Breast hypertrophy

Authors: Mia Demant, MD, Magnus Balslev Avnstorp, MD and Mia Steffensen, MD

Introduction

Breast hypertrophy, characterized by excessive breast tissue development – often bilaterally – presents both functional and aesthetic challenges for patients. As plastic surgeons, a comprehensive understanding of the causes, assessment, surgical techniques, and patient management associated with breast hypertrophy is crucial.

Types and Causes of Breast Hypertrophy

Breast hypertrophy can be classified as either mammary gland hypertrophy or adipose tissue hypertrophy. Causes may include genetics, hormonal influences, weight gain, and pregnancy.

Patient Assessment

Thorough evaluation of breast hypertrophy patients involves:

• Clinical history: Assess the onset, progression, and impact of hypertrophy on the patient’s physical and emotional well-being.
• Physical examination: Determine breast size, shape, asymmetry, skin quality, and the presence of associated symptoms such as back/neck pain or discomfort.
• Psychosocial assessment: Understand the patient’s motivations, expectations, and psychological impact of breast hypertrophy.

Non-Surgical Management

In cases where surgery is not immediately indicated, consider:

• Supportive measures: Encourage patients to use well-fitted bras for improved comfort and posture.
• Physical therapy: Address any musculoskeletal issues related to breast weight.
• Weight management: Advise on healthy lifestyle choices that may alleviate the hypertrophy’s effects.

Surgical Techniques

• Breast Reduction (Reduction Mammaplasty): Remove excess glandular and adipose tissue, achieving proportional breast size and improving functional discomfort.
• Breast Lift (Mastopexy): Address ptosis and sagging by reshaping breast tissue and repositioning the nipple-areolar complex.
• Combined Augmentation-Mastopex: Suitable for patients desiring both size reduction and enhanced breast shape.
• Liposuction: Effective for adipose tissue hypertrophy; suitable for patients with minimal glandular enlargement.