Gynecomastia is the benign enlargement of male breast tissue. In a true gynecomastia chest, there is a firm disc of glandular tissue sitting behind and around the nipple-areola — it can often be felt as a rubbery lump when the area is pinched. On top of the gland there is usually some fat, and in longer-standing cases the skin stretches a bit too.
Pure chest fat (sometimes called pseudogynecomastia) feels soft all the way through, with no firm disc under the nipple. That distinction matters because the two look similar in a t-shirt but need different operations. Fat-only chests often respond well to liposuction alone. Glandular gynecomastia almost always needs direct gland excision, because liposuction will not remove a firm disc no matter how aggressive the cannula.
The consultation includes a physical exam with the patient sitting, lying, and flexing, along with a check for asymmetry, nipple position, and skin quality. A history of whether the fullness has been stable for years or is still changing also guides planning. For more detail before the visit, the guide on gynecomastia vs chest fat walks through it properly.