Breast
The breast is the upper ventral region of an animal’s torso, particularly that of mammals, including human beings. The breasts of a female primate’s body contain the mammary glands, which secrete milk used to feed infants. Both men and women develop breasts from the same embryological tissues. However, at puberty, female sex hormones, mainly estrogen, promote breast development which does not occur in men. As a result, women's' breasts become far more prominent than those of men.
Anatomy
Anatomically, breasts are modified sudoriferous (sweat) glands which produce milk in women, and in some rare cases, in men.[2] Each breast has one nipple surrounded by the areola. The color of the areola varies from pink to dark brown and has several sebaceous glands. In women, the larger mammary glands within the breast produce the milk. They are distributed throughout the breast, with two-thirds of the tissue found within 30 mm of the base of the nipple.[3] These are drained to the nipple by between 4 and 18 lactiferous ducts, where each duct has its own opening. The network formed by these ducts is complex, like the tangled roots of a tree. It is not always arranged radially, and branches close to the nipple. The ducts near the nipple do not act as milk reservoirs; Ramsay et al. have shown that conventionally described lactiferous sinuses do not, in fact, exist. Instead, most milk is actually in the back of the breast, and when suckling occurs, the smooth muscles of the gland push more milk forward.
The remainder of the breast is composed of connective tissue (collagen and elastin), adipose tissue (fat), and Cooper's ligaments. The ratio of glands to adipose tissues rises from 1:1 in nonlactating women to 2:1 in lactating women.[3]
The breasts sit over the pectoralis major muscle and usually extend from the level of the 2nd rib to the level of the 6th rib anteriorly. The superior lateral quadrant of the breast extends diagonally upwards towards the axillae and is known as the tail of Spence. A thin layer of mammary tissue extends from the clavicle above to the seventh or eighth ribs below and from the midline to the edge of the latissimus dorsi posteriorly. (For further explanation, see anatomical terms of location.)
The arterial blood supply to the breasts is derived from the internal thoracic artery (formerly called the internal mammary artery), lateral thoracic artery, thoracoacromial artery, and posterior intercostal arteries. The venous drainage of the breast is mainly to the axillary vein, but there is some drainage to the internal thoracic vein and the intercostal veins. Both sexes have a large concentration of blood vessels and nerves in their nipples. The nipples of both women and men can become erect in response to sexual stimuli,[4] to touch, and to cold.
The breast is innervated by the anterior and lateral cutaneous branches of the fourth through sixth intercostal nerves. The nipple is supplied by the T4 dermatome.
Lymphatic drainage
About 75% of lymph from the breast travels to the ipsilateral axillary lymph nodes. The rest travels to parasternal nodes, to the other breast, or abdominal lymph nodes. The axillary nodes include the pectoral, subscapular, and humeral groups of lymph nodes. These drain to the central axillary lymph nodes, then to the apical axillary lymph nodes. The lymphatic drainage of the breasts is particularly relevant to oncology, since breast cancer is a common cancer and cancer cells can break away from a tumour and spread to other parts of the body through the lymph system by metastasis.
Shape and support
Breasts vary in size, density, shape, sag and position on a woman's chest, and their external appearance is not predictive of their internal anatomy or lactation potential. The natural shape of a woman's breasts is primarily dependent on the support provided by the Cooper's ligaments and the underlying chest on which they rest (the base). Cooper's ligaments, also known as the suspensory ligaments of Cooper, suspend the breasts from the clavicle and the clavi-pectoral fascia. As their fibers run around and through the breast, these ligaments support the breasts in its position on the chest wall and maintain their normal shape. The breast is also attached at its base to the chest wall by the deep fascia over the pectoral muscles. In a small number of women, the frontal ducts (ampullae) in the breasts are not flush with the surrounding breast tissue, which causes the sinus area to visibly bulge outward.
Relatively round breasts which protrude almost horizontally.
Some breasts are high and rounded, and protrude almost horizontally from the chest wall. Such high breasts are common for girls and women in early stages of development. The protruding or high breasts are anchored to the chest at the base, and the weight is distributed evenly over the area of the base of the approximately dome- or cone-shaped breasts.
In the “low” breast, a proportion of the breasts' weight is actually supported by the chest against which the lower breast surface comes to rest, as well as the deep anchorage at the base. The weight is thus distributed over a larger area, which has the effect of reducing the strain. In both males and females, the thoracic cavity slopes progressively outwards from the thoracic inlet (at the top of the breastbone) above to the lowest ribs which mark its lower boundary, allowing it to support the breasts.
The inframammary fold (or line, or crease) is an anatomic structure created by adherence between elements in the skin and underlying connective tissue[5] and represents the inferior extent of breast anatomy. Some teenagers may develop breasts whose skin comes into contact with the chest below the fold at an early age, and some women may never develop such breasts; both situations are perfectly normal. The relationship of the nipple position to the fold is described as ptosis, a term also applied to other body parts and which refers in general to drooping or sagging. Due to breast weight and relaxation of support structures, the nipple-areola complex and breast tissue may eventually hang below the fold, and in some cases the breasts may extend as far as, or even beyond, the navel. The length from the nipple to the sternal notch (central, upper border) in the youthful breast averages 21 cm and is a common anthropometric figure used to assess both breast symmetry and ptosis. Lengthening of both this measurement and the distance between the nipple and the fold are both characteristic of advancing grades of ptosis.
The end of the breast, which includes the nipple, may either be flat (a 180° angle) or angled (angles lower than 180°). Breast ends are rarely angled sharper than 60°. Angling of the end of the breast is caused in part by the ligaments that suspend it, such that the breast ends often have a more obtuse angle when a woman is lying on her back. Breasts exist in a range of ratios between length and base diameter, usually ranging from ½ to 1.
Development
Main article: Thelarche
Male with severe gynecomastia
Girls develop breasts during puberty, as a result of changing sex hormones, chiefly estrogen, which also has been demonstrated to cause the development of woman-like, enlarged breasts in men, a condition called gynecomastia.
In most cases, the breasts fold down over the chest wall during Tanner stage development.[6] It is typical for a woman's breasts to be unequal in size particularly while the breasts are developing. Statistically it is slightly more common for the left breast to be the larger.[7] In rare cases, the breasts may be significantly different in size, or one breast may fail to develop entirely.
A large number of medical conditions are known to cause abnormal development of the breasts during puberty. Virginal breast hypertrophy is a condition which involves excessive growth of the breasts, and in some cases the continued growth beyond the usual pubescent age. Breast hypoplasia is a condition where one or both breasts fail to develop.
Changes
Breast with visible stretchmarks.As breasts are mostly composed of adipose tissue, their size can change over time. This occurs for a number of reasons, most obviously when a girl grows during puberty and when a woman becomes pregnant. The breast size may also change if she gains (or loses) weight for any other reason. Any rapid increase in size of the breasts can result in the appearance of stretchmarks.
It is typical for a number of other changes to occur during pregnancy: in addition to becoming larger, the breasts generally become firmer, mainly due to hypertrophy of the mammary gland in response to the hormone prolactin. The size of the nipples may increase noticeably and their pigmentation may become darker. These changes may continue during breastfeeding. The breasts generally revert to approximately their previous size after pregnancy, although there may be some increased sagging and stretchmarks.
The size of a woman's breasts may fluctuate during the menstrual cycle, particularly with premenstrual water retention. An increase in breast size is a common side effect of use of the combined oral contraceptive pill.
Breasts sag if the ligaments become elongated, a natural process that can occur over time and is also influenced by the breast bouncing while exercising (see Sports bra). Breasts can decrease in size at menopause if estrogen levels decline.
Function
Breastfeeding
An infant breastfeeding
Main article: Breastfeeding
The primary function of mammary glands is to nurture young by producing breast milk. The production of milk is called lactation. (While the mammary glands that produce milk are present in the male, they normally remain undeveloped.) The orb-like shape of breasts may help limit heat loss, as a fairly high temperature is required for the production of milk. Alternatively, one theory states that the shape of the human breast evolved in order to prevent infants from suffocating while feeding.[8] Since human infants have a small jaw (not protruding, like other primates), the infant's nose might be blocked if the mother's chest was too flat.[8] According to this theory, as the human jaw receded, the breasts became larger to compensate.[8]
Milk production unrelated to pregnancy can also occur. This condition, called galactorrhea, may be an adverse effect of some medicinal drugs (such as some antipsychotic medications), extreme physical stress or endocrine disorders. If it occurs in men it is called male lactation, and is often classified as a pathological symptom due to its strong correlation to pituitary disorders. Newborn babies are often capable of lactation because they receive the hormones prolactin and oxytocin via the mother's bloodstream, filtered through the placenta. This neonatal liquid is known colloquially as witch's milk.
Sexual role
See also: Mammary intercourse, Toplessness, Breast fetishism, and Cleavage (breasts)
In some cultures, breasts play an important part in human sexual behavior; they are also important female secondary sex characteristics.[9] Compared to other primates, human breasts are proportionately large throughout adult females' lives and may have evolved as a visual signal of sexual maturity and fertility.[10] On sexual arousal breast size increases, venous patterns across the breasts become more visible, and nipples harden. Breasts are sensitive to touch as they have many nerve endings, and it is common to press or massage breasts with hands during sexual intercourse (as it is with other bodily areas representing feminine secondary sex characteristics as well). Oral stimulation of nipples and breasts is also common. Some women can achieve breast orgasms. In the ancient Indian work the Kama Sutra, light scratching of the breasts with nails and biting with teeth are considered erotic.[11]
Breasts are also regarded as aesthetically pleasing as well as erotic. Research conducted at the Victoria University of Wellington showed that breasts are often the first thing men look at, and for a longer time than other body parts. The writers of the study had initially speculated that the reason for this is due to endocrinology with larger breasts indicating higher levels of estrogen and a sign of greater fertility, but the researchers said that "Men may be looking more often at the breasts because they are simply aesthetically pleasing, regardless of the size." [12]
Other suggested functions
Zoologists point out that no female mammal other than the human has breasts of comparable size, relative to the rest of the body, when not lactating and that humans are the only primate that has permanently protuberant breasts. This suggests that the external form of the breasts is connected to factors other than lactation alone.[citation needed]
Some zoologists (notably Desmond Morris) believe that the shape of female breasts evolved as a frontal counterpart to that of the buttocks, the reason being that while other primates mate in the rear-entry position, humans, because of their upright posture, are more likely to successfully copulate by mating face to face, the so-called missionary position. Morris suggested in 1967 that a secondary sexual characteristic on a woman's chest would have encouraged this in more primitive incarnations of the human race, and a face-on encounter may have helped found a relationship between partners beyond merely a sexual one.[13] However, this theory has since been generally disregarded due to the discovery that other primates, such as orangutans, routinely mate in the face-to-face position even though the females do not have prominent breasts.
The female gelada monkey in estrus presents swollen breasts to signal her reproductive status to the males. Based on that, evolutionary psychologists suggest that human female breasts may have evolved to permanently indicate to human males that the female is apt for reproduction.[citation needed]
History
A "Snake Goddess" statuette of ancient Minoan Civilization, c. 1600 BC.
In European pre-historic societies, sculptures of female figures with pronounced or highly exaggerated breasts were common. A typical example is the so-called Venus of Willendorf, one of many Paleolithic Venus figurines with ample hips and bosom. Artifacts such as bowls, rock carvings and sacred statues with breasts have been recorded from 15,000 BC up to late antiquity all across Europe, North Africa and the Middle East. Many female deities representing love and fertility were associated with breasts and breast milk. Figures of the Phoenician goddess Astarte were represented as pillars studded with breasts. Isis, an Egyptian goddess who represented, among many other things, ideal motherhood, was often portrayed as suckling pharaohs, thereby confirming their divine status as rulers. Even certain male deities representing regeneration and fertility were occasionally depicted with breast-like appendices, such as the river god Hapy who was considered to be responsible for the annual overflowing of the Nile. Female breasts were also prominent in the Minoan civilization in the form of the famous Snake Goddess statuettes. In Ancient Greece there were several cults worshipping the "Kourotrophos", the suckling mother, represented by goddesses such as Gaia, Hera and Artemis. The worship of deities symbolized by the female breast in Greece became less common during the first millennium. The popular adoration of female goddesses decreased significantly during the rise of the Greek city states, a legacy which was passed on to the later Roman empire.[14]
During the middle of the first millennium BC, Greek culture experienced a gradual change in the perception of female breasts. Women in art were covered in clothing from the neck down, including female goddesses like Athena, the patron of Athens who represented heroic endeavor. There were exceptions: Aphrodite, the goddess of love, was more frequently portrayed fully nude, though in postures that were intended to portray shyness or modesty, a portrayal that has been compared to modern pin ups by historian Marilyn Yalom.[15] Although nude men were depicted standing upright, most depictions of female nudity in Greek art occurred "usually with drapery near at hand and with a forward-bending, self-protecting posture".[16] A popular legend at the time was of the Amazons, a tribe of fierce female warriors who socialized with men only for procreation and even removed one breast to become better warriors (the idea being that the right breast would interfere with the operation of a bow and arrow). The legend was a popular motif in art during Greek and Roman antiquity and served as an antithetical cautionary tale.
Cultural status
In religion
Some religions afford the breast a special status, either in formal teachings or in symbolism. Islam forbids public exposure of the female breasts.[17] In Christian iconography, some works of art depict women with their breasts in their hands or on a platter, signifying that they died as a martyr by having their breasts severed; one example of this is Saint Agatha of Sicily. In Silappatikaram, Kannagi tears off her left breast and flings it on Madurai, cursing it, causing a devastating fire.
In practice
A Himba woman wearing traditional clothing in northern Namibia. A small number of societies have no cultural proscriptions on women going bare-breasted.
See also: Modesty, Nudism, and Exhibitionism
Breasts are secondary sex characteristics and sexually sensitive. Bare female breasts can elicit heightened sexual desires from men in certain cultures. Cultures that associate the breast primarily with sex (as opposed to with breastfeeding) tend to designate bare breasts as indecent, and they are not commonly displayed in public, in contrast to male chests. Other cultures view female toplessness as acceptable, and in some countries women have never been forbidden to bare their chests; in some African cultures, for example, the thigh is highly sexualised and never exposed in public, but the breast is not taboo. Opinion on the exposure of breasts often depends on the place and context, and in some Western societies exposure of breasts on a beach may be acceptable, although in town centres, for example, it is usually considered indecent. In some areas the prohibition against the display of a woman's breasts only restricts exposure of the nipples.
Women in some areas and cultures are approaching the issue of breast exposure as one of sexual equality, since men (and pre-pubescent children) may bare their chests, but women and teenage girls are forbidden. In the United States, the topfree equality movement seeks to redress this imbalance. This movement won a decision in 1992 in the New York State Court of Appeals—People v Santorelli, where the court ruled that the state's indecent exposure laws do not ban women from being barebreasted. A similar movement succeeded in most parts of Canada in the 1990s. In Australia and much of Europe it is acceptable for women and teenage girls to sunbathe topless on some public beaches and swimming pools, but these are generally the only public areas where exposing breasts is acceptable.
When breastfeeding a baby in public, legal and social rules regarding indecent exposure and dress codes, as well as inhibitions of the woman, tend to be relaxed. Numerous laws around the world have made public breastfeeding legal and disallow companies from prohibiting it in the workplace. Yet the public reaction at the sight of breastfeeding can make the situation uncomfortable for those involved.
Clothing
Since the breasts are flexible, their shape may be affected by clothing, and foundation garments in particular. A brassiere (bra) may be worn to give additional support and to alter the shape of the breasts. There is some debate over whether such support is desirable. A long term clinical study showed that women with large breasts can suffer Myalgia, or shoulder pain as a result of bra straps,[18] although a well fitting bra should support most of the breasts' weight with proper sized cups and back band rather than on the shoulders.
Plastic surgery
Main article: Breast implant
Breast implant patient, pre-operative (left) and post-operative (right)
Bilateral breast reduction
Plastic surgical procedures of the breast include those for both cosmetic and reconstructive surgery indications. Some women choose these procedures as a result of the high value placed on symmetry of the human form, and because they identify their femininity and sense of self with their breasts.
After mastectomy (the surgical removal of a breast, usually to treat breast cancer) some women undergo breast reconstruction, either with breast implants or autologous tissue transfer, using fat and tissues from the abdomen (TRAM flap) or back (latissiumus muscle flap).
Breast reduction surgery is a common procedure which involves removing excess breast tissue, fat, and skin with repositioning of the nipple-areolar complex (NAC). Cosmetic procedures include breast lifts (mastopexy), breast augmentation with implants, and procedures that combine both elements. Implants containing either silicone gel or saline are available for augmentation and reconstructive surgeries. Surgery can repair inverted nipples by releasing ductal tissues which are tethering. Breast lift with or without reduction can be part of upper body lift after massive weight loss body contouring.
Any surgery of the breast carries with it the potential for interfering with future breastfeeding,[19][20][21] causing alterations in nipple sensation, and difficulty in interpreting mammography (xrays of the breast). A number of studies have demonstrated a similar ability to breastfeed when breast reduction patients are compared to control groups where the surgery was performed using a modern pedicle surgical technique.[22][23][24][25] Plastic surgery organizations have generally discouraged elective cosmetic breast augmentation surgery for teenage girls as the volume of their breast tissue may continue to grow significantly as they mature and because of concerns about understanding long-term risks and benefits of the procedure. Breast surgery in teens for reduction of significantly enlarged breasts or surgery to correct hypoplasia and severe asymmetry is considered on a case by case basis by most surgeons.
Health
Breast health factors
Factors that appear to be implicated in decreasing the risk of, or early diagnosis of breast cancer are regular breast examinations by health care professionals, regular mammograms, self examination of breasts, healthy diet, and exercise to decrease excess body fat. Healthy diet appears to reduce the risk of breast cancer, and includes limiting dietary fat, eating a balanced diet that includes plenty of nutrients, and dietary fibre such as are found in fruits and vegetables, and restricting intake of alcohol to a maximum of two drinks per day or less.[26]
There is an extensive body of research on iodine and breast diseases. [27]
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Breast Massage
Breast massage has been practiced for years as a means of stimulating healthy breast growth or natural breast enlargement and breast health. Research scientists state that in ancient Persia the massage therapy primarily focused on the breasts of females to promote circulation with the help of essential oils. Here is a detailed description on how to give the right breast massage and the need for it.
hy should you massage your breast regularly?
Breasts are one of the body tissues made up of blood vessels, milk ducts, fat glands, connective tissue, and complex lymphatic vessels. Each of them play an important role in achieving the desired breast health. The lymphatic system helps in removing viruses, toxins, debris, bacteria, cancer cells, and other unwanted material from the body. The lymph nodes are linked throughout the body and act as a major line of defense against the spread of diseases in the body. However, when lymphatic vessels and nodes become restricted due to tight inner wears or clothing, the body's defense system begins to break down. This makes the body prone to many diseases, even Cancer.
Women who wear tight bras for more than 15 hours continuously in a day, have an increased risk of acquiring breast cancer. As the bra limits limits the flow of toxins that need to be released, resulting in the increased cancer rate. Any more than a gentle amount of pressure can flatten the lymphatic vessel and stop the toxic flow from the breast. Therefore, women irrespective of age should try to avoid wearing bras at night and should also massage their breast regularly as it keeps your breast healthy, firm and beautiful.
Self Breast Massage
Breast massage has been used in beauty parlors and massage parlors, as a means of breast growth promotion and healthy lymphatic drainage. It is also practiced as a post operative therapy
for women who have undergone mastectomies and breast surgery
as it helps in breaking down scar tissues and even healing tissue regeneration. Here is a step by step procedure to help you practice self breast massage in the privacy of your home.
Self breast massage should be done at least twice a week. You can do it on bare skin or by using some vegetable oil to move more comfortably. However, stay away from mineral based or scented oils.
• Starting from the nipple, push downwards with the three longer fingers of your hand. Make sure the movement is done with less pressure, that is not more than, what you would apply to your eyelid. Deep pressure can flatten the lymphatic vessel and stop the flow of toxins and fluids. For effective results make this stroke really slow. Remember, massage is not all about squeezing some muscle it is just putting the right pressure on the right area.
• Next, gently massage the breast in a kneading motion, by lifting and pressing movements.
• Carefully use your hands to slowly twist the breast in a clock-wise and anti-clockwise direction. Make sure not to put too much tension on the breast.
• Finally, rest your palms on the breast in such a way that they don't cover the areola and area facing downwards. Then move your palms downwards so that the fingers rub against the side surfaces of the breast. This should not be done on the nipple, as it may spoil its shape.
• To make the breast firmer, practice the breast lift technique. In this procedure, the breasts are lifted skywards, while placing both hands on the breast, from the upper to the lower side. The breast is released when it is as full stretch. Repeat it at least 5 times on each breast
Brassiere
A brassiere (pronounced UK: /ˈbræzɪər/, US: /brəˈzɪər/; commonly referred to as a bra /ˈbrɑː/) is an article of clothing that covers, supports, and elevates the breasts. Since the late 19th century, it has replaced the corset as the most widely accepted method for supporting a woman's breasts.
Women wear bras for a variety of purposes, for support, to improve the shape of breasts, to reduce or to enlarge the perceived breast size, to restrain breast movement during an activity such as during exercise, to enhance their cleavage or to facilitate nursing. Most bras are designed to be form-fitting and to lift the breasts off the chest wall if they sag and to restrain their movement. Bra designers strive to produce a garment that is both functional and aesthetically pleasing.
For some people, the bra has become a garment with erotic significance and a feminine icon or symbol with political and cultural significance beyond its primary function. Some feminists consider the brassiere a symbol of the repression of women's bodies.[1] Historically, when a young girl gets her first bra, it may be symbolic of her coming of age.[2]\\
tymology
Support of the bosom by a bodice (French: brassiere from 1900)
The French word brassière refers to a baby's vest (undershirt) or lifebelt, underbodice or harness. The word brassière derives from bracière, an Old French word meaning "arm protector" and referring to military uniforms (bras in French means "arm"). This later became used for a military breast plate, and later for a type of woman's corset. The current French term for brassière is soutien-gorge, literally, "held under the neck" or "throat-support". In French, gorge (throat) was a common euphemism for the breast.[3] This dates back to the garment developed by Herminie Cadolle in 1905.
The term "brassiere" seems to have come into use in the English language as early as 1893.[4] Manufacturers were using the term by about 1904, Vogue magazine first used it in 1907,[5] and by 1911 the word had made its way into the Oxford English Dictionary.[3] On November 13, 1914, the newly formed U.S. patent category for "brassieres" was inaugurated [6] with a patent issued to Mary Phelps Jacob.[7] In the 1930s, "brassiere" gradually came to be shortened to "bra." In the French-speaking Canadian province of Quebec, both soutien-gorge and brassière are used interchangeably.
There is an urban legend that the brassiere was invented by a man named Otto Titzling who lost a lawsuit with Phillip de Brassiere (fill up the brassiere). This originated with the 1971 book Bust-Up: The Uplifting Tale of Otto Titzling and the Development of the Bra and was propagated in a song from the movie Beaches.[8]
[edit] History
Elastic brassiere from 1907
Main article: History of brassieres
During recorded history, women have used a variety of garments and devices to cover, restrain, or elevate their breasts. Brassiere or bikini-like garments are depicted on some female athletes in the 1400s BC during the Minoan civilization era. Similar functionality was achieved by both outerwear and underwear. In China during the Ming Dynasty a form of foundation cloth complete with cups and straps drawn over shoulders and tied to the girth seam at the lower back called a dudou was in vogue among rich women.[9] Popularity continued into the Qing Dynasty (1644–1911). In English they are known as "stomach protectors" or "tummy covers".[10]
From the 1500s onwards, the undergarments of wealthier women were dominated by the corset, which pushed the breasts upwards. In the latter part of the 1800s, clothing designers began experimenting with various alternatives to the corset, trying things like splitting the corset into multiple parts: a girdle-like restraining device for the lower torso, and devices that suspended the breasts from the shoulder for the upper torso.
By the early 1900s, garments more closely resembling contemporary bras had emerged, although large-scale commercial production did not occur until the 1930s. Since then, bras have replaced corsets and bra manufacture and sale has become a multi-billion-dollar industry. Over time, the emphasis on bras has largely shifted from functionality to fashion.[11][12]
[edit] Construction and fit
A brassiere usually consists of two cups for breasts, a centre panel (gore), a band running around the torso under the bust, and shoulder straps. Some bras are strapless. Bras are typically made of a fabric such as cotton or polyester. Spandex and lace may also be used for various parts of the bra. The cups may be supported by underwires made of metal and sometimes coated in plastic. Strapless bras usually use embedded underwire to support the breasts. Wirefree bras support breasts using strengthened, larger cups and wider bands.
These bras are sometimes referred to as softcup bras. The underwire shares the breast weight with the shoulder straps.[13] The bra is usually fastened with a hook fastener on the band, typically at the back. In some bras the fastener is in the front, between the cups. Others are pulled on over the head and have no fasteners. Some bras contain padding to improve comfort, conceal the nipples, or enhance bust size. Bust size and cleavage are also enhanced with breast pads inside the cups and by wearing push-up bras.
[edit] Fitting
A correctly fitting bra[14] should have the following features:[15]
• When viewed from the side, the chest band should be horizontal, should not ride up the back, and should be firm but comfortable.
• Each cup's underwire at the front should lie flat against the sternum (not the breast), along the infra-mammary fold, and should not dig in to the chest or the breasts, rub or poke out at the front.
• The breasts should be enclosed by the cups and there should be a smooth line where the fabric at the top of the cup ends.
• The apex of the breast, the nipple, must be in the center of the cup.
• The breast should not bulge over the top or out the sides of the cups, even with a low-cut style such as the balconette bra.[16][17][18]
• The straps of a correctly fitted bra should not slip off the shoulder and the back of the bra should not ride up.
• The breasts should be supported primarily by the band around the rib cage, rather than by the shoulder straps.
• The wearer should be able to breathe and move easily without the bra slipping around.
Nevertheless providing a well-fitting bra continues to prove a major challenge to manufacturers, since the garment is designed to form fit, yet individual women exhibit a large range of shapes and sizes.[19]
[edit] Bra sizes
Adjustable hooks permit adjustment for in between sizes and for the vertical position of the breasts. The band of a correctly fitted bra should ride horizontally across the woman's back.
Main article: Brassiere measurement
There is considerable variation in women's breast volume, shape, size and spacing. The majority of a woman's breast volume may be towards the bottom, sides or top of her bosom, which affects the bra size actually needed. Manufacturers make standard bra sizes that provide women a "close" fit, however women can have a difficult time finding a correctly fitted bra because of the variations in sizes between different manufacturers. A correctly fitted bra is determined by accurately calculating a woman's chest size (or band size) and her breast volume (the cup size). The band size can be adjusted slightly using the two or three alternate sets of fastening hooks and eyes in the clasp. The bra straps (over the shoulders) can usually also be adjusted slightly.
Bra sizes can vary widely, depending on the manufacturer, material used, and other considerations, and women can have difficulty finding a correctly-sized bra. This can be a challenge for both smaller- and larger-busted women.
Surveys of bra sizes tend to be very dependent on the population studied and how it was obtained. For instance, one study reported that the most common size was 34B, followed by 34C, that 63% were size 34 and 39% cup size B. However, the survey sample was drawn from 103 Caucasian student volunteers at a Midwest U.S. university aged 18–25, and excluded pregnant and nursing women.[19]
In a study of 103 women seeking mammoplasty, researchers concluded that "obesity, breast hypertrophy, fashion and bra-fitting practices combine to make those women who most need supportive bras the least likely to get accurately fitted bras."[20] Their research found that bra measuring systems often lead women to choose an incorrect size, most commonly resulting in too large a cup size (by a mean of three sizes) and too small a band size (by a mean of four sizes).[20]
[edit] Mechanical design
Bra designers liken designing a bra to building a bridge, because similar forces are at work. Just as a bridge is affected vertically by gravity and horizontally by earth movement and wind, forces affecting a bra's design include gravity and sometimes tangential forces created when a woman runs or turns her body.[21] "In many respects, the challenge of enclosing and supporting a semi-solid mass of variable volume and shape, plus its adjacent mirror image—together they equal the female bosom—involves a design effort comparable to that of building a bridge or a cantilevered skyscraper."[21]
Commenting about brassiere design, British Chiropractic Association representative Tim Hutchful said, ""Bras are like suspension bridges. You need a well-engineered bra so your shoulders don't end up doing all the work. Bras that don't fit will affect the shoulders and chest, and will almost certainly cause back pain as you get older."[22]
[edit] Calculating cup volume
Bra designers can calculate the volume of a brassiere cup in several ways depending on the shape of the breast. If the breast is round and essentially the shape of a half-sphere, any of three formulas might be used.[21]
where V equals the volume of one-half sphere, D equals the diameter of the sphere, and r equals the radius of the sphere.
If the breast is shaped more like a cone, the designer might use a formula like the following:[21]
where Db equals diameter of the cone's base and h equals the height of the cone. Other formulas can be derived as needed to design bras for differently shaped breasts.
The chest band and cups should provide support for most of the weight of the breasts, rather than the shoulder straps. Over-reliance on the straps for support can result in health problems for the woman. In most bras the straps are adjustable by sliding fasteners, and are usually made of a stretchable material such as spandex.
The average breast weighs about 0.5 kilograms (1.1 lb).[23] Each breast contributes to about 4-5% of the body fat and thus 1% of the total body weight of an average woman. One of the principal functions of a bra is to elevate and "support" the breasts, that is, to raise them from their normal position lying against the chest wall. This is considered the defining characteristic of the bra: supporting the weight from the back and shoulders, as opposed to lift solely from below (as corsets do).[1] Over-reliance on the shoulder straps for support can lead to poor posture, back pain and neck pain due to pinched nerves. In a well-fitted bra, 80% of the breast weight is supported by the chest band, something which is particularly important to women with larger breasts.[16]
The major engineering weakness of the bra, particularly if poorly fitted, is that it acts as a pulley, transferring the weight of the breasts from the lower chest wall to higher structures such as the back, shoulder, neck, and head. This can result in pain and injury in those structures, especially for women with pendulous breasts.[24]
[edit] Types of bra
A plunge push-up bra
Main article: brassiere designs
There is a wide range of brassiere styles available, designed to match different body types, situations, and outer garments. The degree of shaping and coverage of the breasts varies between styles, as do functionality, fashion, fabric, and color. Common types include backless, balconette, convertible, cupless, demi cup, front-fastening, full coverage, halter, longline, minimizing, padded, plunge, push-up, racerback, sports/athletic, sheer, strapless, strapless-backless, t-shirt, underwire, wireless, sports bra, and invisible.[25] Some designs combine one or more these styles.
[edit] Cultural significance
[edit] The bra as a fashion item
Woman wearing a designer demi-cup bra
Many Western women place a great deal of importance on their physical appearance, especially their body shape and body image. The Western media, especially advertising, emphasizes a woman's body shape, especially her breasts. The majority of adult women in the United States are not happy with their breasts.[26]
Firm, upright breasts are typical of youth.[27] Within Western cultures that place great value upon youth, bras are marketed to emphasize their ability to preserve a youthful appearance. The design of fashionable rather than solely functional bras[28] has been influenced by changing fashions in outerwear and in popular culture.
Pin-up photo of Jane Russell in a bullet bra for the September 21, 1945 issue of Yank, the Army Weekly, a weekly U.S. Army magazine fully staffed by enlisted men.
In the United States, the shape of bras has changed. During the 1920s, the fashion for breasts was to flatten them as typified by the Flapper era. In the 1930s, Maidenform developed cup sizes, helping to provide added support to individual breasts. During the 1940s and 1950s, the sweater girl became fashionable, supported by a bullet bra (known also as a torpedo or cone bra) like that worn by Jane Russell in the The Outlaw.[29]
During the 1960s, bra designers and manufacturers began introducing padded bras and bras with underwire. Women’s perception of undergarments changed, and in the 1970s, they began to seek more comfortable and natural looking bras.[29] In response to the feminist era, many bra manufacturers' marketing claimed that wearing their bra was like not wearing a bra.[30] Although in popular culture the invention of the bra is frequently attributed to men, in fact women have played a large part in bra design and manufacture, accounting for half of the patents filed.[1]
[edit] Social pressures and trends
Bra fence in New Zealand
The average American woman today owns six bras, one of which is a strapless bra, and one in a colour other than white.[31][32] Consumers spend around $16 billion a year on bras.[5] In the last 15 years alone, the average bust size among North American women has increased from 34B to 36C.[5] A number of sources state that about 90% of Western women wear bras, although no authoritative source for this fact is available.[33][34][35] Some women wear bras because of notions of modesty; others because they believe that it is part of their cultural norm and that not wearing a bra would lead to ostracism. Some wear bras because they believe it improves their appearance; while others because they find wearing a bra more comfortable than going without.
Bras are a relatively recent invention and are by no means universally worn around the world. In a cross-cultural study of bra size and cancer in 9,000 women during the 1960s, a Harvard group found 93% of women wore bras (from 88% in the UK to 99% in Greece), but could not find enough women in Japan who wore bras to complete their study.[36] In a number of cultures, including Europe and other Westernized countries outside the United States, there are no social restrictions against sunbathing or swimming topless.[37] There is less emphasis on the necessity to wear a bra as well.
The prevalence of the bra, and perceived social expectation to wear one, does not imply that openly displaying it is encouraged. On the contrary, it is often not considered suitable to expose one's brassiere in public in western cultures, even partially, despite the fact that it is similar in appearance to the upper part of a bikini; to do so may be considered sexually provocative.[38]
Even considering this relative cultural taboo, being seen in one's bra is still more socially acceptable than exposing the bare breasts. Indeed, women may choose to be seen in just a bra to make a specific point. For instance, bras have recently been used by organisations like breast cancer charities to raise money, either by sponsored walks[39] or to sell bras owned or decorated by celebrities.
In 1994, a significant shift in advertising lingerie occurred when advertising executive Trevor Beattie working for TBWA/London featured Eva Herzigova in a close-up of her black Wonderbra and cleavage with the title, "Hello boys." Looking down at her breasts, it's not clear whether she's addressing male admirers or her breasts. The ground-breaking, racy ad campaign resulted in many imitations along with a few complaints that the photograph demeaned women.[40][41] The influential poster was featured in an exhibition at the Victoria and Albert Museum in London[42] and it was voted in at number 10 in a "Poster of the Century" contest.[43]
[edit] Bralessness in public
There has been increasing comment that many entertainers, actresses and members of the fashion industry have chosen not to wear bras. A well known example is a member of the BBC Gardening's Ground Force, Charlie Dimmock.[44] Other celebrities noted for public bralessness include Britney Spears,[45] Clare Danes,[46] Lindsay Lohan,[47] Nadine Coyle,[48] Mischa Barton,[49] fashion executive Tamara Mellon,[50] and former model and France's first lady Carla Bruni, who welcomed Russian president Dimitry Medvedev at a state dinner in tight, revealing dress.[51][52]
[edit] Brassieres and security
The United States Transportation Security Administration recommends against underwire bras because they can set off the metal detectors,[53] though some travelers say they wear them and they don't set off the detector every time. Film maker Nancy Kates claims that she was "forced to strip off her bra and walk through airport security without support" when the underwires in her bra set off a metal detector.[54] According to underwire manufacturer S & S Industries of New York, who supply bras to Victoria's Secret, Bali, Warner's, Playtex, Vanity Fair and other bra labels, about 70 percent of women wear steel underwire bras.[55]
In response, Triumph International, a Swiss company, launched what it called a "Frequent Flyer Bra" in late 2001. The bra uses metal-free clasps and underwires made of resin instead of metal that are guaranteed to not set off metal detectors.[55]
[edit] Opposition to bras
Some feminist writers have considered the bra as an example of how women's clothing has shaped and even deformed women's bodies to historically aesthetic ideals, or shaped them to conform to male expectations of what is desirable. Professor Lisa Jardine observed feminist Germaine Greer talking about bras at a formal college dinner:
At the graduates' table, Germaine was explaining that there could be no liberation for women, no matter how highly educated, as long as we were required to cram our breasts into bras constructed like mini-Vesuviuses, two stitched white cantilevered cones which bore no resemblance to the female anatomy. The willingly suffered discomfort of the Sixties bra, she opined vigorously, was a hideous symbol of male oppression.[56]
Some people question the medical or social necessity of bras.[57] This has been referred to as breast freedom, bra freedom, or simply going braless.[58][59][60][61]
In October 2009, Somalia’s hard-line Islamist group Al-Shabaab forced women in public to shake their breasts at gunpoint to see if they wore bras, which they called "un-Islamic". Those found to be wearing a bra were publicly whipped because bras are seen as "deceptive" and to violate their interpretation of Sharia law.[62][63]
[edit] Health issues
[edit] Ptosis (sagging)
See also: Breast
Anatomically, the breasts are composed of soft, glandular tissue, with few support structures, such as connective tissue. Breasts are composed of the mammary glands, which remain relatively constant throughout life, as well as the adipose tissue or fat tissue that surrounds the mammary glands. It is the amount and distribution of adipose tissue and, to a lesser extent, glandular tissue that leads to variations in breast size. In addition, the breasts contain ligaments, although their exact function as related to breast support is not been agreed upon by experts. These ligaments, and the overlying skin (referred to as the dermal brassiere)[64][65] help determine the resulting breast shape.
As the breasts mature, they fold over the lower attachment to the chest wall (infra-mammary fold), and their lower (inferior) surface lies against the chest wall when vertical. In popular culture, this maturation is referred to as "sagging" or "drooping", although plastic surgeons refer to it as ptosis. The surgical procedure to lift the breast is called mastopexy.[66][67]
Although the exact mechanisms that determine breast shape and size remain largely unknown,[68] it has long been claimed that this occurs because the normal anatomical support is inadequate, especially in older women and those with larger breasts. Hence the bra is often proposed as a means of providing artificial support, based on the presumption that the breasts cannot support themselves.[69] Health professionals have, however, found no evidence to suggest that the bra slows ptosis of breasts.[70] Bra manufacturers have also stated that bras only affect the shape of breasts while they are being worn.[71]
Indeed, there are indications that wearing a bra may have an effect opposite to that which was intended. In a Japanese study, 11 women were measured wearing a standardised fitted bra for three months. They found that breasts became larger and lower, with the underbust measurement decreasing and the overbust increasing, while the lowest point of the breast moved downwards and outwards. The effect was more pronounced in larger-breasted women. This may be related to the particular bra chosen for the experiment. There was some improvement after changing to a different model.[72] These findings were confirmed in a much larger French study of 250 women who exercised regularly and were followed by questionnaires and biometric measurements for a year after agreeing not to wear a bra. While there was some initial discomfort at the first evaluation, this gradually disappeared and by the end of the year nearly all the women had improved comfort compared to before the study. The measurements showed firmer, and more elevated and youthful breasts. One example is given of a woman who had breasts that were uncomfortably large, and who had improvement after two years of being without a bra.[73][74]
While some may dispute the reasons why breasts change in shape with age and argue over whether or not the process can be delayed or reversed by wearing a bra, it is a natural process of bodily change. Health ethicists are concerned that plastic surgery and implants have altered our concept of what is "normal" and medicalised women's bodies by making a normal process a "disease."[75]
"There is no medical reason to wear a bra. ... The decision is yours, based on your own personal comfort and aesthetics. And even though, as little girls, we were told that bras save us from hanging breasts, ... whether you have always worn a bra or always gone bra-less, age and breastfeeding will naturally cause your breasts to sag." Dr. Niels Lauersen[76]
"Breasts were fine before the invention of the brassiere. ... This is similar to the myth that women supposedly need corsets to support their stomach muscles...wearing a bra...has no medical necessity whatsoever. ... Except for the women who find bras especially comfortable or uncomfortable, the decision to wear or not wear one is purely aesthetic — or emotional ... If you don't enjoy it, and job or social pressures don't force you into it, don't bother. ... A mistaken popular belief maintains that wearing a bra strengthens your breasts and prevents their eventual sagging. But you sag because of the proportion of fat and tissue in your breasts, and no bra changes that. ... If you don't like wearing a bra, don't wear one." Dr Susan Love[77]
[edit] Fibrocystic disease and breast pain
Some women experience breast pain (mastodynia, mastalgia), particularly when performing strenuous physical activity or exercise. A properly fitted bra reduces such pain and the sports bra has been specifically designed for this purpose.[20][78] Sports bras were found to be more effective than ordinary bras for reducing breast pain caused by exercise.[79] However, the need for wearing a bra at all during exercise has been questioned following extensive studies on athletes and sportswomen.[73]
Numerous websites and publications dealing with fibrocystic disease and breast pain state that a well-fitting bra is recommended for treatment of these conditions.[80][81] For fibrocystic disease there are no studies to support these statements. For breast pain a 2006 clinical practice guideline,[82] makes this statement as level II-3 evidence and a grade B recommendation. However, this rests solely on two short communications of uncontrolled studies.[78][83] In the 1976 UK study, 114 women complaining of pain were professionally fitted with a special bra. 26% of women who completed the study and wore the bra properly had relief of pain, 49% improved, 21% did not, and 4% were worse. There were a lot of dropouts from the study. In the 2000 Saudi Arabia study, 200 women were randomly allocated to either a drug (danazole) or a Sports bra. 58% of the danazole group improved compared to 85% in the sports bra group.[78] No details of what the women wore prior to the study was given. Neither study had an untreated control, and there was no blinding. Breast pain has a very high placebo response (85%)[82] so that a response to any intervention might be expected. It is not clear whether the interventions described can be generalized to a large population. A similar number of websites claim improvement after stopping wearing bras. These are based on anecdotes, since there are no formal studies.
In the specific case of larger breasts, the bra lifts the breasts away from the chest and can prevent two skin surfaces from rubbing together. Without the bra, maceration (loss of skin), intertrigo (rash) and fungal infections are possible.[20]
[edit] Cause and impact on shoulder pain
Beach volleyball
German pole vaulter Floé Kühnert
Standard, well-fitting bras are constructed in the form of a "square frame", anchored by a chest band, with all dimensions fitted (i.e., adjusted) for each woman in a normal standing position with arms at their sides assuming that both breasts are equally sized and positioned. When a woman performs an activity which requires her to lift her arms above the shoulders, the bra's frame is strained and weight is transferred from the chest band to the shoulder straps, putting direct pressure on the trapezius muscles. Even a well-designed bra can thus cause or aggravate shoulder pain. This problem can affect female participants of sports such as volleyball, high jump, or long jump who must continually raise their arms during competition. Some occupations also require repeatedly raising the arms above the shoulders. Women may also experience shoulder pain when elevating their arms if they wear narrow ("spaghetti") strap, poorly designed, or badly fitted bras.[11][84] Each of these concentrates pressure on the trapezius muscle, which may result in neck and shoulder pain, numbness and tingling in the arm, and headaches.[85] Strapless bras put all the weight of the breasts onto the chest band, and extra strain onto the rib cage and back.[86]
To compensate, female athletes can wear athletic or sports bras that offer improved support. Sports bras do not meet some larger busted women's needs, however. "Larger-breasted women, and women who are breast-feeding, often have trouble finding a sports bra that fits, feels comfortable and provides sufficient motion control."[87]
In a five-year study, 100 women who developed pain in their shoulders were given the option to remove the breast weight from their shoulders by not wearing a bra for two weeks. In that two-week period, many experienced relief from pain. Relief was complete among 84% of women who did not elevate their arms. However, their pain symptoms returned within an hour of resuming bra use. Three years later, 79% of the patients had stopped wearing a bra "to remove breast weight from the shoulder permanently because it rendered them symptom free." Sixteen percent worked in occupations requiring them to elevate their arms daily, and this group only achieved partial improvement. Of these, 13 of the 16 ceased to wear a bra, and by six months all were without pain.[86]
[edit] Back pain
Back pain is particularly common among large-breasted women who wear bras which offer insufficient breast support. Bra fitting experts from Bravissimo, who specialize in large cup size bras, say that wearing the wrong size bra can lead to back pain:
Overestimating the width of their back and underestimating cup size... results in the weight of the breasts being carried by the shoulders rather than supported around the chest, and contributes to back pain.[88]
Upper back, shoulder, and neck pain can also be experienced by unusually large-breasted women no matter what size or style bra they wear, leading some women to seek breast reduction surgery.
[edit] Possible negative health consequences
While bras prevent the breasts from sagging against the chest wall they may cause negative health consequences. Bras that are too tight can actually compress the breasts against the chest, possibly constricting the lymphatic system and inhibiting its beneficial effect upon breast tissue.[89][90] Too tight bras also pull the upper thoracic and cervical vertebrae (spine) forward and down, interfering with back, shoulder and chest movement.[20] Others[91] believe that wearing a bra can actually increase the downward movement of the breasts with age, because the chest (pectoralis) muscles that support breasts are used less and atrophy from lack of use.[76]
Like corsets, health professionals have also had concerns about the constricting effects of brassieres, although this varies considerably with design and the relative size of the bra and the breast. While at least sports bras do not usually cause any significant impairment in respiration,[92] some bras may put pressure on nerves.[93][94]
Of particular concern have been claims that the bra causes or contributes to breast cancer. This is denied by major cancer organisations but frequently expressed by women. The major study on which this theory is based is a cross cultural cohort study, which was published as a book "Dressed to Kill" by two epidemiologists, Sydney Ross Singer and Soma Grismaijer, who noted low rates of cancer in cultures that do not use bras. The theory is based on the idea that constriction interferes with lymphatic drainage and heats the breast. No prospective study has attempted to confirm or refute this, although there are substantial difficulties associated with this given the many risk factors already known and confounding with cultural factors. Nevertheless such theories continue to be raised in the medical literature.[95]
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A model with bound breasts, in a karada body harness
Breast bondage is a bondage technique which involves the tying of rope around a woman's breasts in a visually intricate and decorative pattern. Breast bondage most commonly uses rope, but webbing, straps or a harness may also be used. A karada (Japanese for "body") is a rope dress or a rope body harness used in Japanese bondage and other BDSM activities.[1]
Breast bondage often focuses on the decorative aspects of the result, and not on immobilization of the female subject. However, breast bondage can be combined with other techniques which restrict the subject's mobility and can provide securing points for other bondage plays, such as crotch rope and tit torture.
Oral stimulation of nipples
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An illustration of a woman orally stimulating the nipples of her sexual partner.
Oral stimulation of nipples is a human sexual practice. Typically, one person will orally stimulate the nipples of another person. The stimulator may lick, suck, bite, or blow on the other person's nipples.[1] The practice may be performed upon – or by – people of any sex or gender. Some people are able to perform oral stimulation upon their own nipples. Oral stimulation of nipples can be a form of foreplay. Some females experience breast orgasm without other forms of sexual stimulation.[2]
Stimulation of the nipples promotes the secretion of hormone oxytocin, which is known to increase pair bonding, increase trust, decrease anxiety and increase maternal behaviors.
A related, but far less common sexual practice is erotic lactation. Erotic lactation involves deriving sexual stimulus from interaction with or consumption of breast milk, often through adult breastfeeding.
Another sexual act consists in a woman licking or sucking her own nipples so as to stimulate the partner by this vision when it is considered to be erotic.
Mammary intercourse
Mammary intercourse describes a sex act, performed as foreplay or as non-penetrative sex, that involves the stimulation of the male penis by the female breasts. Commonly, this sex act involves the man placing his penis in the woman's cleavage and thrusting between her breasts, while the breasts are squeezed around the penis for additional stimulation. Mammary intercourse can also be combined with fellatio.
