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Some resources distinguish between macromastia, where excessive tissue is less than 2.5 kg, and gigantomastia, where excessive tissue is more than 2.5 kg. The enlargement can cause muscular discomfort and over-stretching of the skin envelope, which can lead in some cases to ulceration. Hypertrophy of the tissues might be caused by increased histologic sensitivity to certain hormones such as female hormones, prolactin, and growth factors; or an abnormally elevated hormone(s) level in the blood, or both. Hypertrophy is a benign progressive enlargement, which can occur in both (bilateral) or only in one (unilateral). It was first scientifically described in 1648.

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