Breast reduction in teens: it’s complicated

July 24, 2012

Do adolescents benefit by waiting until they’re older to get the surgery?
Do adolescents benefit by waiting until they’re older to get the surgery?

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.


The mission of the American Society for Aesthetic Plastic Surgery (ASAPS) includes medical education, public education and patient advocacy. Plastic Surgery News Briefs are summaries of current stories found through various news and magazine outlets that relate to or mention plastic surgery and cosmetic procedures. The views expressed in these news articles do not necessarily reflect the opinions of ASAPS, but are merely published as an educational service to our members and the general public. For additional information on these subjects and other plastic surgery related topics, please go to www.surgery.org

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About ASAPS
The American Society for Aesthetic Plastic Surgery (ASAPS), is recognized as the world’s leading organization devoted entirely to aesthetic plastic surgery and cosmetic medicine of the face and body.  ASAPS is comprised of over 2,600 Plastic Surgeons; active members are certified by the American Board of Plastic Surgery (USA) or by the Royal College of Physicians and Surgeons of Canada and have extensive training in the complete spectrum of surgical and non-surgical aesthetic procedures. International active members are certified by equivalent boards of their respective countries. All members worldwide adhere to a strict Code of Ethics and must meet stringent membership requirements.

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