ABSTRACT
TIP: Many patients need 22-24 cm (notch to nipple) or 10-12 cm (nipple to IMF) range for optimal shape.
PATHOPHYSIOLOGY OF HYPERMASTIA n Commonly, normal estrogen levels and number of receptors2
• Suggests abnormal excessive growth in response to circulating estrogens n Primarily an increase in fibrous tissue and fat, relatively smaller increase in glandular tissue
Fig. 48-1 Ideal breast measurements. (IMF, Inframammary fold; INP, ideal nipple plane; MCP, midclavicular point; MHP, midhumeral plane; SN, sternal notch.)
SYMPTOMS n Back pain n Neck pain n Shoulder grooving n Chronic headaches n Numbness in upper extremities (ulnar distribution most common) n Intertriginous infections, rashes, maceration n Cervical or thoracic degenerative joint disease (DJD) in extreme cases n Difficulty with wardrobe
GIGANTOMASTIA (JUVENILE VIRGINAL HYPERTROPHY OF THE BREAST) n Cause is unknown, and endocrine studies are usually normal. n At least 1800 g is removed per breast. n Condition mostly occurs in girls 11-14 years old.
