Breast development is a complex process influenced by genetic, hormonal, and environmental factors. While most young women experience normal breast growth, some may develop “anomalies” that can affect symmetry, shape, size, or overall breast function. These developmental breast anomalies can have both physical and psychological impacts, making awareness and treatment options essential. At Purity Bridge, our consultant plastic surgeons are experts in treating developmental breast conditions, and we have put together some examples of the types of conditions we frequently treat. We hope that by openly discussing these conditions, those with them do not feel so isolated and alone, and are made aware that treatments do exist that can help them.
Common Developmental Breast Anomalies
1. Polymastia (Accessory Breast Tissue)
Polymastia occurs when extra breast tissue forms along the “milk line,” which extends from the armpit to the groin. This condition may include fully functional breast tissue or simply excess fat and glandular components. It may appear as a swelling or lump in the armpit, that can swell or ached with the menstrual cycle. It is possible to treat this surgically, and remove the accessory breast tissue.
2. Polythelia (Supernumerary Nipples)
Polythelia refers to the presence of additional nipples along the “milk line”, often mistaken for moles or birthmarks. These may appear as fully developed nipples with areolae, or as pigmented blemishes or parts of nipples. Supernumerary nipples can be surgically treated, leaving small scars in their place.
3. Tuberous Breasts
This is a complex condition that occurs from incomplete or abnormal breast development, leading to a variation in breast shapes. The breast may be narrow and elongated with a high inframammary fold and enlarged areolas, there may be herniation of the breast tissue into the areolae resulting in puffy nipples or puffy areolae and there is frequently breast asymmetry (uneven breasts).
There are a variety of surgical procedures that can be used to treat tuberous breasts, ranging from the use of breast lifts, breast implants and fat grafting, with various combinations. Importantly, it is important to appreciate that more than one operation might be needed depending on the situation.
4. Breast hypoplasia
Some women experience significant underdevelopment (hypoplasia) of their breasts on one or both sides. Breast development can occur through to the late teenage years, and occasionally up to twenty or twenty one years old. However, the decision regarding the timing of potential surgical treatment is not purely made on physical examination, but also on the individual’s pyscho-social well-being. Breast hypoplasia can cause significant distress in certain individuals and earlier surgical intervention might be justified (although it is unlikely this would ever take place before 16-years old). Treatment may involve fat grafting, breast implants or a combination of both.
5. Breast asymmetry
Whilst it is normal to have slight differences between breasts, some women develop more marked and obvious differences. These differences can relate to volume (i.e. size difference) but also to shape, nipple position, and the siting of the breast on the chest wall. Occasionally, conditions such as Poland’s Syndrome can also result in other anomalies, such as failure of development of some of the chest wall muscles on the smaller breast side.
In cases of breast asymmetry, each case needs to be taken and treated in a bespoke manner – no two cases are the same. Surgical treatment options will range from breast reductions and breast lifts, through to the use of fat grafting (lipofilling) and breast implants.
6. Breast hypertrophy
Overly large breast development can cause both functional, aesthetic and psychological morbidity. The added weight of large breasts can give rise to musculoskletal issues that cause shoulder, back and neck pain, as well as fungal infections and friction issues under the breast crease. In addition the excess breast weight frequently causes tissue stretch and significant challenges in finding appropriately fitting bras that can support the weight of the breasts.
Fortunately surgical breast reduction surgery (reduction mammaplasty) can provide relief of these symptoms, as well as a marked documented improvement in quality of life for those suffering from heavy breasts.
7. Amastia and Athelia
Amastia and athelia refer to the lack of development of breast tissue or nipple/areola complex respectively. Reconstructive procedures can be employed to construct a new nipple, with tattooing being used to provide the colour of the areola, and a combination of tissue expanders, breast implants and fat grafting might be employed to reconstruct the breast.
8. Gynecomastia (Male Breast Development)
Enlargement of male breast tissue due to hormonal imbalances is called gynaecomastia (or gynecomastia, also referred to as male breast development). It can result from the side effects of medication, or underlying health conditions. Sometimes it occurs during puberty or at other stages of life. The breast tissue is often firm, and sometimes can be painful. In addition it can have a profound impact on the life of those who develop it.
A number of surgical treatments can help to treat gynaecomastia, and these can include excision through a scar around the underside of the areola, liposuction techniques, or, in severe cases, mastectomy type operations and replacement of the nipple/areola on as a type of skin grat.
Psychological and Social Impact
Overall, developmental breast anomalies of all types can significantly affect self-esteem and body image, leading to severe emotional distress. Consulting with a plastic surgeon, endocrinologist, or therapist can help individuals navigate their options and mental well-being. This is fundamental in being able to live a free and happy life, and to effectively functional in a modern society.
Conclusion
While developmental breast anomalies vary in severity and impact, medical and surgical advancements provide numerous treatment options. We strongly advise that a consultation with a healthcare provider will allow the best approach for each individual’s needs.
Understanding these conditions and available treatments empowers individuals to make informed decisions and seek appropriate care, ultimately enhancing both physical and emotional well-being.
