HOW DO I TELL IF MY GYNECOMASTIA IS CAUSED BY FAT OR BREAST TISSUES?

• Enlargement of the male breast  is most often a combination of both glandular tissue and extra fatty tissue. 
  
• The breast gland tissue feels firmer than the fat, but you might not be able to tell the difference. 
• An examination  by a Plastic Surgeon can usually differentiate this.
• Imaging studies such as ultrasound, Xray or MRI can be done to confirm. But an Ultrasound study is simple and cheap and cen give good information
• If you have a very lean body  with hardly any fat, with firm tissue directly behind the nipple/ areola  then chances are this is mostly breast gland tissue.
• My first step in correcting this is to be to check if you are  near your ideal weight and rule out any medical issues that may be treatable without surgery. 
• Medically reversible causes of gynecomastia are uncommon.
• So the best treatment is surgery. Results from surgical management done by a Plastic Surgeon are highly successful and satisfying.