“Macromastia” refers to the condition of having large, heavy breasts that cause back pain, headaches, poor posture, and other physical symptoms. Chronic pain in the neck, shoulders, and back, in particular, is one of the most prominent symptoms of macromastia. This can lead to other health issues — such as difficulty exercising, numbness and tingling in the arms, and poor posture — that can make life burdensome for patients. While many people try alternative solutions to alleviate the pain of an excessive breast size, non-surgical methods like heat packs, a supportive bra, and medications treat the symptoms of macromastia rather than targeting the root cause of chronic pain. Fortunately, breast reduction surgery offers the most effective and comprehensive treatment to make the breasts lighter and more manageable, thereby reducing or even eliminating back pain.
Why Do Large, Heavy Breasts Cause Back Pain?
Large, heavy breasts can place constant and excessive strain on the musculoskeletal system, leading to persistent discomfort in the neck, shoulders, and back. The weight of the breasts pulls the torso forward, forcing the spine to compensate in order to maintain balance. Over time, this forward pull can contribute to kyphotic posture (rounding of the upper back), overstretching of the supporting ligaments, and chronic tension in the shoulder and neck muscles.
Additionally, the muscles of the upper back must work overtime to counteract the gravitational force of the breasts, which can lead to fatigue, spasms, and inflammation. Many patients with macromastia also experience compressed nerves in the upper back and shoulders, which may cause numbness, tingling, or radiating pain into the arms and hands. Even bra straps can deepen this burden, as the constant downward pressure on the shoulders can compress soft tissues and nerves, further intensifying discomfort. Combined, these factors may create a cycle of pain and poor posture that cannot be resolved without reducing the actual weight of the breasts. This is why breast reduction surgery can be so effective — rather than treating the symptoms, it removes the physical source of strain, allowing the spine and surrounding muscles to return to a more natural and comfortable alignment.
According to Philadelphia plastic surgeon David Bottger, MD, breast reduction can be life-changing for women who feel held back by the weight of their overly large breasts. The procedure makes the breasts more proportional to their body size and removes excess skin, fat, and glandular tissue causing a dominant appearance. This also has the effect of lessening the weight of the breasts, which often resolves any neck, back, or shoulder pain experienced. Among the other health benefits possible with breast reduction include:
Improved Posture
With less heaviness and weight on the chest, patients naturally adopt a more upright and balanced posture. This reduces tension across the spine and shoulders, promoting healthier long-term musculoskeletal alignment.
Reduced Skin Rashes, Irritation, and Chafing
Large breasts can trap moisture and cause irritation beneath the breast folds. Reducing one’s breast size often minimizes chronic rashes, infections, and discomfort in these areas, particularly while exercise or strenuous activity.
Greater Exercise Tolerance
Activities such as running, yoga, weight training, and even brisk walking become significantly easier and more enjoyable. Many patients find they can participate in physical activities they previously avoided, which can have positive effects on cognitive focus, confidence, and self-esteem.
A More Active Lifestyle
Breast reduction frequently enhances both physical ability and body confidence. Patients often find clothing fits better, movement feels less restrictive, and day-to-day life is no longer shaped around managing pain or limitations.
More Lifted Contours
Breast reduction can also provide a significant breast lift in most patients, elevating and reshaping the breasts for a more youthful and proportionate appearance. While cosmetic improvements are not the primary goal of surgery, they are an appreciated bonus for many patients and can help enhance self-image and overall well-being.
Most importantly, breast reduction aims to give you a more comfortable and carefree quality of life by alleviating the burdens of large, heavy breasts. Dr. David Bottger can speak with you about how breast reduction — or perhaps another treatment option — may be able to address your concerns and achieve your goals. Contact our Philadelphia practice for more information.
Editor’s note: The original version of this blog was published on June 1, 2023.