What’s the difference between gynecomastia and “pseudogynecomastia”? Are these conditions treated differently? January 25, 2023 Gynecomastia is the presence of excess tissue above the breast gland that causes unwanted volume, whereas pseudogynecomastia is caused by the presence of fat cells in the breast. Typically, most patients who have unwanted “man boobs” have a combination of both. Depending on the type of tissue you have, our surgeons will design a custom treatment plan to achieve your desired results.