Dr. Capone interviewed by Pittsburgh Post-Gazette

Burned by your bra?

Long a wardrobe staple, the bra is often poorly chosen, with painful consequences

Tuesday, September 25, 2001
By Mackenzie Carpenter, Post-Gazette Staff Writer

Sara Pitzer is, by her own description, a heavyset woman who doesn’t enjoy wearing tight undergarments.

And so, when driving home after a particularly bad day at the office, she would often perform this relaxation exercise her mother taught her:

“I’d unhook my brassiere under my clothes, slip the straps and pull it out through a sleeve and hang it on the outside car mirror.”

Pitzer, a former State College resident now living in North Carolina, says she wears a bra only when she has to, and is still looking for “a bra that doesn’t hurt.”

She’s not alone.

As Americans age and obesity rates increase, average bra sizes are going up — to a 36C, according to Maidenform (although other companies, such as Bali, still peg it at 34B, but moving steadily toward 36 B and C). And whether small-breasted or large, between 65 and 85 percent of all women wear the wrong-sized bra, according to experts.

Discomfort aside, is it possible that the brassiere — a staple of the American woman’s wardrobe since the early 20th century — may actually pose a health hazard?

The answer may be yes.

A recent online dispatch from Intelihealth.com — an Internet health service that partners with Harvard Medical School — warned that the wrong bra can cause back pain, itching, rashes, headaches and breast pain during exercise; too-loose bras can tear delicate tissue fibers and ligaments that support the breast.

And for women suffering from hypermastia — the medical term for extremely large breasts — the problem becomes particularly acute, says Dr. Raymond Capone, chief of the division of plastic surgery at UPMC Shadyside.

Capone has seen many women troop through his office with telltale “shoulder grooves” — the result of years of wearing a brassiere with straps that are too thin to carry the weight of the breasts efficiently.

While large breasts pose a problem in and of themselves, “I believe that for the past 75 years a rather curious undergarment has exacerbated these symptoms: the bra,” wrote Capone in an article published last spring in the University of Pittsburgh’s Physicians Newsletter.

Indeed, in person, Capone waxes positively indignant on the subject of ill-fitting brassieres.

“Women have to be smarter consumers,” he said in a recent interview. “When you have large breasts, you should not buy these sexy narrow straps.”

It’s all a matter of engineering, he says. With the advent of bras in the 1920s, “women began suspending their breasts from very narrow straps over the shoulder girdle. This feat serves to focus the considerable torque associated with the weight of large breasts” on that part of the body.

Capone limits his critique to those undergarments designed more for cleavage than for comfort. Sports bras, he says, are generally a better choice because they feature wide straps and more support across the back.

“While the French brassiere may be a fascinating invention for the small-breasted flapper of 1920 Paris,” in inventing the bra, he wrote, “I believe mankind may have taken a wrong turn.”

It’s all in the fit

Representatives of the bra industry beg to differ.

“A lot of women do get ridges in their shoulders, but it has less to do with the strap than with how the infrastructure is made,” says Lisa Boecker, marketing manager for Barely There. She said support from a well-fitted bra should come from around the body and the underwire, not the straps.

“The straps are there to hold the top of the cups,” not to support the breasts, she said.

“If you’re relying on a strap for support, it stands to reason that wider straps are better, but the reality is you shouldn’t be relying on the strap. The bra should stay in place without it — that’s really the test.”

Maidenform officials, to some degree, agreed with Capone.

“We’ve heard complaints,” about bras that are uncomfortable, said Manette Scheininger, senior vice president of marketing. “Large-size bras should not have narrow straps,” she added flatly, noting that the company’s Lilyette brand has straps that are wider than average and increase in width with an increase in cup size.

Part of the problem, too, is that many women come into a fitting room convinced that they are a smaller size than they really are, Boecker said.

“Nobody wants to be a size 10 shoe, and a lot of women feel like that about bras. We’ll bring a bra in that’s a double D and the woman will say, “Oh that’s not my size,” when in fact it absolutely is.”

Even small-breasted women are frustrated, however, with the choices out there.

“It’s almost impossible to find an ‘A’ cup bra,” says Marilyn Yalom, a Stanford University professor and author of the 1997 book “The History of the Breast.” And a lot of them are padded because the assumption is if you’re small-breasted, you want a larger look, she said.

Would the vast number of breast implants — which end up as ‘C’ cup bra sizes, coincidentally the new average size — have anything to do with the decreasing selection of bras in the A cup size?

Certainly not, claim bra manufacturers.

“I don’t think any of us manufacture for breast implants,” said Boecker, adding that 70 percent of the market is for “average” sizes. The rest, about 30 percent, consists of full-figured women and only a tiny percentage involves women seeking an A cup.

Whatever the case, it’s becoming rarer and rarer for women to even have a fitting, even though experts say women should be re-measured by a professional every two years.

Smaller lingerie stores that feature custom fittings, though, have diminished in number. A few, such as Cheeks in Shadyside and Pussy Cat in Squirrel Hill, do remain, along with the ubiquitous Victoria’s Secret.

And while the larger department stores, Kaufmann’s, Lazarus and Saks, do have fit specialists in their lingerie departments, the vast majority of bra purchases are at discount stores like Wal-Mart and Kmart.

Still, many women resist the idea of bras that are good for you.

“Some women hate those wide-strap bras. They’ll look at them, and say, ‘who wants to wear a harness?’ ” said Laura Richardson, a buyer at Cheeks.

62-year-old Madonna

Sara Pitzer, the North Carolina woman, says she went braless in the 1970s. Not any more.

“It used to be I didn’t care who knew. Now I don’t want to scandalize anybody,” she said, noting that her efforts to find the right bra have still met with failure. Once, at a “custom” fitting, she ended up with an elaborate contraption that had Pitzer’s 40-something daughter, who was in the dressing room with her, crying tears of laughter.

“I looked like a 62-year-old wearing Madonna cones.”

Needless to say, she didn’t buy the bra.

“But I’ll never be able to drink out of a paper fountain cup with a straight face again.”

Getting the best fit

Bali Co. offers these tips on fitting a bra

Q: What’s the best way to put on a bra?

A: Slip the straps over your shoulder, bend forward at the waist and ease your breasts into the cups. Adjust your breasts so the nipples are centered into the fullest point of the cup. The cup should completely contain the breast (with the exception of push-up styles). Hook the enclosure at the middle position. Stand upright. Adjust the straps so that breasts are at a comfortable height.

Q: Why do the cups of my bra wrinkle?

A: Cups should completely contain the breast. Bulges at the top or sides mean the cup is too small. Wrinkles mean the bra is too large.

Q: My bra cuts and binds when I move. Is it the wrong size?

A: Maybe. Hook the back closure less tightly or try the next larger band size. Also, if the bra has narrow sides, it may be the wrong style for you.

Q: My straps keep falling off my shoulders. What should I do?

A: The cups may be too big. Since you’re not filling out the top of the cup, your straps slide down your shoulder. Try a smaller cup size.

Intelihealth, an Internet health news services that partners with Harvard Medical School, offers an online calculator for women to determine their correct bra size. You can find this at www.intelihealth.com. Click on Women’s Health and go down to “Finding a Bra that Fits”.

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