Bilateral Gestational Gigantomastia Complicating Pregnancy: A Challenging Case Refractory to Conservative Management

Gestational gigantomastia (GG) is a rare condition characterized by excessive and rapid breast enlargement during pregnancy, resulting in significant physical discomfort, functional limitations, and significant psychological impact. We present a case of a 33-year-old multiparous woman in her third pregnancy, who developed severe bilateral GG by 16 weeks of gestation. Despite initial conservative management, including analgesia and pharmacological (bromocriptine) therapy, the condition worsened causing functional impairment and recurrent mastitis requiring repeated hospital admissions. The pregnancy was electively induced due to physical limitations at 35 weeks of gestation; however, the labour was complicated by obstruction, necessitating an emergency Cesarean section. Postpartum the patient developed severe lactational mastitis complicated by sepsis necessitating intensive care unit admission. After recovery and cessation of breastfeeding, she elected to undergo Wise-pattern bilateral reduction mammoplasty with free nipple-areolar complex grafting four months into her postpartum period. The procedure provided substantial functional relief and a favorable esthetic outcome. This case highlights the potential complexity of managing GG and the need for individualized care. Although conservative treatments may offer temporary relief, surgical intervention is often necessary in severe cases.