In India, the prevalence of back pain due to large breasts is notable. Cultural and genetic factors may contribute to a higher incidence of large breast sizes among Indian women. Additionally, societal norms and limited access or wearing wrong size supportive garments can exacerbate the physical and psychological impact of large breasts. Consequently, many Indian women may experience significant discomfort and seek medical intervention, including breast reduction surgery, to alleviate chronic back pain and improve their quality of life.
Back pain is one of the problems caused by large breasts due to the excessive weight of the breast tissues that exert pressure on muscles and ligaments located in the back, neck and shoulders thereby subjecting a person to chronic pains. The poor posture maintained to counterbalance weight issues worsens this kind of pain. In most cases, women with huge breasts experience severe neck, shoulder and back pains throughout their lives that curtail their day-to-day activities.
A BMI over 30 may aggravate these symptoms as extra weight combined with that from breasts’ results in increased strain on the body. With time there is a high probability of misalignment that will affect the spine leading to posture deficits through additional stress across its surrounding muscles as well as recurring agony.
Besides back pain, large breasts can cause neck and shoulder pain, skin irritation or rashes under the breasts, and grooves in the shoulders from bra straps. They can also limit physical activity, leading to weight gain and associated health problems, and may cause emotional and psychological distress due to body image concerns. Back pain associated with large breasts is typically located in the upper and middle back due to the direct strain on the upper thoracic spine and surrounding muscles. However, compensatory changes in posture can also lead to lower back pain over time.
Women with large breasts commonly report a dull, aching pain in the upper back, neck, and shoulders, which can become more severe and sharp with physical activity or prolonged periods of poor posture. Throbbing pain may also occur due to muscle spasms or tension. Activities that exacerbate back pain include prolonged standing or sitting, especially with poor posture, lifting heavy objects, and high-impact exercises. Additionally, activities requiring repetitive shoulder movements, such as reaching or carrying heavy bags, can increase discomfort. The distribution of pain varies, with most individuals experiencing upper and middle back pain due to the direct load on the thoracic spine and shoulder girdle. However, compensatory changes in posture to alleviate upper back pain can lead to secondary lower back pain over time.
Lifestyle changes that can help mitigate back pain include maintaining a healthy weight, engaging in regular physical activity to strengthen muscles, practicing good posture, avoiding high-impact activities that strain the back, and wearing supportive bras. Stress management and adequate rest are also important.
Many women find breast reduction very helpful and consider it to improve their quality of life. Doctors consider different parameters to determine if a patient is an appropriate candidate for breast reduction operation include severity and duration of the back pain, ineffectiveness of non-surgical treatments, general health status of the patient as well as size and weight of the breasts. The operation also takes into consideration psychological factors marriage and child birth status and patient’s wish to have surgery. Average recovery time following a breast reduction procedure involves a week of rest and restricted physical activity. Initially, there can be swelling, bruising, and tenderness. Most patients are able to return to regular activities in 2-3 weeks while full recovery takes several months. It is important to have follow-up appointments to check on healing.
The majority of patients report great relief from pain after their surgery and are satisfied with how their breasts look like post-surgery. They often claim improved posture, better participation in physical activities, and improved quality of life overall. Generally speaking, cosmetic outcomes were positive since most women reported natural-looking breasts which were proportional too. Yet breast reduction just like any other surgical procedure carries its own risks including infection, bleeding or hematoma formation, scar formations or nipple changes besides sensation changes on nipples or the whole breast itself. Additionally, some may experience asymmetry or dissatisfaction with aesthetic results, but these cases occur infrequently when the surgeon has good skills.
In conclusion, large breasts can significantly impact a woman's physical and emotional well-being, often leading to chronic back pain and related issues. While non-surgical treatments and lifestyle changes can offer relief, breast reduction surgery remains a highly effective option for many. Indian women, in particular, may face unique challenges, making awareness and access to appropriate care essential for improving their quality of life.
(Author: Dr. Ashok B C, HOD - Department of Plastic Reconstructive and Aesthetic surgery & Chief of Medical Services, Aster Whitefield Hospital, Bengaluru)
