Juvenile gigantomastia: Subcutaneous mastectomy with primary reconstruction

Abstract

Introduction. Gigantomastia is one of the most severe anomalies of the female breasts and is caused by their pathological enlargement. Juvenile gigantomastia (JG) of the breasts is a rare disease of an unknown etiology characterized by a sudden and alarmingly rapid, continued growth of the breasts in puberty. Case report. We present two patients with massive bilateral JG. Both patients had normal hormonal status and denied any other health issues, including a positive family history of gigantomastia. The skin overlying the breasts was red, without ulcerations, and with visibly enlarged superficial veins. The nipples were not well defined from the surrounding skin and were positioned below the level of the umbilicus. Patients were successfully treated with a surgical technique consisting of a bilateral subcutaneous mastectomy with the primary reconstruction of the breasts using polyurethane implants and reconstruction of the nipple by the free nipple graft technique. The histopathological reports from both patients’ biopsy specimens presented diffuse hyperplasia of the glandular and stromal tissue. Both patients had excellent esthetic results with minimally visible postoperative scars. Conclusion. Surgical management of JG is the primary means of treatment. This paper presents significant results and effects of plastic surgery, and the applied surgical method can be recommended for the successful management of JG.

Keywords

• breast
• juvenile gigantomastia
• subcutaneous mastectomy