be the obliques and muscles tensed:
Hands on Hips, Muscles Tensed
Puffy nipples comes in various degrees from nothing at all to quite large. In every male the Puffy Nipple Anatomy
will be the same, even someone with a flat chest. There will be gland, fat, and skin. Gland will compress differently than will fat. As one looks through a Puffy Nipple Gynecomastia Picture Gallery
to see other cases, just how one's chest fits in gets a perspective of what is out there.
Some want the curve over the male chest contour to be flat, not pointed over the nipple areola region. Others feel it is a normal anatomic variation. Others need that contour to be flat for activities such as Bodybuilders with Gynecomastia
. Then building more muscle tends to push what gland is there out further or contours become more of a problem flexing muscles that then also push the gland out. For such individuals I would ask then to provide additional relaxed and then flexed muscles arms on hips oblique views as seen in the more advanced Revision Gynecomastia Standard Pictures
If someone had scarring issues then options for a subtle gynecomastia surgery possible intervention would outweigh potential advantages. I have recommended against surgery for individual with such scar issues and similar contour issues. I have operated on other cases, but a real evaluation of if someone is suitable for surgery required so much more information before I would consider offering surgery in my practice to get the results you see.
Bodybuilding can be rewarding in its own. It does not manage gynecomastia, but does help shape the muscle. If gland then becomes a contour issue, then surgery becomes an option. For those not interested in the muscle shaping with exercise but want to see what a rounded shape is like on their chest, there are the No Surgery Body Shaping Garments
that flatten the shape. I posted a series of example of various contours. Look in the mirror and compare to typical cases that I was demonstrating the garment working. The effectiveness is less the more subtle the contour issue to begin with. So if you go that route, posting "before and after" how the garment helps or does not help, can be of benefit to others.
In our office the option was easy. We had the garments there for our patients to try on. Most like the shape and bought them not wanting to take them off. That option to try on is no longer there, but the Second Stage Gynecomastia Garments
are still available online.
Jumping into surgery is not always the best option. Subtle gynecomastia options depend on so many factors beyond what I have discussed as the wrong surgeon or wrong approach can result in a disaster. A surgeon really needs the skill to pull off this type of problem and simple front side view photos just do not tell the entire story of what is going on with how the tissue moves, flexes, and interacts with tissues above or under it.
Hope this helps,
Michael Bermant, MD
Retired Plastic SurgeonLearn More About Gynecomastia and Male Breast Reduction