Can breast reduction surgery relieve back pain?

Breast-reduction_large 
Each week, I meet with female patients seeking relief for their chronic back pain and other large-breast-related health issues. 


Some are referred to me by their family doctors, while others may have a friend or family member who’s experienced the health benefits of breast reduction surgery.

Often these women fall into two categories. 

  1. Younger patients who developed large breasts around the time they were going through puberty, when their bones in the spine and neck and muscles in the shoulder and back weren’t fully developed to support their weight. 
  2. Older women who developed large breasts after having children and whose breasts didn’t return to their original size. 

Both groups experience back, neck and shoulder pain; their bras cause grooves and sometimes skin breakdown in their shoulders; they deal with frequent rashes between and under their breasts; and the weight of their breasts may limit their ability to engage in sports and physical activity.

So how can breast reduction surgery help with all of this?

I work closely with my patients to make sure we remove enough breast tissue by weight so there is a release in the load on the back. The amount of breast tissue removed in grams is customized to each patient based on their height, weight and body surface area. It’s important to note the surgery changes the bra cup size, not the bra number.

Following surgery, how long do patients have to wait for their back pain to improve?

The results are immediate. For most patients, the back pain is completely gone, provided the patient doesn’t have other conditions that contribute to her back pain.

Should surgery be your first option if you have large breasts and back pain?

No. Start with non-surgical treatment options first. Physical therapy can help strengthen muscles and improve posture. Over-the-counter pain medications can help with muscle soreness and pain. Support bras can help minimize movement. Deodorant and powders can control moisture. Weight loss may reduce breast size.

Who’s a good candidate for surgery?

If non-surgical treatment options for back pain have failed, breast reduction surgery can be a more definitive approach to addressing the issue. A family doctor can make the referral to a plastic surgeon to discuss treatment options.

What can I expect if I’m considering breast reduction surgery?

I educate my patients so they fully understand the surgery, follow-up care and the expected outcome so they have a positive experience. During the two and a half hour surgery, I remove extra skin and excess breast tissue and reposition the breast and the nipple. When completed, the breast is more proportionately sized and lifted for an attractive look.

Breast reduction surgery is an outpatient procedure, so patients go home the same day. They can shower 24 to 48 hours after surgery. Patients wear a support bra day and night for three to four weeks.

For pain control, while the patient is asleep under anesthesia, an ultrasound-guided needle is used to insert a long-acting pain medication between the pectoral muscles in the chest. After surgery, I prescribe a combination of acetaminophen, Lyrica and Celebrex. No narcotic pain medication is given, which helps shorten the recovery time and decreases risk associated with narcotics. 

In two to three weeks, patients can return to work and resume most activities. They just have to avoid heavy lifting for six weeks. In about three months, the breast tissue will settle into the size it will be, and patients can start purchasing their preferred bras in the new cup size.

Is it possible for the breasts to increase in size following surgery?

As plastic surgeons, we can turn back the clock but we can’t stop the clock. Breast size can increase after surgery if the patient gains weight, gets pregnant or experiences rare hormonal changes. 

Dr. Rajiv Chandawarkar is an associate professor of plastic surgery at The Ohio State University Wexner Medical Center.