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Macromastia: Large breasts cause problems for teen girls

Macromastia (also called gigantomastia) is characterized by excessive growth of the breasts that occurs spontaneously during puberty, pregnancy or while taking certain medications.

The teen years are difficult enough, but for girls who suffer from this condition, the likelihood of eating disorders and low self-esteem are greatly increased.

Girls experience a wide range of growth and developmental changes during their teenage years. No two girls develop at exactly the same rate, but girls who develop unusually large breasts often suffer from low self-esteem as well as physical problems.

What is macromastia?

Also known as gigantomastia, this condition causes the breasts to grow unusually large and symptoms most often appear in adolescent girls. It is not known for certain what causes the abnormal breast growth, but it may be related to an increased sensitivity to hormones. Many women with the condition also have significant asymmetry issues, with one breast being larger than the other. Breasts may also grow quite rapidly, which can be painful in addition to embarrassing. Adolescent girls with macromastia suffer from more breast pain, back pain, neck and shoulder pain, eating disorders and low self-esteem.

Breast-reduction surgery is a commonly performed procedure that improves the physical health and well-being of patients with breasts that are too large, but both physicians and parents are wary of choosing to operate on adolescent girls. While approximately two-thirds of adolescent macromastia patients are overweight, typically weight reduction does not generally affect the size of their breasts.

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Studying the effects

Dr. Brian Labow is a pediatric plastic surgeon in the Department of Plastic and Oral Surgery at Children’s Hospital Boston. Each year, Dr. Labow performs about 100 surgeries on adolescent girls to reduce the size of their breasts. “I wondered, how do you measure the impact of the surgery?” says Dr. Labow. “And do adolescents benefit by waiting until they’re older to get the surgery?” Conventional thinking has been to wait until adolescent girls are older before performing a breast-reduction surgery, which is the most effective way to improve the quality of life for these patients.

Dr. Labow was the principal investigator in a study of almost 100 patients between the ages of 12 and 21 who suffer from macromastia, but who had not yet had breast reduction surgery. The patients were followed through the Adolescent Breast Clinic at the Department of Plastic and Oral Surgery at Children’s Hospital Boston from October 2008 through August 2011. These identified patients were then compared to a control group of patients from the same age group who did not experience macromastia.

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What researchers found

The conclusions of the study suggest that macromastia has a substantial negative impact on girl’s self-esteem, health-related quality of life, physical well-being and eating patterns. Physicians and parents should be aware of the potential benefits of allowing early breast-reduction surgery on both the mental and physical health of adolescent girls. ”They are suffering,” says Dr. Labow. “If you wait about three years after menarche [when a girl’s menstrual periods start], the breasts may grow slightly but not enough to necessitate waiting longer.”

While each patient’s situation is different, the data from this study show that adolescent girls who suffer from unusually large breasts may benefit from earlier breast-reduction surgery, rather than waiting until they are older.

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