Extreme juvenile gigantomastia with bilateral excision of 16.5 kg (27% of body weight) in a 15-year-old adolescent: a case report.

Juvenile gigantomastia is a rare clinical entity associated with major functional and psychological consequences. We report the case of a 15-year-old adolescent with a body mass index of 24.2 kg/m2 who presented with extreme bilateral gigantomastia progressing over 2 years. Reduction mammoplasty using the Thorek technique was performed, with a total excision of 16.5 kg (27% of body weight). The procedure was complicated by postoperative hypovolemic shock requiring blood transfusion and intensive care monitoring. Secondary partial necrosis involving both the nipple and areolar components of the nipple-areola complex subsequently occurred and was treated with a full-thickness skin graft harvested from the inguinal region. Despite these complications, the patient achieved satisfactory functional and esthetic outcomes at 8-month follow-up. This case highlights the severity of extreme juvenile gigantomastia and the importance of staged surgical management.