Medical aspects of bras

[fisherdvm]

All right, don't blow this thread off as another silly joke by fisher. Unfortunately, this is a big issue for me in my work. My patient's, especially the elderly with diabetes, are very prone to a skin problem called "intertrigo". This is a complex of problems - maceration from sweat, abrasion from fabric of the bra, yeast over growth or "candidiasis", and bacteria colonization and overgrowth. The problem can occur in any skin folds (armpits, breast folds, abdominal folds, groin, and gluteal cleft).

My standard treatment is the same - a mild topical steroid for no more than 2 or 3 days a week, and a topical antifungal. Occasionally, I will add a topical antibiotic. I also recommend that they can place gauze pads or dry towel under the breast at night for ventilation, and the use of an antifungal powder like Zeosorb AF.

But the biggest issue here is ventilation and support. I usually refer these patients to the medical supply stores and sports equipment stores for advice on what type of bras to buy.

Can anyone give me a practical approach to how to select a bra for these patients? Who is an expert at this area?

 

[erparamedic]

I am, by no means, an expert in this area. However, I can say that the "girls" used to be VERY large, and bras were a big problem for me, as nobody carried my size. Two years ago, I had a reduction (paid for by insurance), and it's the best thing I've ever done for myself! The "girls" are now a nice, normal size, and bras are MUCH more comfortable!

The problem that bras presented for me were heavy sweating, shoulder, neck, and back pain, and occasional mild rash and headaches. Cotton bras were better tolerated. Underwires were NOT tolerated at all... painful to wear. I never had any problems like yeast or bacterial infections. I think that using cotton bras, and powder helped in that area. Satin bras were uncomfortable because they increased the sweating.

That said... my only advice would be to recommend cotton bras and the daily use of powder. If the patient has insurance, and they have overly large breasts that cause problems such as the yeast/bacterial infections (that you mentioned), shoulder, neck, or back pain, headaches (yes, they can be caused by the pull from large breasts) or the patient has "divits" in their shoulders from bras, etc.... recommend seeing a plastic surgeon for a reduction. The plastic surgeons know how to write up the "medical necessity" letter so that insurance is likely to cover the operation.

The only other option... as far as choosing a bra... would be to find a bra specialty store in your area. For me, there was a store across town that sold bras for mastectomy patients and "large breasted" women. However... they did not sell cotton bras, which was the most comfortable for me. But... it was an option.

Geesh... I'm glad this is in the women's forum!

 

[BabyDuck]

according to a friend with larger breasts...

many many women are wearing the wrong bra size, which only adds to problems. find out who / where in your area really assists with proper sizing, and send the ladies there. my friend pays up to $80 per bra, but they fit...then she goes on ebay & buys more of the same style for about $30.

 

[erparamedic]

according to a friend with larger breasts...

many many women are wearing the wrong bra size, which only adds to problems. find out who / where in your area really assists with proper sizing, and send the ladies there. my friend pays up to $80 per bra, but they fit...then she goes on ebay & buys more of the same style for about $30.

Very good point, BabyDuck! It's VERY important to know the correct size! Be careful who measures you though... you want somebody/someplace that specializes in it, or you will, once again, wind up in the wrong size. (I was measured wrong at Lane Bryant, and when I went to the specialty bra place, they measured me correctly.)

"Good" bras are very expensive... I remember paying $60+ for mine... and was thrilled if/when I could find them on Ebay (only new with tags!!!).

 

[Bobbin-along]

Get properly sized for the right bra.

Find a style that fits your body type. Women whos breasts sit up high on the chest need to find styles that don't have an underwire that rides up too high in the middle of the sternum or pokes under the armpit. Sometimes underwire free bras are the solution, but if they are the wrong cup size then you end up exaserbating the skin-skin contact at the breast fold as the cup doesn't have enough material to cover.

It may be expensive, but buy a bra that really truly fits. If you are a DD or smaller head to Macy's or other upper end department store where Bali, VF, and others train staff, or who bring in a corporate fitting team a couple times a year who can help you find a bra from a wide selection. 2x a year Bali and sister companies usually have a sale where if you buy 3 you get 2 free. that helps offset the 40-50$ per bra price. Once you hit DDD or larger size, you will need to visit the specialty stores. That's where things can start being expensive. Plan on 50-80$ per.

For support and comfort, many of the new shaped sports bras are the cat's pants. You get cotton, support, and comfort. Unfortunately the new styles haven't migrated their way to DDD and up. Which to me implies that the industry doesn't think that girls with big breasts exercise. Maybe if they made better bras for bigger sizes we'd be more likely to bounce around! The new styles are molded cups and so the mono-boob look is completely eliminated.

 

[erparamedic]

For support and comfort, many of the new shaped sports bras are the cat's pants. You get cotton, support, and comfort. Unfortunately the new styles haven't migrated their way to DDD and up. Which to me implies that the industry doesn't think that girls with big breasts exercise. Maybe if they made better bras for bigger sizes we'd be more likely to bounce around! The new styles are molded cups and so the mono-boob look is completely eliminated.

That's a big problem that I had when I was "big breasted"... couldn't find a sports bra ANYPLACE! It was terrible. (I was also a size H) Now that I'm much smaller and perky again... (LOL)... my options are soooo much better!

Another note... I am a big girl... and even when I lost weight, nothing would come off of the breasts. So... for docs that just say, "lose some weight"... it doesn't always work for "that place".

 

[Missdirected]

Post #5 backing up the previous - you must get the right size bra. The majority of women are not wearing a proper fitting bra, believe it or not. A proper fit will not allow a bra to ride or move around. I personally go to Dillards. Don't know if you have one in your are. Anyway, the girls there are trained in fitting. Just make sure you get a girl that has been doing it a while and let them help you (or your patients). They will guide you to the good bras - and I don't mean label names - I mean good as in quality and fit. You are going to pay between $50-80 but they will work and last. They also carry all sizes! There were HH's and G's out on the rack the other day when I was there

 

[drl]

Fisher,
sports bras would probably be the thing to recommend (properly fitted, of course). They are designed to separate and support the breasts, and most feature moisture management and ventilation.
Not that I can relate with my a-cups... some of us do lose weight in the chest, usually first!

 

[Missdirected]

Fisher,
sports bras would probably be the thing to recommend (properly fitted, of course). They are designed to separate and support the breasts, and most feature moisture management and ventilation.
Not that I can relate with my a-cups... some of us do lose weight in the chest, usually first!

I disagree. They don't lift and separate. They squish and hold.

 

[erparamedic]

I disagree. They don't lift and separate. They squish and hold.

I agree.