Teenager gets her future back after surgeons remove 21kg from her chest

Nancy* is seated on a bench outside clinic room 24 at Kenyatta National Hospital (KNH), She is here for her second clinic after a life-changing surgery that she had on September 22. The difference in her demeanour is striking. She looks happier, lighter.

 “How are you doing?” We ask.

 “Very well. I am okay,” she responds, a blush spreading across her cheeks as she adjusts her glasses.

Her recent medical review went well, and even without saying a word, her radiance speaks volumes: she is finally at her best.

 Her mother, who had stepped away for a phone call, soon joins us, her smile ready to share the good news about her daughter’s progress.

For 18 months, Naomi Mutendwa’s 17-year-old daughter carried weight on her breast that she never imagined would one day feel light. 

 "When you looked at her, it was as if she was carrying two infants on both sides of her chest," says Naomi. 

 Nancy was diagnosed with a condition called juvenile gigantomastia, one which Dr Benjamin Wabwire, a plastic and reconstruction surgeon at KNH who also led the team that conducted the procedure that successfully removed about 21 kilogrammes from Nancy's breast, says is a rare condition that leads to breast enlargement in a bizarre manner.

 For context, a healthy six-year-old child weighs about 20 kilogrammes. Imagine carrying that weight on your chest for a year and a half, with no way to put it down.

Also read: “How a 6kg breast reduction changed my life after years of pain”

Nancy’s mother explains that her daughter initially had a normal puberty. Her breasts began to enlarge noticeably in Form One, but before then, they were of normal size. The accelerated growth started as she was transitioning to Form Two.

 “I asked her if she felt any pain. There was none,” she says.

Naomi was so stressed, and all she did was to cry and to pray because she did not have the financial muscles to even take her daughter for check-up.

 “I barely slept those days. I could close my eyes in bed but I was always in deep thought,” she recalls.

 Deep down, she knew that it was not normal for a child’s breast to grow that big, so she borrowed some money from a pastor and took her child to the nearest hospital in their county.

 At the hospital, an X-ray of Nancy’s breast was taken and when there was nothing alarming to warrant treatment, they went home with no proper diagnosis.

 She went to a second hospital, where she got a referral note to go to the Kenyatta National Hospital.

 “I brought my child all the way to Nairobi. They did some tests and admitted her. I left her briefly to go home and came back to an empty bed only to learn that she was in surgery. The wait was long, but I had faith that she was in good hands,” she tells us.

 Nancy was in the theatre for 11 hours. She emerged stable and was taken straight to the wards. “I was so happy,” her mother beams. “I could call her name on that first day after the surgery, and she responded.”

Becoming a teacher

 Nancy now has a chance to go back to school and fulfil her dream of becoming a teacher.

Dr Wabwire explains that Nancy’s condition is classified as juvenile because during that period, breasts undergo pubertal development in young girls and they are expected to 
grow at a certain rate. If they exceed that rate, then a young girl may end up with a size that is abnormally large.

 “This is different from cancerous growth or breast enlargement in a mature lady. Most of the time, the condition is caused by abnormal response of the developing breasts through stimulation by the female hormones,” he explains.

 He notes that with the rapid growth, comes issues such as physical strain to a young patient because of too much weight hanging from their chest.

 "Even if they were to support it with a bra or something thing else, it still exerts a lot of physical strain on their shoulders, back muscles and the neck, and this can take a physical toll on their health," says Dr Wabwire. 

 There are also psychological effects because if someone was fitting in with their peers, they start feeling different. 

 "Given this is a stage where most young people will also be developing their self-esteem and identity, it can really hit them hard," he says. 

 Other complications that may come with rapid enlargement of the breasts include skin breaking and formation of wounds that are painful.

 He says the condition is more common in adult women compared to the younger ones, adding that most women walk around with the condition without knowing it. They may have extra two or three kilos, but it is still a medical condition.

 In Nancy's case, for instance, she weighed about 57 kilos before the reduction. Dr Wabwire explains that after the surgery, she lost about 37 per cent of her weight.

 "If you take out 37 per cent of someone's weight, the repercussions can be dire because you are taking out blood and that is bound to have some effect on a person's heart," he explains, adding that the procedure required a meticulous surgical team, where each member played a crucial role, to achieve this safely.

 Now, Nancy is recuperating and going for follow-up clinics like the one she came for on the day of the interview. This is to help doctors access if her quality of life is improving after the surgery. 

Also read: When breast size hurts

 "We can tell by just looking at her. Simple things like a smile and having confidence means that the patient is doing well," says Dr Wabwire. 

 While gigantomastia is quite common, a significant barrier to treatment is that some private health insurers classify surgery for the condition as cosmetic, denying many the chance for essential medical care.  Nancy’s treatment was covered by the Social Health Authority. Dr Wabwire encourages other insurers to include the procedure, given its long-term effects. 

“People have now exploited this gap in access to services, becoming agencies to link people to medical care, even when some are not professionals,” he cautions, highlighting the need for formal and accessible treatment pathways.

For Nancy, however, the future is now bright and full of promise, free from the weight that held her back for so long.

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