Breast Hypertrophy Treatment
Skin infection, neck and back pain are some of the discomforts a person with breast hypertrophy or extremely large breasts can experience. People with this condition have breasts that have grown abnormally large and heavy, causing physical and psychological discomfort. Breast reduction surgery may be recommended to help improve a patient’s symptoms and overall quality of life.
What Is Hypertrophy of the Breast?
Breast hypertrophy, also known as gigantomastia or macromastia, happens when one or both breasts develop abnormally large due to excessive tissue growth. This condition primarily affects people with female reproductive anatomy, including those assigned female at birth. Breast hypertrophy treatment is characterized by:
- Breast with an excessive growth of over 3.30 pounds per breast
- Excess breast tissue that’s more than 3% of a person’s body weight
Patients with breast hypertrophy often face some of these problems:
- Breast pain (mastalgia)
- Pain in the neck, upper back or lower back
- Chest wall discomfort and pulmonary problems
- Chronic postural imbalance that may result in spine osteoarthritis or other musculoskeletal changes to the body’s trunk
- Bra strap groove deformity, which is a noticeable dent or depression in the skin between the neck and shoulder. It can be caused by the long-term weight and tension from the brassiere strap for carrying hypertrophied breast/s
- Challenge in finding a comfortable sleeping position
- Excessively large breasts can impede sports, exercise and other physical activities
- Difficulty reaching the inframammary fold (the fold under the breasts) for cleaning, making hygiene a challenge and this area prone to infection
- Trouble finding ready-made clothing that properly fits
Breast hypertrophy may also come with psychological challenges, such as social stigma, low self-esteem and poor self-image.
What Is Breast Reduction Surgery
Breast reduction or reduction mammaplasty is a surgical treatment for breast hypertrophy. It’s a major surgery that involves removing excess skin and breast tissue to achieve a breast size proportional to the patient’s body and alleviate the discomfort that comes with excessively large breasts. You may be a candidate for this procedure if you:
- Experience back, shoulder and neck pain due to the excessive weight of your breasts
- Struggle with many physical activities due to breast size
- Suffer from shoulder indentations from bra straps
- Have irritated skin under the breast crease
- Are bothered by your breast size
- Are healthy overall without life-threatening medical conditions or illnesses that can affect healing
- Are a nonsmoker or do not use vaping products
What To Expect Before Breast Reduction Surgery
During your consultation for breast reduction surgery, disclose to your plastic surgeon the following:
- Medical conditions, previous treatments and any allergies
- Current medications or supplements you’re taking
- Whether you consume alcohol or tobacco
- Family history of breast cancer
- Results of previous mammograms or biopsies
Your surgeon will check your general health status, risk factors and pre-existing conditions. Your breasts will be examined and measured in detail. Photos of the possible surgical site will also be taken for your surgeon’s reference. Your surgeon will thoroughly discuss the procedure’s risks, benefits, preparation and other details to help you set realistic expectations. They will recommend a treatment plan depending on your condition and goals. Take the consultation as an opportunity to ask questions about the procedure.
What Happens During Breast Reduction?
Your surgeon may ask you to do the following to help you prepare for breast hypertrophy surgery:
- Physical examination and lab work
- Breast imaging studies
- Stop smoking and stop using recreational drugs
- Adjust your current medications or take other medications
- Avoid taking medications such as aspirin or drugs that can increase bleeding
Breast reduction surgery generally follows these steps:
- Your surgeon will administer general anesthesia or intravenous sedation, depending on what’s recommended. You will be asleep and pain-free for the entire procedure.
- The type of incisions the surgeon will make on the breast will depend on what’s needed.
- The nipple will be repositioned while remaining connected to its original nerve and blood supply. The areola's diameter will be reduced if needed. Some underlying breast tissue will be removed, and the rest will be lifted and shaped.
- The incisions will be closed with layered sutures deep within the breast tissue to support the breast's new shape. Skin adhesives, surgical tape and/or sutures will be used to close the skin.
You will be taken into a recovery area immediately after surgery for close monitoring. You will be discharged once the doctor evaluates that your condition is stable, usually within the day. Your doctor will prescribe medications and give you instructions to help you with recovery and a follow-up appointment schedule with your plastic surgeon. You may need to wear a support bra during recovery.
What To Expect After Breast Reduction
Each patient’s recovery depends on a range of factors, so there is no definite timeline for what to expect day by day after breast reduction. In general, post-surgery patients may experience the following during recovery:
- Week 1 – It’s normal to experience pain, bruising and swelling within the week of your surgery. You may take doctor-prescribed medications to help ease pain. You will have to significantly limit your physical activity.
- Week 2-3 – Patients generally feel much better within 2 to 3 weeks post-surgery. Your doctor may allow you to return to work depending on the nature of your job. You still have to limit your physical activities and exercises.
- Week 4-5 – You will still need to wear a support bra. Your doctor may allow you to increase your physical activity by this time.
- Week 6 onwards – Continue monitoring your breast for possible abnormalities. By this time, start scheduling routine mammograms with your doctor. You can also start discussing resuming normal activity with your surgeon, and ways to help improve the appearance of surgical scars.
