The difference between gynecomastia vs. fat is the breast tissue will feel softer and more pliable when there is no breast glandular tissue. Pseudogynecomastia can be determined during a physical exam with a gynecomastia pinch test.
Pseudogynecomastia will usually occur in men who are overweight. Another symptom of pseudogynecomastia is when male breasts change with weight gain or loss. When true gynecomastia symptoms are present, weight loss will not get rid of male breast enlargement.