Macromastia
Under macromastia even Mammahypertrophie or Hypermastie called, refers to overly tall breasts in women. The size, which is still regarded as normal, is based on the individual body proportions and the self-image of the person concerned. A very pronounced finding can be described as gigantomastia , e.g. B. if the fabric weighs more than 1.5 kg per side. On average, a breast in women who are not breastfeeding weighs 150–400 g.
Sometimes toddlers develop temporary swelling of the mammary gland that will resolve on its own. Real macromastias can develop during puberty between the ages of 11 and 16, presumably due to increased hormone production or sensitivity (puberty mastopathy, virgin mastopathy). The glandular tissue and the connective and supporting tissue grow together; the tissue structure is normal. Before puberty onset breast growth is a symptom that can precocious puberty be, which in turn is caused by various hormonal disorders.
Those affected often suffer from poor posture, skin inflammation, neck and back pain. Stigma and psychological problems can also arise. The treatment is usually initially medicated, possibly combined with general weight-reducing measures. If the effect is not sufficient, the breasts can be surgically reduced (plastic reduction). Women aged 15–16 Year of life can be offered. In Germany, the statutory health insurance companies only cover the costs if there is an "objectifiable illness", which in case of doubt must be proven by expert reports. A guideline is at least 500 g of weight to be removed per side. Other experts assume a total weight of 1500 g, or 2% of the body weight. Orientation towards the pain picture or the patient's request is rejected as too subjective. Overall, the assessment situation is inconsistent.
Web links
- Breast reduction in the website of the German Society of Plastic, Reconstructive and Aesthetic Surgeons
- The Royal College of Surgeons of England (2014): Commissioning guide: Breast reduction surgery. (Surgical Breast Reduction Referral Policy, in English)
- Costs and price examples at mybody.de
Individual evidence
- ↑ Mammahypertrophy in the Pschyrembel
- ↑ Peter M. Vogt: Practice of plastic surgery: plastic-reconstructive operations - plastic-aesthetic operations - hand surgery - burn surgery . Springer-Verlag, January 2, 2012, ISBN 978-3-540-37573-9 , p. 736.
- ↑ a b R. Bässler: Pathology of the mammary gland . Springer-Verlag, March 7, 2013, ISBN 978-3-642-66846-3 , p. 45.
- ↑ AS Xue, EM Wolfswinkel u. a .: Breast reduction in adolescents: indication, timing, and a review of the literature. In: Journal of pediatric and adolescent gynecology. Volume 26, Number 4, August 2013, pp. 228-233, doi: 10.1016 / j.jpag.2013.03.005 , PMID 23889919 (review).
- ↑ Graf von Finckenstein, J .: Plastic surgery: What the health insurance companies recognize as a disease. Dtsch Arztebl 2000; 97 (4): A-157 / B-131 / C-127
- ↑ Minutes of the meeting of Working Group 2 “Social Medicine and Assessment Questions” of the DGOU , 2014 (accessed December 11, 2019)
