Macromastia in adolescence

Macromastia is a deforming, disabling, and painful condition, especially in the adolescent. Multiple procedures have been advocated and are successful for the reduction of breast tissue. In addition, adjunctive therapy with hormones may prevent relapse. The hormonal influences on breast development and the etiology of macromastia remain complex and not well understood. It is safe to surmise that the pathologic condition is multifactorial, with both inherited and acquired aspects. In the various techniques for reduction, it is important to have a clear understanding of vascular and neural innervation of the breast in order to maintain maximum security in reduction without loss of excessive vital tissue. Although both sensory ability and lactation function are diminished with most procedures and eliminated with some, careful planning and patient counseling in all cases should lead to maximal benefit and optimal results.