Semin Plast Surg 2013; 27(01): 049-055
DOI: 10.1055/s-0033-1347167
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Hyperplastic Breast Anomalies in the Female Adolescent Breast

Erik M. Wolfswinkel
1   Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
,
Valerie Lemaine
2   Division of Plastic Surgery, Mayo Clinic, Rochester, Minnesota
,
William M. Weathers
1   Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
,
Chuma J. Chike-Obi
1   Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
,
Amy S. Xue
1   Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
,
Lior Heller
1   Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
› Author Affiliations
Further Information

Publication History

Publication Date:
23 May 2013 (online)

Abstract

Macromastia in adolescents is multifactorial and usually idiopathic, associated with obesity or hormonal imbalances. Less commonly, it can result from virginal or juvenile breast hypertrophy, a rare condition of unknown etiology, where an alarmingly rapid breast enlargement occurs during puberty. Breast hypertrophy in the adolescent population can have significant long-term medical and psychological impacts. Although symptoms can be severe, many plastic surgeons, pediatricians, and parents are often reluctant to surgically treat adolescent macromastia. However, reduction mammoplasty is a safe and effective treatment and may be the only way to alleviate the increased social, psychological, and physical strain caused by macromastia in adolescents.

 
  • References

  • 1 Larson K, Gosain AK. Cosmetic surgery in the adolescent patient. Plast Reconstr Surg 2012; 129 (1) 135e-141e
  • 2 Cunningham BL, Gear AJ, Kerrigan CL, Collins ED. Analysis of breast reduction complications derived from the BRAVO study. Plast Reconstr Surg 2005; 115 (6) 1597-1604
  • 3 Kerrigan CL, Collins ED, Kim HM , et al. Reduction mammaplasty: defining medical necessity. Med Decis Making 2002; 22 (3) 208-217
  • 4 Kerrigan CL, Collins ED, Striplin D , et al. The health burden of breast hypertrophy. Plast Reconstr Surg 2001; 108 (6) 1591-1599
  • 5 Wagner DS, Alfonso DR. The influence of obesity and volume of resection on success in reduction mammaplasty: an outcomes study. Plast Reconstr Surg 2005; 115 (4) 1034-1038
  • 6 Chao JD, Memmel HC, Redding JF, Egan L, Odom LC, Casas LA. Reduction mammaplasty is a functional operation, improving quality of life in symptomatic women: a prospective, single-center breast reduction outcome study. Plast Reconstr Surg 2002; 110 (7) 1644-1652 , discussion 1653–1654
  • 7 Spector JA, Karp NS. Reduction mammaplasty: a significant improvement at any size. Plast Reconstr Surg 2007; 120 (4) 845-850
  • 8 Mandrekas AD, Zambacos GJ, Anastasopoulos A, Hapsas DA. Reduction mammaplasty with the inferior pedicle technique: early and late complications in 371 patients. Br J Plast Surg 1996; 49 (7) 442-446
  • 9 Spector JA, Singh SP, Karp NS. Outcomes after breast reduction: does size really matter?. Ann Plast Surg 2008; 60 (5) 505-509
  • 10 Cerrato F, Webb ML, Rosen H , et al. The impact of macromastia on adolescents: a cross-sectional study. Pediatrics 2012; 130 (2) e339-e346
  • 11 Lee MC, Lehman Jr JA, Tantri MD, Parker MG, Wagner DS. Bilateral reduction mammoplasty in an adolescent population: adolescent bilateral reduction mammoplasty. J Craniofac Surg 2003; 14 (5) 691-695
  • 12 Evans GR, Ryan JJ. Reduction mammaplasty for the teenage patient: a critical analysis. Aesthetic Plast Surg 1994; 18 (3) 291-297
  • 13 McMahan JD, Wolfe JA, Cromer BA, Ruberg RL. Lasting success in teenage reduction mammaplasty. Ann Plast Surg 1995; 35 (3) 227-231
  • 14 Pruthi S, Jones KN, Boughey JC, Simmons PS. Breast masses in adolescents: clinical pearls in the diagnostic evaluation. Am Fam Physician 2012; 86 (4) 325-326
  • 15 Simmons PS, Jayasinghe YL, Wold LE, Melton III LJ. Breast carcinoma in young women. Obstet Gynecol 2011; 118 (3) 529-536
  • 16 Shannon C, Smith IE. Breast cancer in adolescents and young women. Eur J Cancer 2003; 39 (18) 2632-2642
  • 17 Cruz-Korchin N, Korchin L, González-Keelan C, Climent C, Morales I. Macromastia: how much of it is fat?. Plast Reconstr Surg 2002; 109 (1) 64-68
  • 18 Webb ML, Cerrato F, Rosen H, DiVasta AD, Greene AK, Labow BI. The effect of obesity on early outcomes in adolescents undergoing reduction mammaplasty. Ann Plast Surg 2012; 68 (3) 257-260
  • 19 Denzer C, Weibel A, Muche R, Karges B, Sorgo W, Wabitsch M. Pubertal development in obese children and adolescents. Int J Obes (Lond) 2007; 31 (10) 1509-1519
  • 20 Morimoto T, Komaki K, Mori T , et al. Juvenile gigantomastia: report of a case. Surg Today 1993; 23 (3) 260-264
  • 21 Baker SB, Burkey BA, Thornton P, LaRossa D. Juvenile gigantomastia: presentation of four cases and review of the literature. Ann Plast Surg 2001; 46 (5) 517-525 , discussion 525–526
  • 22 Uribe Barreto A. Juvenile mammary hypertrophy. Plast Reconstr Surg 1991; 87 (3) 583-584
  • 23 Kupfer D, Dingman D, Broadbent R. Juvenile breast hypertrophy: report of a familial pattern and review of the literature. Plast Reconstr Surg 1992; 90 (2) 303-309
  • 24 Sperling RL, Gold JJ. Use of an anti-estrogen after a reduction mammaplasty to prevent recurrence of virginal hypertrophy of breasts. Case report. Plast Reconstr Surg 1973; 52 (4) 439-442
  • 25 Arscott GD, Craig HR, Gabay L. Failure of bromocriptine therapy to control juvenile mammary hypertrophy. Br J Plast Surg 2001; 54 (8) 720-723
  • 26 Lloyd II KM, Dennis M. Cowden's disease. A possible new symptom complex with multiple system involvement. Ann Intern Med 1963; 58: 136-142
  • 27 Ali E, Athanasopoulos PG, Forouhi P, Malata CM. Cowden syndrome and reconstructive breast surgery: case reports and review of the literature. J Plast Reconstr Aesthet Surg 2011; 64 (4) 545-549
  • 28 Li G, Robinson GW, Lesche R , et al. Conditional loss of PTEN leads to precocious development and neoplasia in the mammary gland. Development 2002; 129 (17) 4159-4170
  • 29 Fisher W, Smith JW. Macromastia during puberty. Plast Reconstr Surg 1971; 47 (5) 445-451
  • 30 Ship AG. Virginal and gravid mammary gigantism—recurrence after reduction mammaplasty. Br J Plast Surg 1971; 24 (4) 396-401
  • 31 Griffith JR. Virginal breast hypertrophy. J Adolesc Health Care 1989; 10 (5) 423-432
  • 32 Losee JE, Serletti JM, Kreipe RE, Caldwell EH. Reduction mammaplasty in patients with bulimia nervosa. Ann Plast Surg 1997; 39 (5) 443-446
  • 33 Kreipe RE, Lewand AG, Dukarm CP, Caldwell EH. Outcome for patients with bulimia and breast hypertrophy after reduction mammaplasty. Arch Pediatr Adolesc Med 1997; 151 (2) 176-180
  • 34 Miller BJ, Morris SF, Sigurdson LL , et al. Prospective study of outcomes after reduction mammaplasty. Plast Reconstr Surg 2005; 115 (4) 1025-1031 , discussion 1032–1033
  • 35 Schnur PL. Reduction mammaplasty-the Schnur sliding scale revisited. Ann Plast Surg 1999; 42 (1) 107-108
  • 36 Collins ED, Kerrigan CL, Kim M , et al. The effectiveness of surgical and nonsurgical interventions in relieving the symptoms of macromastia. Plast Reconstr Surg 2002; 109 (5) 1556-1566
  • 37 Blomqvist L, Eriksson A, Brandberg Y. Reduction mammaplasty provides long-term improvement in health status and quality of life. Plast Reconstr Surg 2000; 106 (5) 991-997
  • 38 Coriddi M, Koltz PF, Gusenoff JA. Reduction mammaplasty, obesity, and massive weight loss: temporal relationships of satisfaction with breast contour. Plast Reconstr Surg 2011; 128 (3) 643-650
  • 39 Singh KA, Pinell XA, Losken A. Is reduction mammaplasty a stimulus for weight loss and improved quality of life?. Ann Plast Surg 2010; 64 (5) 585-587
  • 40 Küçükaydin M, Kurtoğlu S, Okur H , et al. Virginal hypertrophy. Case report. Turk J Pediatr 1994; 36 (3) 243-248
  • 41 Ryan RF, Pernoll ML. Virginal hypertrophy. Plast Reconstr Surg 1985; 75 (5) 737-742
  • 42 Hoppe IC, Patel PP, Singer-Granick CJ, Granick MS. Virginal mammary hypertrophy: a meta-analysis and treatment algorithm. Plast Reconstr Surg 2011; 127 (6) 2224-2231
  • 43 Gliosci A, Presutti F. Virginal gigantomastia: validity of combined surgical and hormonal treatments. Aesthetic Plast Surg 1993; 17 (1) 61-65
  • 44 Mayl N, Vasconez LO, Jurkiewicz MJ. Treatment of macromastia in the actively enlarging breast. Plast Reconstr Surg 1974; 54 (1) 6-12
  • 45 O'Hare PM, Frieden IJ. Virginal breast hypertrophy. Pediatr Dermatol 2000; 17 (4) 277-281
  • 46 Zacharin M. Current advances in bone health of disabled children. Curr Opin Pediatr 2004; 16 (5) 545-551
  • 47 Brzozowski D, Niessen M, Evans HB, Hurst LN. Breast-feeding after inferior pedicle reduction mammaplasty. Plast Reconstr Surg 2000; 105 (2) 530-534
  • 48 Cruz NI, Korchin L. Lactational performance after breast reduction with different pedicles. Plast Reconstr Surg 2007; 120 (1) 35-40
  • 49 McCulley SJ, Schaverien MV. Superior and superomedial pedicle wise-pattern reduction mammaplasty: maximizing cosmesis and minimizing complications. Ann Plast Surg 2009; 63 (2) 128-134
  • 50 Lista F, Ahmad J. Vertical scar reduction mammaplasty: a 15-year experience including a review of 250 consecutive cases. Plast Reconstr Surg 2006; 117 (7) 2152-2165 , discussion 2166–2169
  • 51 Berthe JV, Massaut J, Greuse M, Coessens B, De Mey A. The vertical mammaplasty: a reappraisal of the technique and its complications. Plast Reconstr Surg 2003; 111 (7) 2192-2199 , discussion 2200–2202
  • 52 Rohrich RJ, Gosman AA, Brown SA, Tonadapu P, Foster B. Current preferences for breast reduction techniques: a survey of board-certified plastic surgeons 2002. Plast Reconstr Surg 2004; 114 (7) 1724-1733 , discussion 1734–1736
  • 53 Hall-Findlay EJ. Vertical breast reduction. Semin Plast Surg 2004; 18 (3) 211-224
  • 54 Hall-Findlay EJ. Pedicles in vertical breast reduction and mastopexy. Clin Plast Surg 2002; 29 (3) 379-391
  • 55 Hall-Findlay EJ. Vertical breast reduction with a medially-based pedicle. Aesthet Surg J 2002; 22 (2) 185-194
  • 56 Hall-Findlay EJ. A simplified vertical reduction mammaplasty: shortening the learning curve. Plast Reconstr Surg 1999; 104 (3) 748-759 , discussion 760–763
  • 57 Landau AG, Hudson DA. Choosing the superomedial pedicle for reduction mammaplasty in gigantomastia. Plast Reconstr Surg 2008; 121 (3) 735-739
  • 58 Quint E, Engelland A, Strauch B. Management quandary. Breast reduction in the adolescent. J Pediatr Adolesc Gynecol 2004; 17 (2) 147-149
  • 59 Faria FS, Guthrie E, Bradbury E, Brain AN. Psychosocial outcome and patient satisfaction following breast reduction surgery. Br J Plast Surg 1999; 52 (6) 448-452
  • 60 Boschert MT, Barone CM, Puckett CL. Outcome analysis of reduction mammaplasty. Plast Reconstr Surg 1996; 98 (3) 451-454
  • 61 Eggert E, Schuss R, Edsander-Nord A. Clinical outcome, quality of life, patients' satisfaction, and aesthetic results, after reduction mammaplasty. Scand J Plast Reconstr Surg Hand Surg 2009; 43 (4) 201-206
  • 62 Saariniemi KM, Keranen UH, Salminen-Peltola PK, Kuokkanen HO. Reduction mammaplasty is effective treatment according to two quality of life instruments. A prospective randomised clinical trial. J Plast Reconstr Aesthet Surg 2008; 61 (12) 1472-1478
  • 63 Saariniemi KM, Joukamaa M, Raitasalo R, Kuokkanen HO. Breast reduction alleviates depression and anxiety and restores self-esteem: a prospective randomised clinical trial. Scand J Plast Reconstr Surg Hand Surg 2009; 43 (6) 320-324
  • 64 Singh KA, Losken A. Additional benefits of reduction mammaplasty: a systematic review of the literature. Plast Reconstr Surg 2012; 129 (3) 562-570
  • 65 Glatt BS, Sarwer DB, O'Hara DE, Hamori C, Bucky LP, LaRossa D. A retrospective study of changes in physical symptoms and body image after reduction mammaplasty. Plast Reconstr Surg 1999; 103 (1) 76-82 , discussion 83–85
  • 66 Piza-Katzer H. Reduction mammaplasty in teenagers. Aesthetic Plast Surg 2005; 29 (5) 385-390
  • 67 Chadbourne EB, Zhang S, Gordon MJ , et al. Clinical outcomes in reduction mammaplasty: a systematic review and meta-analysis of published studies. Mayo Clin Proc 2001; 76 (5) 503-510
  • 68 O'Blenes CA, Delbridge CL, Miller BJ, Pantelis A, Morris SF. Prospective study of outcomes after reduction mammaplasty: long-term follow-up. Plast Reconstr Surg 2006; 117 (2) 351-358