Large breasts can be an asset or a liability. Plastic surgeons describe the condition of having large breasts as “macromastia.” There are teens with large breasts who are prom queens; others suffer physical and emotional discomfort.

Some teens are so burdened by overly large breasts that they seek breast reduction surgery. Philly.com spoke with a pediatric plastic surgeon who performs about 100 breast reduction surgeries a year on adolescent girls. His study on these teens asks one important question: “Do adolescents benefit by waiting until they’re older to get the surgery?”

Adolescent girls seek breast reduction surgery because of neck and shoulder pain, low self-esteem, undesired attention and difficulty finding clothes that fit. But there are teens with large breasts that are happy. Further, it’s not easy to make a diagnosis of macromastia. “A very short girl wearing a “D” cup size bra may be miserable, while a taller teen may feel fine with that size.” 

A further complication is that most teens are uncomfortable visiting a doctor to discuss this problem. “By the time I see them, the breast has become their enemy,” says the doctor. Another factor is that two-thirds of teens with macromastia are overweight. However, weight reduction typically doesn’t resolve the breast-size problem.

Ninety-six girls between the ages of 12 to 21, diagnosed with macromastia, were studied by a plastic surgeon at Children’s Hospital in Boston. The control group was 103 healthy girls with no identified breast issues. Participants answered questions about physical functioning, pain, general health, vitality, social functioning, self-esteem, mental health, body image and eating. They were also asked breast-specific issues such as cup size, breast concerns and if they had considered breast surgery.

The study results suggest that macromastia has a negative impact on health-related quality of life, self-esteem, physical symptoms and eating behaviors among adolescents. According to Philly.com, there is a triple risk of eating disorders in this group compared with the girls in the control group.

Of significance is that the data support allowing girls to get the procedure in adolescence rather than making them wait. He says, “They are suffering. If you wait about three years after menarche, the breasts may grow slightly but not enough to necessitate waiting longer.”

Another prominent plastic surgeon warns that the surgery poses risks. “Especially for those who are overweight, the risks include delayed wound healing, scarring and an unsatisfactory outcome.” Possible side effects include an inability to breast feed and short-term changed in nipple sensitivity. For those reasons, it makes sense to first encourage the teen to lose weight. But that can be difficult, especially since macromastia can make it tough to exercise.

If you’re a teen with this problem, or the parent of such an adolescent, your best bet is to get more information from a board-certified plastic surgeon that has a significant history of dealing with macromastia. For a referral, go to surgery.org, the website of the American Society for Aesthetic Plastic Surgery.