What the Physical
Exam for Gynecomastia Reveals
During the initial consultation for male breast reduction, Dr. Miguel Delgado, M.D. will review the patient’s history and will try to determine the cause for the development of female type breasts. In a blog posted previously, what is covered at the initial consultation is reviewed. That blog can be viewed here. The blog states that Dr. Delgado will perform a physical exam. This blog is to explain what takes places during the physical.
First, Dr. Delgado will determine if the patient has “pseudogynecomastia” (caused by fat alone) or “true gynecomastia” (a combination of fat and breast tissue.) On the exam table, having the patient lay flat on his back, allows Dr. Delgado to use his forefinger and thumb to gently pinch the area around the areola. He is looking to see if he can feel a firm disk-shaped amount of tissue. If there is not any firmness but it is just soft and pliable, the patient most likely has “pseudogynecomastia” which can be resolved by liposuction or in some cases non- surgical CoolSculpting. If breast tissue is felt, this would be an indication of “true gynecomastia” requiring surgical incision of the tissue along with some liposuction.
Secondly, Dr. Delgado will be checking for any nipple discharge and if there is any enlargement of lymph nodes in the armpits and/or breasts. Asymmetry or lumps in the testicles may be a sign for additional tests. Breast cancer in men is quite rare, and most lumps are benign, however swelling of the breasts can be caused by testicular cancer and in some cases, further testing may be recommended. During surgery, if warranted, Dr. Delgado may determine that tissues samples should be sent to pathology.