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THE BRA FITTING MASTER HANDBOOK - PART 2

01 October 2018

INTIMODA CONTINUES THE SERIES OF ARTICLES BY RENOWN POLISH BRA FITTING SPECIALIST KATARZYNA SALATA.

Though a bra may seem an innocuous daily item, an ill- fitting one can be extremely harmful, creating constant pressure on a very sensitive part of the body. The risk of impaired lymph movement increases, which can lead to the appearance of edema and inflammation of the mammary gland, as well as discomfort and even pain while wearing the bra. Highly innervated and penetrated by a dense grid of blood vessels, mammary glands are particularly sensitive to temperature, trauma, and above all, to prolonged squeezing. In this regard, understanding the medical and anatomical ramifications as well as making women aware of the many aspects of bra fitting that directly relate to personal health is, in my opinion, extremely important in the work of a bra fitter. Four years ago when I first saw a picture of the lymphatic system of the chest, I immediately noticed one detail: bra straps, underwire, center gore (located between the cups) and underband are exactly where the lymph nodes are located! I then worked with a group of bra fitters, and we learned how to choose the right lingerie for women after a mastectomy (the removal one or both mammary glands) or sector resections. To avoid hampering lymph flow and to prevent lymphedema—which can occur at any point after lymph removal or radiation treatment to the lymph nodes— in the upper limbs on the side of the removed mammary gland, understanding how the lymph nodes function and how to prevent excessive bra pressure in this area was of paramount importance for us.At the same time, I realized that preventing excessive compression of the lymph nodes is an extremely important point not only for women who have undergone mastectomies, but also for women who do not suffer from breast cancer.

BRA FITTING: HEALTH AND COMFORT
Since that moment, during bra fitting sessions I began to learn from clients where they felt pain or discomfort while wearing lingerie. It turned out that the most painful area is directly under the mammary glands as well as in the armpits, where the underwire ends. I sought to better understand the cause by paying particular attention to where the wires and band are located and the force of their pressure, and, if the clients complained of discomfort, I asked when this discomfort arose: when they sat quietly or moved actively?I realized that it was necessary to develop new methods for choosing and adjusting bras that should be implemented during the bra fitting process, and I began to deepen my knowledge simultaneously in three directions. First, I observed the structure of the chest and studied its characteristics: the structure of the ribs, sternum and shoulders, the height of the mammary glands and the distance between them. Secondly, I began to take into account the client's breathing and the changes in chest volume when inhaling and exhaling. Finally, I began to study the anatomy of the breast and the structure of the lymphatic system in the thorax. I wrote an article about the first two concentrations of my research, published in the February 2018 issue of Intimoda, and now I would like to share more about the critical third point.

ANATOMY LESSON
The structure of the mammary gland

Did you know that the Latin name for the mammary gland – glandula mammaria – also gave its nomenclature to a whole class of vertebrates: mammals (Latin: Mammalia)? The mammary glands are situated symmetrically on the front wall of the chest between the third and sixth or seventh pair of ribs. The distance between them depends on individual structure. Most of the mammary gland is located on the pectoralis major, and only a minor lateral part is situated on the serratus anterior muscle (Bochenek A., Reicher M. Gruczoł sutkowy, Anatomia człowieka, T V. PZWL 2008).The breast is located under the clavicle, limited medially by the edge of the sternum, and limited laterally by the middle axillary line. In the picture you can see that the mammary gland consists of three types of tissue: glandular, located primarily in the areola and nipple, connective and fatty tissues (subcutaneous fat and fatty tissue located behind the gland and between the lobes). The volume of these tissues varies from one individual to the next, therefore, doctors distinguish between two types of breasts: those with predominantly fatty tissue or predominantly glandular tissue. According to studies, the ratio of these tissues in humans is genetically determined and only varies slightly based on hormones or aging. This is why understanding physiological changes and individual client needs are so informative to the process of choosing of a bra.

The mammary glands are permeated with lymph (a fluid that travels through the lymphatic system’s channels carrying cells to help the body fight infections) and a network of blood vessels (veins and arteries), and the sensory nerve terminals are located within the skin of the thorax and armpits. This causes an increased reaction to any agents in these areas, including any interaction between the surface of the bra and the body: for example, pressure or friction as a result of movement of material or the bra itself. In this context, when dealing with clients, it is necessary to explain the relationship between, for example, a cup that’s too small and the resulting discomfort or pain in the armpit area.

Why does the breast have this shape?
The mammary glands have a semicircular or conical shape, and function as a paired organ: the body’s largest cutaneous gland. As the mammary glands do not have muscles, but rather overly the pectoralis major muscles, they are naturally held in place by skin, ligaments and fasciae consisting of dense connective tissue. The field of study in the structure of the breast is quite young, however I would like to pay attention to two significant events related to it. The first is the classification of Cooper’s ligaments in 1840. The name comes from the author of their discovery – Astley Cooper. Cooper’s ligaments are connective strips of fibrous tissue that support the breast from above and below and lift it up, thereby helping it to maintain structural integrity. They reach from the skin through the mammary glands to the edge of the pectoral muscle. According to a study by Dr. Joanna Scurr of the University of Portsmouth in the United Kingdom, the strength of these ligaments weakens by 65% in women over 45 years, and the elasticity by 40% compared to younger women.

The second event, and one of the latest developments in the field of research on the structure of the breast, is the discovery in 1996 of horizontal and lateral supporting ligaments by the German plastic surgeon Elizabeth Würinger. Würinger’s ligaments are strong connective tissue that hold the mammary glands in a suspensory U-like cradle and support the entire structure of the gland (source: https://clinicalgate.com/the-central-septum-in-breast- reduction-and-mastopexy/ 28.06.2018). The research of Joanna Scurr (2009) in the field of breast biomechanics has shown that the mammary gland extends in three directions, with only 44% of movement occurring vertically. To prevent ligament sprains, improve breast health and reduce the risk of sagging, the mammary gland must be properly supported by stabilizing the bra band and choosing the right cup size so that it completely covers the mammary gland. The mammary glands require support and further adjustment of the bra at every life event that can affect breast size: puberty, pregnancy, breast feeding, menopause, weight changes, sports, physical work, and aging.

Lymphatic system
The lymphatic system covers the entire body. If you look at the positioning of the lymphatic system in the chest, you can see that bra straps, underwires and band are situated precisely in those areas where the lymphatic vessels and lymph nodes pass (apical axillary, subscapular axillary, breast, supraclavicular and epigastric).The lymph nodes are located along the efferent lymphatic vessels. They are shaped like a bean and range in size from 2 to 20 mm. They play a crucial role in the normal functioning of the immune system: removing bacteria, viruses and fungi, and collecting lymph with lymphatic vessels. Lymph flows in the lymphatic vessels, which means if too much external pressure is exerted upon them, edemas and even cysts may occur in this area as a result of trauma or incorrect movement of the tissue fluid. It is interesting to note that the more I speak with clients about the structure of the breast and the location of the lymph nodes, and the more I share this knowledge with them and explain the effect that an improper choice of a bra has on their health, the more I see that such sincere communication supports mutual trust and helps build our relationship. In addition, I also obtain useful information; for example, they are more likely to share with me what causes them discomfort when wearing a bra, or the most important elements that they look for in a bra.

When conducting a bra fitting, I am able to identify specific and common pitfalls. Delay of lymph movement, based on prolonged compression of the lymphatic vessels or lymph nodes in the mammary gland, can occur due to:
• improper adjustment of the bra band: it slips if it is too loose, and compresses if it is too tight,
• incorrect selection of the underwire shape: too wide or too narrow for the anatomical form of the breast,
• wire pressure on the breast tissue or friction in the axillary area, • incorrect cup size: too small or too large, which also leads to excessive pressure from underwire, straps and bra band on the mammary glands and the area under them,
• incorrect placement of the bra’s center gore: too high or causing too much pressure,
• incorrect bra wearing.

FIVE METHODS FOR CORRECTLY SELECTING A BRA

1 Check the band fitting. If it is placed too low, it will descend to the diaphragm, the main respiratory muscle, and can weaken its work, negatively affecting the functioning of the respiratory system and circulatory systems.
2 Train the client to move her breast tissue into the bra cup by scooping gently from the outermost side. Then the wires will be placed around the breast and it is safe to say that the cup size and wire shape fit correctly. If the cup is too small or large, or if the style does not fit the figure, the wires will dig into the body, exerting constant pressure on the mammary gland and other parts of the body, which can cause pain.
3 Verify that the space at the base of the chest between the wire and the edge line of the breast is full. If an empty space remains, move the wire up, directly to the base of the mammary gland. This is important in order to avoid excessive squeezing of the epigastric lymph nodes and other organs of the abdominal cavity that can create discomfort.
4 Check in three positions to ensure that the wires are correctly positioned: stand directly in front of the mirror, then turn first to the right side and raise the right arm, turning next to the left side with the left arm raised. These three points of view allow you to check bra positioning against the respective mammary glands. In the case of an asymmetrical breast, the wire of the larger mammary gland will point forward, and on the smaller one, the wire will point back. Choose the style with optimal position of the wires around the edge line on both sides of the mammary glands.
5 Explain to the client that the bra straps, positioned on the same line as their attachment to the cup, reduce pressure on the sternocleidomastoid and trapezius muscles. Thus, you can evade muscle pain, which occurs as a consequence of the disturbance of blood circulation, and discomfort when turning the head and neck in various directions. Knowing the structure of the mammary glands and understanding the functions of the lymph nodes will help the client to better understand the effects that her bra has on these sensitive areas and to appreciate the relationship between a correct choice of bra and personal health. When the client understands the reasons behind choosing a different style or bra size, she is extremely willing to listen to our opinion. It is also important to talk about the positive outcome of such a choice: bra discomfort will disappear, which not only makes the woman feel better, but also directly benefits her health. www.DobraKreacja.pl facebook.com/DobraKreacja

ABOUT KATARZYNA SALATA
She has been working in the lingerie industry since 2006, and in 2013 she founded the international independent consulting company Dobra Kreacja. Katarzyna Salata provides advice to lingerie companies’ teams of designers and their internal design studios. She was the first in the bra fitting industry to take into account the individual anatomical features of the chest when choosing a bra. She is an expert in the field of bra construction, adjustments and sales, she conducts trainings for manufacturers, wholesalers and stores’ sales assistants in Poland and abroad. She provides active assistance to the Amazons (women who have undergone breast surgery), and conducts professional master-classes in bra fitting (International Brafitting MasterClass), as well as individual seminars for lingerie stores.

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