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Pediatric and adolescent breast hypoplasia
What is pediatric and adolescent breast hypoplasia?
Breast hypoplasia (hy·po·pla·sia) is development of inadequate breast tissue to meet the individual’s expectations of an adequate or desirable breast size. While there is no universally agreed cut off between breast hypoplasia and small breasts, breasts can be considered hypoplastic if there is no breast development, where there is insufficient breast tissue to support breast feeding, or if the amount of breast tissue is small enough to cause significant psychosocial consequences for the individual.
The extent of breast hypoplasia is variable. In some women, breasts do not develop at all, but in most women seeking treatment for breast hypoplasia, the problems faced by these women are psychosocial. Poor self esteem, unwillingness to undress in front of others, being teased by peers, difficulty with their identity as a woman and difficulty with relationships are commonly mentioned.
What are signs and symptoms of pediatric and adolescent breast hypoplasia?
The diagnosis of breast hypoplasia is made clinically by assessing the size and shape of the breasts together with their impact on the different aspects of your life. Depending on the age of the patient and the extent of breast development, testing for hormone levels and review with a pediatric endocrinologist may be recommended.
Signs to look for are that breast development has not started by the age of 13 or by the age of breast development in other women in your family, breasts that have developed into an unexpected shape and breasts that have not developed sufficiently for your expectations of what is adequate or desirable.
What are the causes of pediatric and adolescent breast hypoplasia?
The age at which breasts start to develop and the time taken for breast development is very variable. In most girls, breast development will begin between the age of seven and 14, and be complete between the age of 13 and 18, although there can be a further gradual change in size over the following few years.
Breast development is driven by hormones, most importantly estrogens. Although, in most women with breast hypoplasia, hormone levels are normal, occasionally this condition can be caused by problems with hormone production, regulation or with the breast tissue’s response to the hormones. Identifying and treating this early can result in natural breast development without the need for surgery.
How is pediatric and adolescent breast hypoplasia treated?
Treating breast hypoplasia in children and young women, it is important to realize that breasts can develop at different ages and can take varying amounts of time to reach their final size, so it is important to wait until the natural breasts have developed prior to planning surgery.
We offer a personalized treatment to take into account not only the extent of the condition and how the individual patient is affected, but also to look ahead to how that young woman will grow and develop over time.
Treatment for breast hypoplasia also depends on whether there is a treatable hormonal imbalance, which can be treated medically by a pediatric endocrinologist.
If that is not the case, breast hypoplasia can be treated by:
- Breast augmentation
- Fat transfer
- The Brava® bra - used alone or in combination with fat transfer
When considering any surgery for breast hypoplasia, it is important to appreciate that your breasts will change during your whole life, especially during and after pregnancy, and that especially any technique involving breast implants can give good results to start with, but these results can worsen as your breasts change naturally.
Any young woman undergoing insertion of breast implants is likely to outlive those implants and should expect further surgery to replace her breast implants or to correct any complications from implants over the years.
Pediatric and adolescent breast hypoplasia doctors and providers
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Alex Kane, MD Plastic and Craniofacial Surgeon -
Jessica May, MD Plastic and Craniofacial Surgeon -
James Seaward, MD Plastic and Craniofacial Surgeon
Frequently Asked Questions
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What is a tuberous or tubular breast?
A tuberous breast, also known as tubular breast, is one specific variety of breast hypoplasia, in which insufficient breast tissue develops in certain areas of the breast. Typically, the lower half is underdeveloped compared with the upper half. The breast base, which is the measurement of the width of the breast at the chest wall, is small and the nipple areolar complex (the nipple and the darker colored skin around the nipple) is widened and looks unnatural compared with the overall shape and size of the breast.
The fold under the breast tends to be at a higher position, and the breasts tend to be widely spaced apart. The breast grows forwards and droops downwards, with a lack of fullness to the breast. The cause for this is unknown and it can affect only one of the two breasts, with the other developing normally. Correction of tuberous breasts involves both increasing the overall size of the breast, and correcting the construction in the lower half to allow the breast to widen and develop a full and natural shape.