Gynecomastia, commonly known as “man boobs,” is a condition where males develop excess breast tissue. This can be a source of embarrassment and discomfort for many men, affecting their self-confidence and quality of life. While gynecomastia can sometimes resolve on its own, in other cases, medical intervention may be necessary.

Until recently, the only real solution for gynecomastia was surgery. However, thanks to recent advancements in fat reduction technologies, like CoolSculpting, individuals with mild to moderate gynecomastia can potentially achieve a chiseled, masculine chest without surgery. But can CoolSculpting truly and effectively treat gynecomastia? That’s more complicated.

To understand if CoolSculpting can treat gynecomastia, you must understand some key concepts about what gynecomastia is, what it isn’t, and how CoolSculpting works.

What is (and isn’t) gynecomastia?

Gynecomastia refers to the enlargement of glandular tissue in the male breast, leading to a more feminine appearance commonly known as "man boobs." This condition can arise due to hormonal imbalances, certain medications, obesity, or underlying medical conditions. Hormonal fluctuations, such as an imbalance between testosterone and estrogen levels, can trigger the development of excess breast tissue. Additionally, certain medications can also contribute to gynecomastia by disrupting hormonal balance.

Actual gynecomastia vs. pseudogynecomastia

It's essential to differentiate between actual gynecomastia and pseudogynecomastia when considering treatment. Actual gynecomastia involves the enlargement of glandular tissue in the male breast, whereas pseudogynecomastia is characterized by excess fat accumulation in the chest area. You can have gynecomastia even if you’re close to your ideal weight, but pseudogynecomastia is mostly caused by excess fat deposits in the chest.

Pinchable fat is a common sign of pseudogynecomastia

To assess if you have gynecomastia, start by examining the texture of the excess tissue in your chest area. Pinchable fat that feels soft and doughy is often indicative of pseudogynecomastia, where excess fat accumulates in the chest. In contrast, if you feel firm or rubbery tissue beneath the nipple, it may suggest actual gynecomastia, characterized by enlarged glandular tissue. Some may also have a combination of both — excess glandular tissue and excess fat.

The characteristics of gynecomastia:

• Enlargement of glandular tissue in the male breast
• Presence of firm or rubbery tissue beneath the nipple
• Often affects both breasts but can be unilateral (one-sided)
• May be accompanied by tenderness or sensitivity in the breast area
• Can result in a more feminine or swollen appearance of the chest

The characteristics of pseudogynecomastia:

• Excess fat accumulation in the chest area
• Soft, pinchable fat that feels doughy to the touch
• Typically not associated with firm or rubbery tissue beneath the nipple
• May be unilateral or bilateral
• Often caused by obesity or weight gain

What is CoolSculpting, and can it treat gynecomastia?

CoolSculpting is a non-invasive cosmetic procedure that targets and reduces stubborn pockets of fat in various areas of the body. Using controlled cooling technology, CoolSculpting freezes fat cells, causing them to crystallize and eventually die off. The body then naturally eliminates these dead fat cells over time. CoolSculpting is commonly used to treat areas such as the abdomen, flanks, chin, and chest (in men) to contour the body and achieve a more sculpted appearance without surgery.

CoolSculpting is only used for targeted fat reduction

CoolSculpting specifically targets and reduces localized pockets of fat in various body areas. While it is highly effective at contouring specific areas such as the abdomen, thighs, flanks, and chin, it is not intended for overall weight loss or the removal of excess glandular tissue. Instead, CoolSculpting is best suited for individuals who are close to their ideal body weight but struggle with stubborn areas of fat that resist diet and exercise.

So, what does that mean for gynecomastia?

For gynecomastia, CoolSculpting offers a non-invasive solution that targets excess fat in the chest. While it effectively treats pseudogynecomastia, where the appearance of man boobs is caused by excess fat accumulation, it doesn’t address glandular tissue enlargement. In cases where glandular tissue is present, a combination of CoolSculpting and other treatments, such as hormone therapy or surgical options, may be more effective for achieving the desired results.

How does CoolSculpting treat pseudogynecomastia?

CoolSculpting treats pseudogynecomastia through cryolipolysis. During treatment, controlled cooling is applied to the targeted area on the chest using specialized applicators. The cold temperature selectively freezes and damages fat cells in the chest without harming surrounding tissues. Over time, the body's natural inflammatory response clears away the damaged fat cells, leading to a reduction in fat volume and an improved chest contour. This process effectively eliminates excess fat deposits and reshapes the chest without surgery.

CoolSculpting only works on mild to moderate pseudogynecomastia

CoolSculpting can effectively treat pseudogynecomastia caused by mild to moderate volumes of excess fat, i.e., if you are already close to your ideal weight. However, CoolSculpting is not a total weight loss procedure, and there’s a limit to the volume of fat cells it can reduce. If you are significantly overweight or obese, you may need to consider other weight loss methods, such as diet, exercise, and potentially surgery, before considering CoolSculpting.

CoolSculpting can treat gynecomastia if:

• The predominant concern is excess fat accumulation in the chest area (pseudogynecomastia) and
• not excess glandular enlargement (gynecomastia).
• You have mild to moderate pseudogynecomastia, characterized by localized fat deposits.
• You are close to your ideal body weight but struggle with stubborn areas of fat.
• There is no significant glandular tissue enlargement present.
• You are seeking a non-invasive alternative to surgical procedures for fat reduction.
• You are willing to undergo multiple sessions (usually 3 to 5)  to achieve optimal results.

CoolSculpting is a promising non-invasive option for individuals with excess fat deposits in the chest that are resistant to diet and exercise, which may be called pseudogynecomastia. It’s not suitable for actual gynecomastia, which is caused by excess glandular tissue and can only be treated through surgery. At Genesis Lifestyle Medicine, our providers will carefully evaluate your chest to determine which of the two categories you fall under and if you’re a suitable candidate for CoolSculpting. Please schedule a consultation to explore your CoolSculpting candidacy.