Gigantomastia: Causes, Diagnosis, and Treatment of Big Breasts

Breast Surgery for Gigantomastia or Very Big Breasts

Gigantomastia (also called breast hypertrophy) is a rare condition where a woman develops abnormally large breasts. Gigantomastia is a benign (non-cancerous) condition, and it can happen during puberty or pregnancy. There are several types of gigantomastia, however, the exact mechanism of why they happen is not well understood by doctors.

Since there’s no “normal” breast size, defining a size limit for gigantomastia is a little bit tricky. However, some doctors choose to define it as having an excess of 1 or 2 kilograms of breast tissue on each side. Having very large breasts can become annoying and cause a wide range of problems. It can cause;

  • Neck and back pain
  • Infection in the underboob area
  • Problems with breastfeeding
  • Breast pain
  • Ulcers
  • And, other complications.

There are several treatments for gigantomastia depending on the severity of your condition and the type of gigantomastia you have. Treatment can range from pharmacological agents to surgical breast reduction.

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What are the symptoms of gigantomastia (giant breasts)?

Gigantomastia is defined as excessive growth in breast tissue, and it can affect one or both breasts, causing breast asymmetry. The speed at which the breasts grow to become giant is different depending on each case. In some women, the breasts might grow over years, while in others they might grow over weeks or even days depending on the mechanism. Symptoms associated with large breasts can become debilitating. They include:

  • Neck and back pain from the constant pull by your heavy breasts
  • Breast pain (also called mastalgia)
  • Posture problems
  • Inflammation and itchiness especially in the underboob area
  • Ulceration and skin abrasions
  • Infection or abscess formation
  • Numbness in your nipples from nerve damage caused by constant pressure
  • Saggy breasts -heavy breasts stretch the skin and cause it to become lax, leaving you with large droopy boobs.

In addition to the physical symptoms listed above, having large breasts can also make finding well-fitted clothes and undergarments more difficult. It can also interfere with your day to day life including the ability to play sports or do any form of exercise. To some women, having giant breasts can also be a source of social embarrassment and distress. This in turn can lead to social anxiety, depression, and dissatisfaction with their body image.

Is gigantomastia dangerous?

Gigantomastia is usually a benign condition that can cause minor complications like breast pain, back pain, minor skin abrasions, breast infection, and others. The presentation and severity differ from patient to patient, and symptoms can be very mild and slowly progressive, or they can be severe and develop acutely. On rare occasions, acute breast growth might cause some complications that require urgent breast reduction surgery to treat.

What are the different types of gigantomastia?

Doctors classify gigantomastia into 4 types depending on how and when they happen:

  • Gestational gigantomastia: This is breast hypertrophy that happens during pregnancy. Doctors think that this type of gigantomastia is initiated by the hormonal changes that occur during pregnancy.
  • Juvenile gigantomastia: This is when breast hypertrophy happens during puberty, also thought to be the result of hormonal changes.
  • Drug-induced gigantomastia: Certain drugs have the potential to trigger hypertrophy of the breasts
  • Idiopathic gigantomastia: This is when the trigger of gigantomastia cannot be identified. It is also the most common type of gigantomastia.

Although gigantomastia can be classified according to the above criteria, doctors still are not sure how exactly hormonal changes and drugs can trigger breast tissue to grow uncontrollably.

Will gigantomastia cause problems with breastfeeding?

Breast hypertrophy can pose a problem for many women who want to breastfeed. Several complications of breast hypertrophy can develop after childbirth, such as breast infection (mastitis), reduced milk production, breast pain, and blistering, which can make breastfeeding either very difficult and painful or impossible.

What are the treatments for gigantomastia?

Breast hypertrophy treatment is individualized depending on the severity of symptoms, type of gigantomastia, and speed of breast growth. Here are a couple of examples:

  • If you’re complaining of breast infection (mastitis) or ulcers, your doctor might prescribe topical or oral antibiotics, and recommend that you clean the wounds well and cover them up with sterile gauze.
  • If you have gestational gigantomastia, your doctor may recommend you wait till after delivery, since in many cases giving birth solves the problem.

Some doctors might prescribe a trial of hormone-regulating medications to try and treat gigantomastia without surgery. However, breast reduction remains the cornerstone of treatment and the most effective method of solving the problem:

  • Breast reduction surgery: In general, breast reduction surgery is considered the best treatment for enlarged breasts, and the most effective way to treat gigantomastia. There are different techniques that can be used, and your surgeon will explain this to you during your initial consultation. During breast reduction surgery, your plastic surgeon will perform a skin incision and expose the breast tissue. He/she will cut out and remove excess breast fat until your breasts reach the desired size. After that, the surgeon will cut out the excess skin to pull the wound edges together, giving you firm and perky boobs. Since very large boobs usually become saggy and droopy because of their weight and the effect of gravity, breast reduction surgery is usually combined with a breast lift to improve not only their look but also their shape.
  • Breast reduction can help reduce neck and back pain caused by large breasts, and it can effectively treat the complications of breast hypertrophy.

Learn more about Breast Development Problems and How They’re Treated.

What to expect after breast reduction surgery?

You should expect some pain, bruising, swelling, and bleeding from the wound for the first few days after surgery. Your plastic surgeon will prescribe you some antibiotics to prevent infections and painkillers to control the discomfort. He/she will instruct you on how you should change your wound dressing and will tell you when to come in to have your sutures removed. You should be able to get back to your regular activities within a couple of days after surgery. The change in size is immediately visible after the operation, however, you should expect to lose some more size as the swelling subsides. A few days after surgery, you will start to notice the improvement in your posture as well as a reduction in back and neck pain. This is due to the removal of excessive breast weight pulling down on them.

Does breast reduction surgery leave a scar?

Breast reduction surgery does leave a small scar, usually on the underside of your boob. You should know that our surgeons use the most delicate techniques possible to reduce scar visibility, however, having a small scar after surgery is unavoidable. The scar should fade into the surrounding skin over a few months and it usually takes its final shape and colour around 1 year after surgery.

For more information about Skin and Scar Management, click here.

Gigantomastia is a rare condition that affects some women during certain periods of their lifetime. Treatment for gigantomastia is usually the same as that for naturally large breasts; by performing breast reduction surgery. Breast reduction surgery is very effective in treating breast hypertrophy and will help relieve the symptoms associated with large breasts.

Further Reading and Medical Sources: