The condition in which the male breasts are mainly composed of fatty tissue is called Pseudogynecomastia
Pseudogynecomastia looks much like real gynecomastia but has no medical reason for being there except for the patient being overweight. With genuine gynecomastia there are myriad reasons it occurs, some natural and some medically induced. This can range from side effects from prescription medication, to the use of recreational drugs, onset of puberty, or an underlying medical condition.
Proper diet and exercise are essential and should always be tried prior to male breast reduction surgery and/or breast liposuction. In cases of pseudogynecomastia, this surgery should preferably be done after serious efforts have been made to remedy the problem through weight loss. With pseudogynecomastia, the condition can sometimes be corrected through diet and exercise, however, often the condition does not right itself, and to regain a more masculine chest shape, surgery is needed. Gynecomastia is one of the main reasons that men seek cosmetic surgery today. Since the area surrounding the breast in this type of gynecomastia is mainly fatty tissue, liposuction may offer immediate results.
A common male adipose distribution that is hormonal in nature appears as a circular pattern around the chest and a second area of fat around the abdomen (belt area). This adipose tissue distribution is exaggerated in cases of Pseudogynecomastia, in which the fat may extend to the arm pits and the back.
Large male breasts can be composed of either so called "soft fat," or “hard fat.” In the case of soft fat, liposuction is relatively easy. Hard fat, however, is composed of more fiberous tissue, which may make liposuction more difficult and can increase the possibility of bleeding.
Youth and breast skin elasticity are both factors that may contribute to better results from male breast reduction surgery. In obese individuals the fatty breast tissue may extend into the breast gland tissue and the pectoralis muscle. Liposuction of the breast may have to be extended to the arm pits (axillas) and other areas.
Some men have Male Breast Ptosis (drooping breasts) in where the areola lies below the lower edge of the pectoral chest muscles. This loose skin and lax tissue result from aging, loss of muscle mass, and weight loss. When there is excess skin, breast liposuction combined with excision of the gland may not be sufficient. Breast skin excision may be necessary; a procedure called "Mastopexy."
As with all cosmetic surgery, results will be rewarding if expectations are realistic. As with any surgery, there are some risks which your doctor will discuss with you.