Adolescence can be a challenging time for teenagers. During that time, their bodies grow and change. These changes can cause teenagers to develop physical, or even psychological, difficulties.
One common area of change in teenagers is the chest area. These changes may include macromastia (excessively large breasts in a teenage girl), asymmetric breasts (breasts that are different sizes or shapes in a teenage girl) or gynecomastia (breast development in a teenage boy).
Macromastia is fairly common. Girls with macromastia may have pain in their back, neck and shoulders. They may develop rashes under their breasts. Sometimes, girls with macromastia become unable to participate in physical activities that they used to enjoy, due to the weight of their breasts.
Breast reduction surgery can improve the symptoms of macromastia. During breast reduction surgery, the size of the breast is reduced, and the breast is lifted. You do not have to be a certain age to qualify for breast reduction surgery, but the surgery should be done after your breasts are done growing.
Everybody has some asymmetry. Breast asymmetry is when the difference in size or shape of the breasts is noticeable. There can be many causes of breast asymmetry. Overall, breast asymmetry is less common than macromastia.
Surgery to improve breast asymmetry varies depending on the type and cause of the asymmetry. It may include reducing the larger breast, increasing the size of the smaller breast, or a combination of both. Similar to breast reduction, you should typically wait until your breasts are done growing before having surgery.
Gynecomastia refers to breast development in a boy. More than half of teenage boys develop gynecomastia at some point. However, most of the time, the breast enlargement goes away on its own. Sometimes, the breasts remain enlarged for more than one year, and in those situations they may not shrink on their own. Gynecomastia can cause significant distress and embarrassment in teenage boys. Sometimes, they may even have breast pain.
Most of the time, gynecomastia does not have a known cause. Sometimes, it can be caused by specific factors, such as certain medications. When you are being evaluated for gynecomastia, it is important that you tell your doctor about any medications or drugs you may be using.
Sometimes you may be seen by an endocrinologist (a physician who treats hormone diseases) before surgery to make sure your hormone levels are normal. Surgery for gynecomastia involves removing the excessive breast tissue. Sometimes, excessive skin has to be removed too.
For all three of these breast conditions, surgery has been shown to improve quality of life and self-esteem in teenagers. When choosing where to get evaluated for these conditions, it is important to choose a team that includes plastic surgeons, endocrinologists and psychologists. It is also important to choose a team that is used to treating teenagers.
Ibrahim Khansa, MD, is a surgeon within the Section of Plastic and Reconstructive Surgery at Nationwide Children's Hospital. Dr. Khansa received his medical degree from Harvard Medical School. He then completed a plastic and reconstructive surgery residency at The Ohio State University Wexner Medical Center, including serving as chief resident. This was followed by a pediatric craniofacial fellowship at Children’s Hospital Los Angeles.
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