Breast Deformities
Male Gynecomastia
Some enlargement of the male breast during puberty is a normal event and is secondary to the hormonal changes taking place. These "normal" enlargements present as a firm tender mass beneath the nipple areolar complex and gradually resolve over the following months or year. Gynecomastia is an extreme variant of this where enlargement of one or both sides may reach female proportions. The breast mass generally consists of a combination of fatty and stromal (glandular) tissue.
The cause of gyencomastia is most often idiopathic, meaning that no hormonal or other identifiable cause can be found. It is sometimes familial involving male family members. Nevertheless, all children with gynecomastia should be evaluated by their pediatrician. This evaluation generally looks for any hormonal or endocrine imbalance and should include a careful exam of the testicles (an embryonal type tumor of the testicle may produce gynecomastia).
Female Enlargement
Enlargement of the female breast is a normal occurrence following puberty, pregnancy, and excessive weight gain. In adolescence this enlargement is generally seen as a post pubescent occurrence but excessive weight may be a contributing factor. Rarely, breast development after puberty may be so extreme as to cause skin break down and bleeding (gigantomastia).
Signs of symptomatic breast enlargement include the gland and nipple/areola complex sagging below the infra mammary fold, intertrigo (dermal rash and skin breakdown) on the under surface of the breast, and deep shoulder grooving. Symptoms may include pain in the lateral suspensory area of the breasts, neck, shoulder, and back pain, headache, and numbness in the hands and fingers.
