ARTICLE

Large breasts and teenagers

Large breasts can take mental and physical toll on teens.

Macromastia can bring teens mental and physical anguish, study finds.

Research has shown that some girls with this condition have physical pain and lower self-esteem.

For a number of years there has been controversy in Australia about whether teenagers should undergo plastic surgery. But when a teenager has been suffering physically and mentally then there can be little doubt that she should qualify for treatment.

A new study recently published in the United Stated by Doctor Brian Labow (who performs about 100 breast reduction operations a year on adolescent girls) examines the impact of large breasts on adolescence girls. This has never previously been studied. He questioned whether adolescents benefited by waiting until they were older to have breast reduction surgery.

Macromastia (gigantomastia) is a common condition treated by plastic surgeons and is one of the commonest operations performed by Mr Allan Kalus at Avenue Aesthetic Surgery. According to the American Society of Plastic Surgeons there were more than 63,000 breast reduction operations performed in the United States in 2011.

Doctor Labow said that girls seeking breast reduction surgery in adolescence typically do so because they have experienced issues such as neck and shoulder pain, low self-esteem, undesired attention and difficulty finding clothes that fit.

Not all girls with large breasts are troubled by them. In fact there are many girls with large breasts who are happy. Of course most teenage girls really don’t want to discuss their breasts with a doctor and are often desparate by the time they arrange a consultation.

Complicating the situation is the fact that many adolescence with macromastia are overweight. Losing weight, however, typically doesn’t resolve the breast size problem.

In this study, 96 girls between the ages of 12 and 21 were surveyed. All were diagnosed with macromastia by a plastic surgeon at the Children’s Hospital Boston but had not had plastic surgery. The control groups were 103 healthy girls in the same age range who were patients in other departments at the hospital and had no identifying breast issues and no history of eating disorders or mental health issues.

Participants in the study answered questions about physical functioning and pain, general health, vitality, social functioning, self-esteem, mental health, body image and eating.

The study concluded that macromastia had a substantial negative impact on health related quality of life, self-esteem, physical symptoms and eating behaviors among adolescents independent of a person’s weight.

Notably, among those who are diagnosed with macromastia, there was triple the risk of eating disorders compared to girls in the controlled group.

Doctor Labow said that the data produced by the study supported the value of permitting girls who seek breast reduction in adolescence to have the procedure at that time rather than making them wait until they were older.

Of course breast reduction surgery does entail some risks and these need to be carefully understood by the patient. The main risks are bleeding and bruising, infection and poor healing leaving unsightly scars. It is important that any girl considering breast reduction surgery understands how her surgeon plans to manage these risks.

For example, nipple sensation may be reduced following breast reduction surgery. Many young women undergoing breast reduction also ask about whether they can breast feed in the future. Fortunately there are breast reduction techniques available which preserve both the nerve supply to the nipple and the ability to breast feed and these are the techniques used by Mr Kalus at Avenue Aesthetic Surgery. Indeed, at Avenue Aesthetic Surgery many of our patients have successfully breast fed their babies following breast reduction surgery.