OVERVIEW

What is Macromastia?

Macromastia refers to excessive development of one or both breasts, resulting in abnormally enlarged breast volume. Generally, a unilateral breast volume exceeding 1500mL is considered macromastia, while a volume exceeding 400mL is termed breast hypertrophy.

Pathologically, macromastia is classified into simple and complex types. Simple macromastia involves normal hyperplasia of breast tissue, whereas complex macromastia is accompanied by other breast lesions such as fibroadenomatosis or giant fibroadenoma.

Is Macromastia Common?

Macromastia is clinically rare, and its exact incidence remains unclear, with complex macromastia being particularly uncommon. However, cases have shown an increasing trend in recent years.

SYMPTOMS

What are the common manifestations of macromastia?

• Frequent shoulder and back pain, chest tightness with dyspnea (respiratory distress) in the supine position, and even limited mobility or spinal deformity.

• Due to persistent sagging, the skin of the inframammary fold repeatedly rubs against the chest wall skin, combined with sweat accumulation, leading to local erosion and infection.

• It may cause varying degrees of psychological disorders, such as depression and anxiety.

Can macromastia develop into cancer?

Patients with macromastia have more breast tissue than average. Additionally, young patients often exhibit abnormal estrogen levels or increased breast sensitivity to hormones, both of which may elevate the risk of malignant breast tumors.

CAUSES

What are the causes of macromastia?

Adolescent macromastia is often associated with high estrogen levels and abnormal sensitivity of breast tissue to hormones. Macromastia in young and middle-aged women is caused by breast changes following pregnancy and lactation.

DIAGNOSIS

Which department should I visit for macromastia?

You should go to the plastic surgery, breast surgery, or general surgery department.

How is macromastia diagnosed?

Diagnosis is usually straightforward based on symptoms and physical examination. Distinguishing between simple and complex macromastia requires a combination of physical examination, breast ultrasound, or mammography.
Specific diagnostic criteria include:

• Congenital medical history;

• Enlarged, tense breasts with tight skin;

• Chest pressure, often accompanied by chronic mastitis and pain;

• Possible skin erosion under the breasts;

• MRI to differentiate from breast tumors.

TREATMENT

How to treat macromastia?

For patients with macromastia, especially adolescent girls and young women, routine testing of sex hormone levels such as estrogen and progesterone should be conducted to rule out endocrine system diseases.

Patients with clinical symptoms such as shoulder and back pain or respiratory distress should undergo surgical treatment to remove part of the breast tissue.

Apart from surgery, do health supplements, breast massage, or yoga have therapeutic effects on macromastia?

Other than surgical intervention, no alternative measures are effective for macromastia. Additionally, unlicensed medical institutions or non-medical personnel providing treatment may cause severe harm to patients and constitute illegal activities.

What are the surgical methods for macromastia? What is the purpose of macromastia surgery?

The most commonly used breast reduction surgeries currently include two main methods: the vertical bipedicle technique and the double-ring technique.

Since breasts are crucial to a woman's aesthetic appearance, surgeons must reshape the bulky and sagging breasts to meet feminine aesthetic standards while reducing their size. The surgery primarily involves removing excess breast volume and skin to reposition the sagging breasts and the nipple-areola complex.

What are the main challenges in macromastia surgery?

The main challenges are, first, ensuring adequate blood supply to the nipple-areola complex, and second, minimizing and concealing scars on the breast surface.

What are the pros and cons of different surgical methods for macromastia? How should patients choose a surgical plan?

• The vertical bipedicle technique allows for the removal of a larger amount of glandular and excess tissue, resulting in a fuller and more upright postoperative appearance, making it more suitable for severe macromastia or significant breast sagging. However, its most notable drawback is visible scarring.

• The double-ring breast reduction technique removes relatively less glandular tissue compared to the vertical bipedicle method and carries risks such as insufficient postoperative blood supply to the nipple or necrosis. However, the double-ring technique is simpler in design, and the incision can be confined to the areola, leaving less noticeable scars. It has now become the most widely used method in China.

The choice of surgical plan should be based on factors such as the severity of macromastia, the degree of breast sagging, and the patient's psychological tolerance. Patients should communicate openly and repeatedly with medical professionals.

What other diseases can breast reduction surgery for macromastia easily cause?

Main complications include wound infection, poor wound healing, liquefaction necrosis of breast tissue, and ischemic necrosis of the nipple-areola complex.

What should patients pay attention to after macromastia surgery?

Before the wound fully heals, patients must follow medical advice to prevent exposure or contamination of the wound, change dressings regularly, and avoid excessive arm abduction or lifting, which may strain the wound.

Can macromastia recur after surgery?

Some patients may experience continued excessive hyperplasia of residual breast tissue post-surgery due to high estrogen levels or heightened sensitivity of breast tissue to estrogen. Therefore, regular follow-ups are necessary, and endocrine therapy or even repeat surgery may be required if needed.

DIET & LIFESTYLE

None.

PREVENTION

Can macromastia be prevented?

Reducing the use of estrogen-based contraceptives and avoiding unverified health supplements can lower the risk of developing macromastia.