The mamma, the female breast, is a symbol of nourishment, love and motherhood. But unfortunately, numerous abnormalities can occur in this area. One of them is gigantomastia.
What is gigantomastia?
Gigantomastia (also macromastia, hypermastia or mammary hypertrophy, translated as giant breast) is an excessively large anlage of the female breast. It can be unilateral or bilateral. Due to glandular hyperthonia with accompanying fat proliferation, there is a pathological enlargement of the mamma. According to the textbook, a breast is considered excessive if it exceeds a weight of one thousand grams per side. However, many specialists strongly oppose this criterion, which is much too general, because it does not take into account the individual proportions of the woman’s body. For example, for a woman of 1.50 meters with a body weight of 46 kilograms, a breast weight of 500 grams can already represent a great burden. In affected adolescents, this is referred to as juvenile gigantomastia. The pathological enlargement of a man’s breast is called gynecomastia.
Causes
The causes of gigantomastia are largely unexplained. Factors such as heredity, hormonal changes (for example, during pregnancy or puberty), and obesity, which results in growth of the fat content of the breasts, are discussed.
Symptoms, complaints and signs
The primary symptoms of a giant breast essentially represent severely sagging breasts with a stricken nipple (breast) and enlarged areola. Affected women usually suffer from physical discomfort such as postural problems, neck and back pain due to the weight of the overly large breasts, bra constriction and skin disorders. They may also develop sore skin folds (intertrigo) or mycoses (fungal infections) that settle in the underbust fold area, especially in summer. Furthermore, there may be signs of wear and tear of the cervical and thoracic spine as well as fingers that fall asleep. Frequently, sporting activities and finding a suitable clothing size are a great challenge or hardly or not at all possible. The psychological aspect should not be neglected either. Affected women have the feeling of being stared at and ridiculed by other people, which can result in an unconscious curvature of the posture with which they try to hide the bust. It is not uncommon for this to lead to insecurity, feelings of inferiority, a distorted image of their own body, or even depression. A minimizer bra can protect from prying eyes, but the weight remains and a significant burden on the entire musculoskeletal system.
Diagnosis
A detailed medical history and visual and palpatory findings are used for diagnosis. The breasts are weighed and their size is assessed in relation to the proportions of the patient’s body. For comparison, the preoperative visual findings are also documented with photographs and, if necessary, an ultrasound examination (sonography) is performed.
Complications
Gigantomastia results in very large and drooping breasts. In most cases, the nipple is also greatly enlarged in this condition. Due to the large breasts, most sufferers experience pain in the back and neck due to increased weight on the front of the body. This can cause serious discomfort and pain over a long period of time. Likewise, various skin conditions can develop on the breasts. In many cases, large breasts pose an aesthetic problem, as most patients feel uncomfortable with them. There are feelings of shame, decreased self-confidence and not infrequently inferiority complexes. These symptoms can reduce the quality of life and also lead to psychological complaints and depression. It is also not uncommon for affected women to be looked at excessively, which can lead to severe disorders of consciousness. Treatment does not usually lead to complications. The breasts may be reduced in size or the patient may have to undergo physiotherapy. In case of breast cancer, the damaged regions are also surgically removed. In this case, the further course of the disease depends on the spread of the cancer.
When to go to the doctor?
Since gigantomastia has a very negative impact on the quality of life of the affected person, a visit to a doctor is usually always recommended. Sufferers should then see a doctor if they suffer from a very sagging breast. The nipple itself can also be affected by abnormalities. Usually, these abnormalities do not require treatment if they are only an aesthetic complaint. However, medical treatment for gigantomastia is necessary if the patient also suffers from back pain or severe neck pain as a result. Various skin conditions may also be indicative of gigantomastia and should be investigated. Often, the disease also leads to psychological discomfort or depression, so that those affected are also dependent on psychological treatment. In the first instance, a general practitioner or a gynecologist can be consulted for this condition. However, further treatment depends on the exact symptoms and usually necessitates surgical intervention.
Treatment and therapy
The triggered symptoms, such as tension in the neck and back area, can be relieved by physical measures (physiotherapy, massages). However, this does not eliminate the cause, namely the heavy weight of the breast. This can only be ensured by mammareductionplasty (breast reduction). This significantly improves the patient’s quality of life. The symptoms are often alleviated immediately after the reduction. During this surgical procedure, the breast is reduced to an adequate size and excess tissue is removed. During the operation, the glandular tissue can be removed from the side and upper outer quadrant of the breast as well as from the lower portion. An advantage of removal in the upper outer quadrant is that, according to international studies, patients are less likely to develop breast cancer than those who have had the lower portion removed or those who have not had surgery. A disadvantage of this treatment is the scars that can be seen below the breast after surgery. Since the tissue in women with large breasts tends to be weak due to the heavy weight and the skin is stretched a lot, the inability of the skin to contract sufficiently can result in sagging breasts. It is therefore advisable to have the tissue tightened during the procedure to correct giant breasts and sagging breasts alike. In addition to surgery, additional measures such as targeted back training are recommended. Since gigantomastia is recognized as a breast deformity, in many cases the surgery costs are covered by health insurance. An application must be made to the health insurance company for the costs to be covered. It is advantageous to obtain medical reports for this purpose, which refer to the urgency of a surgical intervention to eliminate the gigantomastia and the problems associated with it. In case of gigantomastia due to severe obesity, conservative therapy in the form of weight reduction and regular gymnastics to strengthen the back muscles is recommended.
Outlook and prognosis
Gigantomastia does not regress on its own. Due to the fact that both breasts together weigh more than 10 kilograms, this quickly leads to posture problems due to an unhealthy relieving posture, as well as back pain and further discomfort due to their extension to other muscles. If the affected woman regularly takes painkillers because of this, they can have a long-term harmful effect on various internal organs, such as the liver and kidneys. If nothing is done about gigantomastia, skin inflammation around the breast also frequently occurs. These are caused by the constant friction of the sensitive skin. Fungal infections in the folds of the body around the breast are also common, especially in the warm season. Sweat, which cannot always be washed away immediately, causes moisture to accumulate under the breast and provides an ideal breeding ground for skin fungus. The only prospect for alleviating the discomfort is a surgical reduction of both breasts that have become too large. Many women welcome this not only to relieve the discomfort, but also because with gigantomastia they often have irregularly sized breasts and this can also be corrected with the surgical reduction.The sooner gigantomastia can be surgically corrected, the better the prospect of a life without permanent postural damage and lasting back and neck pain after surgery.
Prevention
Since the causes cannot be clearly identified, preventive measures can only be taken to a limited extent. Heredity cannot be prevented, nor can hormonal changes. The only risk factor that can be influenced is obesity. Moderate diet and regular exercise can maintain normal weight and prevent excessive increase of fatty tissue on the breast.
Aftercare
With gigantomastia, there are usually no special aftercare options available to the affected person. The patient is primarily dependent on direct treatment of the disease. This is the only way to prevent further complaints or even complications. Self-healing cannot occur in this case. The symptoms of gigantomastia are usually alleviated by physiotherapy or physiotherapy. Many of the exercises from these therapies can also be performed in the patient’s own home, although the help of friends or family is also very helpful. Since gigantomastia also significantly raises the risk of breast cancer, regular examinations of the body should be performed in order to detect a possible tumor disease early and then also to treat it. In some cases, surgical interventions are also necessary to alleviate the discomfort or to tighten the breast. After such an operation, the affected person should rest and take it easy on his or her body. Strenuous activities should be avoided after a surgical procedure, and stressful situations should also be avoided. Possibly, the life expectancy of the affected person is reduced due to gigantomastia.
What you can do yourself
Since the causes of gigantomastia can be very diverse, no general statement can be made about the possibilities of self-help with this condition. However, if gigantomastia occurs after taking certain medications or after a hormonal change, the symptoms can be alleviated by changing the medication. However, this change should only be made after consulting a doctor. Furthermore, a healthy lifestyle with a healthy diet and sports activities can also have a positive effect on gigantomastia. Above all, excessive fatty tissue should be trained off. However, if these measures do not help, those affected are usually dependent on surgical intervention. Since gigantomastia can also have a negative effect on the back, the patient should strengthen the back muscles. Various exercises are available to the affected person, which can also be performed at home. This can also prevent tension in the neck or shoulders. In the case of breast cancer, self-treatment is not possible. Those affected are usually dependent on the support of their friends and family. This can prevent psychological upsets or depression.
