Rebecca Thorne, BBC Health
"I used to walk with my shoulders hunched over, just so people wouldn't see that I had big breasts. I remember that because I was so embarrassed."
Raquel, a university professor from Argentina, decided in 2010 to undergo breast reduction surgery.
Today, the 52-year-old says that after the surgery she has a "sense of freedom" that she didn't have before.
Although large breasts are considered attractive in many parts of the world, it can also be difficult, as they can significantly affect a woman's health and quality of life.
Large breasts are associated with many symptoms, including chronic back pain, headaches, poor posture, numbness, and sleep disturbances, as well as impaired mental health.
According to the latest data from the International Society for Aesthetic and Plastic Surgery, 652.676 breast reduction surgeries were performed worldwide in 2024.
The largest number of these operations was performed in Brazil (115.647), followed by the United States (67.478), France (38.780), Germany (32.068), Turkey (25.334), and India (22.400).
Rakel says she has had chronic back pain since her teenage years due to her large breasts.
But in Argentina, large breasts are often considered a blessing, she says.
"Most men and women tell you that you are very lucky," she explains.
"I wasn't happy. I suffered a lot."
"I suffered as a teenager, and later as a woman and a mother."
In fact, she says she still has back pain from the way she walked trying to hide her breasts.
Raquel says she was active and loved yoga, Pilates, and going to the gym.
But over time, the burden of her large breasts prevented her from engaging in her favorite activities.
Dr Nora Nugent, president of the British Association of Aesthetic and Plastic Surgeons, says that patients who want to have breast reductions most often do so because of limited mobility and difficulty exercising.
"In terms of function, large breasts are heavy, so they pull the body forward and create constant strain on the back and neck," she says.
"They also make exercising quite uncomfortable, and it's very difficult to find a bra that fits well and holds your breasts well."
Raquel says she had to wear "two or three" bras.
And finding the right size bra was an additional financial burden.
"In Argentina, they were very expensive for large breasts," she says.
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"I felt free"
Nugent says that most of her patients in the United Kingdom (UK) have between 500 and 800 grams removed from each breast, although she knows women who have had more removed.
"Sometimes it's not a large amount in relation to total body weight, but it's a large amount for a small area of the body," she explains.
A total of 2,5 kilograms of tissue was removed from Raquel's breasts.
"After the surgery, I remember when I had to pick something up off the floor, I thought, 'Wow, this is a different body.'
"I felt so, so free."
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The power of a good bra
When Professor Joanna Wakefield-Skur went to the doctor about chronic breast pain, she was told that all she needed was a well-fitting bra.
As an expert in biomechanics, she decided to research what makes a good bra.
"I realized that we actually know very little about why we need a bra, what its benefits are, and what the role of a bra is," says Wakefield-Skur.
"The bra was considered more of a fashion item than something functional, with a purpose and health benefits."
"That really disappointed me."
That's why in 2005 she founded a breast health research group at the University of Portsmouth in the UK.
Her team identified four key negative consequences of wearing an ill-fitting bra - pain, skin stretching and tissue damage, changes in breathing patterns and the spacing between heartbeats, and an obstacle to physical activity.
"If you have heavier breasts and they're bouncing up and down, it can actually change the way you breathe."
"It changes the amount of force you exert on the surface."
"It has a kind of impact on the overall functioning of the body."
Through years of research and experimentation, the group also found that during all types of exercise, the chest moves in a figure eight pattern.
They found that the key to reducing chest pain was slowing down movement, not reducing the range of motion.
The team has previously worked with top female athletes, including England national football players, as well as some of the world's best golfers, to help them find the bras that fit them best.
"We've seen some organisations, including the Football Association of England and the World Rugby Federation, invest money in female athletes' health initiatives, and it's only in the last, say, five years," says Wakefield-Skur.
"It's relatively new, but the change is great."
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"Patients want to live a quality life"
Rakel also had to face the opinions of her surroundings about the burden that large breasts pose.
She says she felt judged by others for having breast reduction surgery, and that people often misunderstood her reasons for doing so.
"I think most people thought I had it done for aesthetics, not that I had a health problem," she says.
"I remember when I did that, a woman said to me, 'Now you need to go and fix your stomach, like with liposuction.'"
Despite such reactions, Rakel says she does not regret the decision.
"I'm very happy and now that I'm in menopause, I don't know how I could live with big breasts."
"I can't imagine myself dealing with a body like that."
Nugent says the rise in patients seeking breast reduction surgery is a sign that people are taking more care of themselves.
"The number of not only women, but all patients who want to live a quality life is definitely growing," she says.
"It's not necessarily a pursuit of perfection, but rather of health and well-being."
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