Whether they are large natural breasts or large breast implants, large breasts and back pain may go hand-in-hand.
Large Breasts and Back Pain Issues
Back injury from large breasts is not an uncommon complaint for women with a large natural breast or from those who have had implants. It is important to note, however that large breasts are not necessarily the only cause of back pain in women. Before a misdiagnosis or a surgical procedure, women should consider other causes of back pain, such as obesity, pregnancy, the wrong bra size, poor posture, overexertion or injury in the back bones and muscles, spinal nerve irritation from disc bulging or herniation, and osteoporosis or other spine weakening causes. Large breasts can worsen posture or contribute to the stress of already pulled muscles, and they can make it more difficult for an injured disc to heal. Proper diet and exercise can strengthen the back, making it more likely to heal and less likely to get injured in the first place. Women with unusually large breasts, or who have a sudden enlargement from augmentation surgery, could point to the breasts as the primary source of the back pain. In those cases, surgery may become necessary.1 For women with very large breasts, repetitive strain and poor posture are not the only causes of upper back pain. Just the “weight of the breasts alone can be enough to cause…long-term chronic pain”. This is due to the fact that the excessive weight strains the muscles, making it “difficult to maintain good posture, and even lead to spinal deformity”. Additionally, some women may hunch to try to hide their large breast size, worsening the pain. Other issues for these women are bras with straps that “dig into their skin” and activity limitations. Specifically, breasts with cup sizes of D and larger are most affected.2
Large Breast and Implant Complications
Large breast augmentation surgery can cause a variety of health problems. One Brazilian woman, Sheyla Hershey, set a record for having a 34 FFF-sized chest, after “eight surgeries and a gallon of silicone”, and she still desired larger breasts. Dr. Malcolm Roth said there were good reasons why the state of Texas has limits for the amount of silicone that can be implanted. According to Dr. Roth, “…the larger the implant, the more likely there will be problems down the road”. Such complications “could be wound separation that could lead to exposure of the implant, infection, scarring, certainly pain and capsular contractions”. In addition, there are ethical concerns for the surgeon as well. Part of the surgical training is to “find out if the patient has realistic expectations”. Another woman, with naturally large breasts, said that her 34 DD breasts caused her enough pain that she “was taking three extra-strength Tylenol because my back was hurting so bad, and by the middle of the night I’d be sore again”. She could barely work at her desk. Dr. Andrew Haig noted that the pain for large-breasted women is often in the “back of the rib cage and spine area” due to women arching their back so that “they don’t fall forward”. Sometimes it isn’t the back pain that leads to reduction surgery but embarrassment or other emotional complications, such as not finding clothing that fits or being stared at.3
Women with large breasts can engage in lifestyle changes, take medications, or consider surgery. Many treatments are available for the back pain caused by large breasts, including breast reduction, and wearing supportive garments, such as the best bras for large breasts, proper swimsuits for large breasts, or wearing the best sports bra for large breasts. There are special, customized bras and sports bras that help to “distribute and support the weight of large breasts”, and they are especially helpful for women with “narrow backs, who have a more concentrated distribution of weight”. Exercise and physiotherapy could be useful for weight loss and posture improvement. Some may have to take medications, such as NSAIDs or aspirin, to “get…over the hump” of severe pain, but that is not a long-term solution. One study, from the American Society of Plastic Surgeons, showed that before breast reduction surgery, “half of 179 women with breasts size DD or larger had almost constant upper back pain”, and post-surgery, “only 10 percent of women had these symptoms”.4 Chiropractic care may be another option for patients with large breasts. Back pain is caused by muscle imbalance, joint imbalance, and trigger points. When a cup size is too big for the body’s frame, the muscles and joints are stressed, and the spine curvature is not balanced. To alleviate back pain, it is important to identify the source of the pain, remove the pain, and then remove the cause. Large breasts provide a constant strain, but wearing the correct bra, balancing the spine, and exercising to gain strength can help. In the end, though, some women may still need reduction surgery, but they need to consider the pain levels vs. the risks and costs of the surgery.5
Breast Reduction Surgery
Extremely large breasts can not only lead to back pain, but also neck pain, migraine headaches, numbness in the hands and fingers, shortness of breath, and limiting activities. It may be difficult for women to sit at a desk, pick up their children, or engage in aerobic exercise. As women age, or if they are heavier, the shoulders roll forward, leading to “compression in the thoracic outlet”. The thoracic outlet is “where the ribs, shoulder blades, and nerves come through a rather narrow triangle”. Between the rolling forward and “changes in the anatomic space in the back”, the nerve fibers become compressed, leading to pain. Other pain comes from the pressure of bra straps. If physiotherapy, pain medication, losing weight, and ergonomic changes do not resolve the problem, breast reduction surgery is an option. Such surgeries are on the rise. The operation basically involves the “removal of a pound or more of tissue and fat cells from each breast, and then cutting away the resulting excess skin”. The surgery requires general anesthesia and takes about three hours, although doctors claim it is “a safe procedure with a fast recovery” because muscles and organs are not being moved. Post-operative pain is said to be limited, as well, with normal activities resuming within a couple of weeks. Scarring, however, is permanent and visible. Those with keloids would have worse scarring. There had been concerns that scarring would interfere with mammograms, but improved imaging has made it easier to distinguish scarring from cancer. Recent research has shown that the surgery may give the women a “reduced risk of breast cancer”. One more side effect of the surgery is “nipple numbness”, that is a possible result, but other women may “gain breast sensitivity after surgery”. As long as the nipples are not repositioned, breast feeding is still possible after the operation; however for some women there is a “significant reduction in milk”, leading to an inability to breastfeed after surgery. Financially, the operation costs several thousand dollars, and it may not be covered by insurance. Some insurance companies require “so much tissue to be removed” that women are left with “a near mastectomy result”.6