At Plastic and Craniofacial Surgery for Infants and Children, we treat many boys and girls with breast deformity, including male gynecomastia, female enlargement, and female underdevelopment. To learn more about breast deformities and treatment options for abnormal breast development, request a consultation online or call us at (469) 375-3838 to schedule a time to meet with our skilled team. You can also learn more on our Treatment Options page.
Some enlargement of the male breast during puberty is normal, 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 gynecomastia 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).
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.
A failure of the breast to develop following puberty may result from an absent or hypoplastic breast bud. This may be seen as a variant of Poland’s syndrome and may include a failure of the underlying pectoralis muscle to develop as well as deformity of the chest wall. The opposite breast may be normal or demonstrate compensatory enlargement. With compensatory enlargement the breast fold also drops, making eventual match more difficult.