A Serious Look At Macromastia Medically From A Victim's ViewpointHaving suffered from this condition for quite a number of years, I am going to to share some of what I have learned. Remember that I am not a doctor or medical professional and that all this is just personal opinion.
Since this condition started in seventh grade, I have been to many many doctors, gynecologists, endocrinologists, plastic surgeons and many other specialties. I have seen top notch doctors in both the US and the UK. Sometimes, I have traveled to distant cities in the US or the UK just to see a specific specialist. I have been examined, probed, scanned, tested and analyzed. So I think I have learned enough to be able to make some observations.
One thing that I have noticed is that macromastia crosses many medical specialties- No one area of medicine focuses on it; this, plus the fact that it is rare, not fatal, and involves mostly (but not entirely) women, has resulted in a minimum of research into macromastia and its treatment and causes. It just isn’t a ‘popular’ condition to study.
Besides the doctors I have seen, I have spent many hours reading all I can about the condition. I believe that I have read almost all the articles available that touch on macromastia. When I read a technical article, I look up the words I don’t understand, so by the time I am finished with it I have a real understanding.
In important addition to this, I have met and become friends-- or at least acquaintances-- with about a dozen other young women with this condition. Some I have met in school or in my local area. Although the approach is difficult or impossible for a man, it is easy for me to approach another girl with macromastia. I have never failed to make a friend of a girl I met and wanted to talk to. The talks almost always starts with clothes and ends with talking about men.
I was a member of an internet group which studied macromastia, now shut down, and I met several girls there. Two of them lived close to me enough for us to get together and I see then about once a month.
There is also another internet group especially for for girls and women with macromastia, and their medical professionals. It is a closed group and is only for women. You have to be authenticated by a doctor to get in. But since it is private, there is a very free exchange of photos, experiences and information. This group is still very active. Three girls from this group who live in the eastern US met for a weekend last month. They got many stares.
Combining the information I have acquired over the years from my own experience and these other sources, I find that there are some obvious conclusions.
It is very important to distinguish between macromastia and simply big breasts. Breast size is on a bell curve like many other things. Breasts can be very large and still be normal breasts. In other words, normal and average are not the same thing. For every AA cup there is a DD cup, so to speak. Big breasts on big (i.e., fat) women are usually not macromastia either. They are just fat.
The first thing that I have invariably noticed is that normal breasts, even very large normal breasts, stop growing at some point. They then don’t get much bigger. Macromastia breasts, on the other hand, continue to grow from the precipitating event onward. Whether the growth starts at puberty, stress or pregnancy, the breasts grow. The growth rate sometimes slows, but always continues. For example, I am growing only about a cup size every two years now, and hope it will slow down even more. So that’s one differentiating factor between large but normal and macromastia-- continued growth.
The second thing I notice in all my friends and research is that macromastia does not respond to dieting. Normal breasts get smaller in proportion to lost weight. But almost all the girls I know with this condition have dieted down below their ideal weight, reducing their thighs, stomach, and even neck size but their breasts remain the same size and continue to grow. Dieting has no effect on size or growth rate;- except to make them look bigger. So if you lose breast size when you lose weight, you don’t have macromastia.
Third is size itself. There seems to be a middle ground where a girl can have normal but far above average breasts and where she has actually has macromastia. DD cups are normal and most F (DDD) cups are normal too. But when we get into some of the sizes we are talking about here, H, I, J, K, L, cups on small band sizes, that is macromastia. It is not normal. It is a deformity.
Forth is the shape of the breast. This may surprise you, but I have found it to be true in 100% of the girls I have met. Normal breasts, when they get large, grow down, in a teardrop or a pear shape. Even a very large but normal breast, say a DD, grows downward.
But macromastia breasts are not teardrop shaped, they are ball shaped. Round. Maybe not the size of basketballs but the shape of basketballs. The result in every case is that the inner edge of the left breast and the inner edge of the right breast push each other outwards More like a “T” shape than the inverted “U” or “V” shape. With the macromastia condition, the breasts push each other out and past the chest.
Here is how you can tell macromastia.. Look at the girl facing backward. With a normal breast, you will not see any breast from the rear. No matter how big they are, they are falling downward. With macromastia, looking at the back from the rear, you see two quarter moons ( or half moons) of breast tissue sticking out from either side where the macromastia breasts are pushing each other outward.
This is one of the reasons why the bras have to be custom made. The large bras sold on the internet are just big copies of smaller bras, and they don’t work because the actual shape of the macromastia breasts is much more round and ball-like than the normal breast.
The significance of this distinction between large normal breasts and macromastia is in management and treatment.
Plastic surgery is a real money maker for hospitals; breast reductions are very lucrative. To get insurance companies to pay for them, doctors convince themselves, and us, that reduction is not just a cosmetic procedure but a needed medical procedure.
Reductions from large normal breast to smaller sizes are very successful. From a DD to a C or a D to a B, even a DDD to a B or C, the operation is almost always a success. The nipple is preserved, lactation is preserved and sensation is preserved. These are the kind of reduction operations you read about all the time.
However, with macromastia there seems to me to be much less change of success. Unless growth has totally stopped, a reduction accomplishes nothing…two years later, the breast is large again, but this time it is growing around the scar tissue from the operation so it looks grotesque as well as big. Even if growth has stopped, once the reduction is from a really large size, the nipple is lost, lactation is lost and sensation is lost. A cosmetic nipple is made from other body areas, as would be done with a cancer patient, but it is only cosmetic. The reduced breasts are numb, the nipple is numb and breast feeding is impossible. One girl who had this operation wrote in anther of the other groups that it felt like her chest had been ‘paved with asphalt”. Added to the near certainty that continued growth will result in a bigger breast anyway, standard breast reduction, although lucrative for the doctor and the hospital, is not a good choice, and very few slim girls with real macromastia have it done.
The honest medical truth is, I think, that unless the breasts actually get so big that they interfere with everyday living, the choices are to live with them or have all breast tissue removed. Removing all breast tissue eliminates all future growth. After that, the girl can have a cosmetic breast built like with cancer patients, or just wear a padded AA cup.
What so many people don’t realize is that it NOT a choice of having these huge breasts or having them reduced-- if that was the choice, almost all girls with macromastia could have them reduced. With true macromastia, the choice is to live with them or loose them entirely.
That is why is is so unfair with other women say that “she must like being like that or she’d have them reduced”.
Something else, in 100% of the girls I have talked to, their macromastia breasts very very very sensitive. It is impossible to put into words how sensitive breasts get to be after they get into the macromastia size range. The alveoli are huge as is the nipple. Just the rubbing of cloth makes them erect and starts a physical sexual excitement. Once excited, a light touch is enough to send them into ecstasy. Just a guy blowing air on them is almost too much. The flick of an eyelash is about the right thing. With macromastia, the breasts become the focus of sexual stimulation as much as the clitoris is in normal women.. Not more, but as much as.
So the total loss of all breast tissue is much more of an issue to a girl who has grown up with macromastia than with a normal girl, to whom breasts are just sexual accessories. For us with this condition, they are the main event. Loosing sensation in them by total removal will profoundly affect our sex lives, and is therefore is to be resisted even more.
The result of all this is that the only intelligent decision to make if you are unfortunate enough to have this condition is to live with it, which is what most people do.
With proper posture, correct bras and the right sort of clothing, macromastia does not cause a lot of back or shoulder pain. That’s part of the pitch to get insurance companies to pay for reductions. Well fitting bra straps do not dig into the skin and a well fitted custom bra evenly distributes the weight of the breasts to the chest, shoulders, sides and back. It is not all that much of a problem once you get used to the custom bras and the custom blouses and dresses.
The biggest problems are social, and that is another story.
PLEASE add your comments to this--let’s build up a real comprehensive source of information for women with this deformity. For those of us who have this condition, or care about someone who has it, specific comments are very valuable. Let me know if you have any experiences that validate ( or invalidate) any of the five factors that I have concluded point to macromastia. Let me know your experiences with surgery, etc.
I am not going to go to the trouble of writing things like this unless everyone else contributes. Let’s really make an effort to get to know and help each other here. Guys too, you’re half of the world!