Breast Reduction

After being asked to write a letter to provide the clinical justification to support the decision of a young lady wanting to undergo a breast reduction, I was left with a dichotomy of thoughts as to whether I would support it or not.
As much as I would prefer to avoid surgery and unnecessary chemical and physical insult to an otherwise healthy body, I have to acknowledge that large breasts can be a major cause for pain and bad posture, thereby increasing the risk for spinal deformity and resultant neurological interference that may have devastating effects on one’s overall health and well-being, as well as other repetitive stress injuries to the shoulders and upper extremities.
These problems result from changes in the normal anatomical structure caused by the excess weight on the chest and weak muscular support. Another fact related to this condition is that some women even feel ashamed and actually try to hide them by altering their posture by allowing their shoulders to roll forward. This abnormal posture will put pressure on an area of the upper body near the shoulder called the thoracic outlet. When this occurs, a bundle of nerves and blood vessels can become compressed and cause pain and discomfort (including pins and needles or numbness) down the upper extremities. This may also lead to compression of the organs in the chest, affecting lung and heart function as well as adversely affecting the sympathetic nervous system, leading to dysautonomia, poor adaptability to stress and ultimately poor health, leading to increased medical costs in the future.
Very large breasts not only can affect the curve of the upper and mid-back region but will potentially also affect the lower back and cause severe low back pain. When the upper vertebrae of the spine are altered, the lower vertebrae then assume more stress.
Regular chiropractic adjustments to correct nerve interference and improve adaptability to stress however will reduce all these effects mentioned above as well as ongoing core and postural strengthening exercises to maintain a healthy upright posture. For me surgery is a last resort but I will support it if absolutely necessary.