![]() ![]() Embarrassment, dissatisfaction with body image, poor self-esteem, and disordered eating habits may be observed in many adolescents, including those suffering from breast hypertrophy. This occurs along with a significant social pressure to fit in. 10 The physical transformations characteristic of adolescence, combined with new personal responsibilities, complex relationships, and a budding awareness of human sexuality may contribute to emotional instability. 21, 23, 30, 31Īs reported in adults with macromastia, adolescents with breast hypertrophy suffer from significant emotional distress. In virginal breast hypertrophy, adolescents will present with extremely rapid breast growth, often accompanied by skin hyperemia, dilated subcutaneous veins, and skin necrosis depending on the growth velocity. 29 Shoulder grooving from brassiere straps, along with skin irritation or intertrigo are also frequently seen. Neck pain, shoulder pain and back pain are frequent complaints. The presentation of breast hypertrophy in adolescents is very similar to that of adults. 28 Further investigation of this association is warranted. 27 In 2002, a study by Li et al on a murine model implicated PTEN gene abnormalities as a possible factor in precocious puberty, excessive ductal hyperplasia, and reduction of cellular apoptosis. 26 Cowden syndrome is characterized by multiple hamartomatous lesions and increased risk of breast, endometrial, gastrointestinal, and thyroid cancer, among other features. There are anecdotal reports of familial cases of virginal breast hypertrophy associated with Cowden syndrome, a rare autosomal dominant disorder caused by a mutation of the PTEN (phosphatase and tensin homologue) tumor suppressor gene located on the long (q) arm of chromosome 10. The majority of adolescents diagnosed with this condition eventually undergo reduction mammoplasty, once the breast size is stabilized. 24, 25 Safety and efficacy of pharmacotherapy in virginal breast hypertrophy is currently unknown. 23 These hypotheses are at the root of pharmacotherapeutic attempts to control this condition, using drugs such as tamoxifen, danazol, or bromocriptine. However, previous studies have found normal levels of estrogen, progesterone, gonadotropins, and growth hormone during this rapid growth phase. ![]() 20 An alternative hypothesis is that there is increased hormonal activity. One proposed theory is an end-organ hypersensitivity to normal levels of gonadal hormones. The underlying mechanism causing juvenile breast hypertrophy has not yet been elucidated. No additional surgery has been performed. Tamoxifen was initiated and stabilization of breast growth has been observed. Recurrence of breast hypertrophy and mastalgia was observed 2 months after surgery. Virginal (juvenile) breast hypertrophy in a 14-year-old girl. ( A) Preoperative, and ( B), 1-week postoperative photographs. 10, 11, 12, 13 When considering reduction mammoplasty in a teenager, an accurate diagnosis and a rigorous treatment plan require a team approach, including pediatric, medical, and surgical disciplines. 2, 3, 4, 5, 6, 7, 8, 9 As plastic surgeons increasingly offer reduction mammoplasty to adolescent girls suffering from breast hypertrophy, a growing number of outcome studies in adolescents are available. ![]() Outcomes of reduction mammoplasty have been well studied in adults. 1 It is unclear whether this reflects an upsurge in the incidence of adolescent breast hypertrophy and/or obesity, or if it is due to a lower threshold for surgical consultation. The demand for plastic surgery procedures among adolescent girls has recently increased, including the demand for breast reduction. Many of these problems can be improved with breast reduction surgery. In addition, physical ailments including back pain, shoulder pain, and intertrigo at the inframammary folds cause further anguish. Social issues arise secondary to poor fitting clothing, trouble exercising, and public scrutiny resulting from their enlarged breasts. Vulnerability to developing a negative body image and the desire to fit in predisposes these female adolescents to significant psychosocial stressors. The development of macromastia in adolescence leads to a deforming and distressing condition during a sensitive period in a girl's life.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |