Sometimes there are fatty proliferation of the breasts, without proliferation of glandular tissue.
It is very difficult to distinguish from normal male breast on mammography. It can be diagnosis requires clinical correlation with breast enlargement.
Normal gynecomastia refers to the overgrowth of fat tissue and mammary gland tissue. Pseudogynecomastia refers to the state of mostly fat tissue, rather than mammary gland tissue.
As mentioned above, the true gynecomastia and the pseudogynecomastia differ greatly in their cause. In case of false gynecomastia, the fat is caused by the growth of obesity, etc, But in case of true gynecomastia it is the status which mammary gland is overgrowth.
In case of pseudogynecomastia, if there is little or no development of the mammary gland, and only the fat tissue is overdeveloped, symptoms can be improved by exercise or diet.
However, in the case of true gynecomastia, the symptoms cannot be improved by a diet. Developed mammary tissue does not disappear naturally by exercise. In this case, you will be treated surgically.