Many women desire well-developed, proportionate breasts. When breasts become too large, however, they invite a host of unpleasant health problems, such as back/neck pain, rashes, breathing issues, and difficulty exercising. Macromastia is the medical term for abnormally large breasts.
Centers for Neurosurgery, Spine & Orthopedics (CNSO), offers breast reduction surgery and other cosmetic surgeries for patients in northern New Jersey. Learn more about macromastia, the complications it causes, and how women with this condition can find relief.
Macromastia at a Glance
- Macromastia, also called breast hypertrophy, is a recognized medical condition characterized by abnormally large breasts.
- Large breasts can cause chronic back, neck, and shoulder pain, in addition to skin problems, breathing problems, and emotional distress.
- Non-surgical and surgical treatment options exist to treat and manage macromastia.
- Effective treatment or management for macromastia can improve a person’s quality of life and reduce long-term health risks.
What Is Macromastia?
Macromastia, a type of breast hypertrophy, is the medical term for abnormally large breasts. The medical definition of macromastia varies between patients, as different-sized breasts may be considered “too large” on different frames. It has many potential causes. Macromastia may occur due to:
- Sensitivity to prolactin, a hormone associated with breast growth and lactation
- Sensitivity to growth hormones, which influence physical growth and development
- Certain autoimmune conditions, including lupus
- Genetic or hereditary factors
- Extreme obesity
- Other causes
Breast hypertrophy includes both macromastia and its sister condition, gigantomastia. The difference between these conditions is primarily in scale. Gigantomastia is characterized by significantly faster breast growth to larger sizes, with individual breast weights exceeding five pounds. For this reason, it can be considered a more extreme form of macromastia.
Back Pain from Large Breasts: Why It Happens
Back pain is one of the most common health consequences of macromastia. The human body is designed for balanced weight distribution. When weight is spread evenly across the whole frame, the skeleton and muscles can operate most effectively.
Macromastia increases weight disproportionately around the chest. This alters the body mechanics, pulling the center of gravity forward. As a result, the body is forced to adopt a forward-leaning posture to maintain balance. This altered posture creates continuous strain on the muscles in the neck, shoulders, and back. Patients experience chronic pain as a result.
Over time, the compensatory posture may also permanently alter the curvature of the spine. This condition is known as kyphosis. The altered curvature exacerbates back pain with a high risk of causing herniated discs, pinched nerves, and other painful spine conditions.
Other Health Consequences from Macromastia
Back pain is not the only complication of macromastia. Overly large breasts may cause other health consequences due to altered body mechanics, skin chafing, and other disruptions to normal living. These issues include:
- Muscle fatigue
- Tension headaches
- Grooved shoulders from bra straps
- Recurrent skin rashes and infections
- Low exercise tolerance
- Obesity due to reduced exercise
- Reduced mobility
- Shortness of breath
- Sleep disruptions
Living with macromastia can take a toll on a patient’s emotional health as well. Ongoing pain, discomfort, and reduced physical ability can leave a person feeling discouraged about their ability to participate in favorite activities. In addition, the aesthetics of large breasts may attract unwanted attention that results in depression, anxiety, and body insecurities.
Non-Surgical Management of Macromastia
Mild cases of macromastia can be managed with non-surgical treatments. The focus of this approach is on reducing pain and other symptoms to improve the patient’s comfort and quality of life. Different strategies include:
- Medication: Certain medications, including hormone therapies, can stop breast growth. While these do not make the breasts smaller, they do prevent further enlargement.
- Supportive aids: Specialized bras provide additional support and structure to large breasts, which can reduce muscle strain and skin irritation caused by macromastia.
- Physical therapy: Targeted stretches and exercises increase strength and flexibility, helping the body carry heavy breasts more effectively without posture changes.
- Joint injections: Corticosteroid joint injections provide short-term relief for neck and shoulder pain. This strategy is most effective when used alongside physical therapy.
Patients experience varying degrees of success with non-surgical treatment. While some may experience relief, conservative treatments may not help patients with severe macromastia. If non-surgical strategies fail to address macromastia pain, then more aggressive treatment may become necessary.
Surgical Treatments for Macromastia
Macromastia can be directly and permanently treated with breast reduction surgery. This procedure corrects breast size by removing some of the breast tissue and tightening the skin. It is typically performed under general anesthesia, meaning that the patient is asleep during the procedure. While the patient is anesthetized, the surgeon performs these steps:
- Plans a customized patterned incision encircling the areola
- Removes fat, skin, and glandular tissue until the breast is the desired size
- Occasionally employs liposuction to remove fat from certain areas, if necessary
- Removes skin from around the areola to reduce its diameter, if needed
- Repositions the nipple, which remains attached to its original nerves and blood supply
- Layers sutures (stitches) within the breast tissue to shape and support the breast
- Closes the incisions and tightens the skin over the breast
Afterward, the patient is taken to a recovery room while she wakes up from anesthesia. Most patients can go home the same day as their procedure, though they should arrange transportation to avoid driving while drowsy.
Recovery and Results from Breast Reduction Surgery
Some discomfort, swelling, and bruising are common immediately after breast reduction surgery. While these fade after about a week, patients should continue to limit their physical activity for a few more weeks. The breasts will take up to six weeks to fully heal. The surgeon will provide appropriate dressings and a supportive bra to wear during recovery.
While incisional scars fade over time, they will never disappear. However, the patient will have a permanently reduced breast volume and an improved breast shape. They will usually experience significant and permanent relief from back pain, skin irritation, grooving, and body image issues caused by macromastia.
Find Treatment for Macromastia-Related Back Pain Near You in New Jersey
With breast reduction surgery, patients experience long-term relief from back pain caused by macromastia. Centers for Neurosurgery, Spine & Orthopedics is home to an award-winning plastic surgeon, Dr. Hakan Kutlu, who sees patients at CNSO’s Morristown, NJ, location. Contact CNSO today to learn more about macromastia and the treatments available to reduce back pain from large breasts.
Frequently Asked Questions About Macromastia
Is macromastia the same as obesity-related breast size?
Macromastia is not the same as obesity-related breast size. For obese patients, breast size is caused by weight gain and is proportional to the rest of the body. In macromastia, the breast size increases disproportionately to the body.
Can exercise alone fix back pain from large breasts?
Exercise can improve strength and flexibility to help the body support large breasts more easily. While this may reduce back pain, it does not directly address the cause of pain.
Does insurance cover breast reduction surgery?
Insurance covers breast reduction surgeries that are medically necessary, such as those related to symptomatic macromastia. Patients can speak to their healthcare provider about whether breast reduction surgery is medically necessary for them. Each insurance company has its own set of criteria as to who qualifies for the surgery. Photographs and exam results are submitted to the patient’s insurance company for precertification to confirm coverage prior to scheduling any surgeries.
How do I know if my pain is caused by breast hypertrophy?
A medical diagnosis from a board-certified physician is the best way to determine the cause of pain.
