An essay on Breast Safety

Sex (hard)/BDSM


S asks: I do like to be treated roughly during sex and my friend and I are really into BDSM. He likes to sometimes hit my breasts and I do enjoy that very much. But it sometimes worries me, Breasts are rather tender, aren’t they?
Should I be worried?
“Nos” or “Yo”… 😉 both yes and no… It is true that breasts are of relatively tender material. And you can certainly destroy tissues if you handle ’em to rough. That goes for buttocks, that goes for legs and shoulders and that also goes for breasts. And it seems that repeated pointy mini-trauma (underwires of bra’s that are too small poking in the side of your breast) and does a long duration of pressure creating tissue hypoxia (push-up bras) seem to tend to up the chances of tissue proliferation a little. On the other hand, if we take a closer look at the harsh things babies do, then breast seem to be made to take a pounding.

Borrowing from others

Surfing on Fetlife I came across this gem of information.
On Fetlife: An essay on Breast Safety*
I think it’s important for lovers of breast torture / tit torture / breast bondage / rough sex to be Risk Aware…
You can never be 100% riskfree in BDSM but as a RACK-adept, I think we should inform ourselves 🙂

Voluptuary told me she had this on her hard drive for at least 20 years. And it might be a tad bit cautious in my eyes but it seems still very accurate. And I did not want to alter anything:
Here it is:

We don’t know the original author (if you know who to give credit here, let me know)


An essay on Breast Safety

(Originally From the ‘Knowing your place’ group on Blackplanet)
Author unknown

Fat Necrosis

Fat Necrosis is the destruction of fat cells in the breast due to trauma (injury) or hypoxemia (deprivation of oxygen). Special care must be taken with fatty breast tissue because the blood supply to fat is always poor. Lack of oxygen or an inadequate blood supply causes the cells to die and release particles of fat. The remaining tissue may become hard or calcified.
The breast is not all fat; it also has supporting structures and milk ducts. Other areas of the body have large fatty areas, such as the buttocks, which can experience trauma-induced fat necrosis. However, the breasts are the only largely-fat area that can be isolated and tied up, restricting necessary blood supply.

Fat Necrosis mimics breast cancer both clinically and mammographically. There is no way to tell a cancerous lump from fat necrosis without a biopsy, so the lump must be surgically removed. Fat necrosis doesn’t cause breast cancer, but you can’t assume that a lump in your breast was caused by scarring – it must be removed in order to be sure it’s not cancer.

Symptoms of Fat Necrosis:
1. The lumps are painless, round and firm, formed by the damaged and disintegrating fatty tissues.
2. The skin around the lumps can look red or bruised.
3. The area may or may not be tender.
4. One of the common symptoms of both fat necrosis and breast cancer is dimpling in the breast.
5. Severe scarring within the breast may cause nipple retraction.
6. A clear liquid with a yellow or brownish color may drain from the nipple.
7. Large breasts have more of a tendency to form fat necrosis when traumatized than smaller breasts.

Trauma, which is a blow to the fat tissue, can occur under a variety of circumstances. The degree of injury depends on the force of the blow and its direction. Trauma can also be caused by twisting the tissue, which may happen when rope is being wound around the breast.

Pain is probably the best indicator that damage is being done. Hypoxemia, too little oxygen in the blood caused by poor circulation, is a leading cause of cell death and fat necrosis. The point of no return is difficult to define at the level of the cell. On the most basic medical level, the point of irreversible damage in fat cells occurs in as little as 15-60 minutes.

However, recognizable morphologic changes may not be apparent for a few hours. It requires 8 to 24 hours for the nuclear changes to occur. Meanwhile, the cytoplasm has passed through the stages of swelling and becomes transformed into an acidophilic, granular, opaque mass.

Since it’s difficult to tell by observation alone when the “point of no return” has been hit, a reasonable rule of thumb is: with tight bondage (i.e. a finger can’t easily be inserted between the flesh and the rope) leave the rope tied for less than 15 minutes. Then fully release the rope to allow the blood to re-oxygenate the fat tissue this may take ten to fifteen minutes because the blood supply to fat is very poor.

Trevor Jacques in “On the Safe Edge” recommends that you should always be able to put a finger between the rope and the skin to prevent cutting off the circulation during bondage. If the rope is loose enough to insert one index finger to the knuckle (your choice, male or female finger!) then you should be able to safely leave the rope on for 30 minutes.

If the rope is loose enough for two or three fingers, you can go up to 45 minutes. It’s best not to tie the breasts for more than an hour before releasing the rope to allow thorough circulation to occur. 1/4 inch rope and up is usually recommended for any type of bondage where the rope touches the skin. Pat Califia advises in “Sensuous Magic” that narrower material than 1/4 inch (like string or cord) shouldn’t be used because it can cut the skin. Race Bannon in “Learning the Ropes” reminds us that breathing should never be restricted by rope, so ask the bottom take a deep breath before tying the anchor rope around her chest.

Most leather-s/m technique books advise against suspending a body with rope.** Ideally, if rope is to be used for suspension, a web is created so the body is supported in numerous places and care should be given so the knots don’t put pressure on the skin. Thus, it is not possible to safely suspend someone from their breasts. The cut-off in circulation is exponentially higher because of the added weight of the body during suspension, and there is a significant potential for damaging the fragile supporting structures and the milk ducts of the breasts.


A hematoma is a swelling filled with blood that is caused by trauma. Hematoma can cause scarring in the breast. A small hematoma usually absorbs on its’ own but a large one requires surgery.
Hematoma most commonly form when the skin has been broken. A hematoma is an excellent medium for the growth of bacteria. The inflammatory response results from traumatic rupture of adipocytes, which release their contents, often followed by fat necrosis that causes scar formation.
Symptoms of Hematoma:
1. Bruising or contusion is followed by swelling caused by the passage of fluid through the walls of damaged capillaries.
2. Bacteria can cause infected fat tissue to appear black because of deposits of iron sulfate from the degraded hemoglobin.
3. You may have a fever as a sign of infection.

A hematoma is usually caused by broken skin, yet it is possible for a blow to cause a hematoma. Like fat necrosis due to trauma, the degree of injury depends on the force of the blow and its direction. A hematoma can also be caused by twisting the tissue, which may happen when rope is being wound around the breast. Pain is probably the best indicator that damage is being done.

Fibrocystic Breast Disease

Fibrocystic breasts are prone to the formation of both fluid-filled cysts and fibrous tissue. Typically the breasts have a lumpy feel, and both lumpiness and tenderness increase in the week prior to menstruation. Tight, frequent breast bondage or long painful stimulation should be avoided, as these can increase the formation of breast cysts.


Fibroadenomas are benign breast growths which usually occur in young women. They are a very common cause of breast masses in the 15 to 25 age group. Fibroadenomas also account for 15% of all palpable breast masses in women 30-40 years of age. Clinically, these growths are smooth, firm and easily movable masses. It is generally accepted practice that suspected fibroadenomas should be removed in women over the age of 25. These growths are not associated with an increased risk of breast cancer.

Breast Cancer

Breast cancer is a complex and devastating disease, and the most frequently 178,480 new cases of invasive breast cancer in U.S. women, (vs. 212,920 in 2006). 40,910 breast cancer deaths – 40,460 women and 450 men (vs. 40,970 women and 450 men in 2006).

2,030 men will be diagnosed with breast cancer (vs. 1,720 in 2006). 62,030 new cases of carcinoma in situ – approximately 85% will be ductal carcinoma in situ (vs. 61,980 in 2006). The in situ numbers are not included in the calculations of incidence.

While fewer women are expected to be diagnosed with invasive breast cancer in 2007, the incidence is still 1 in 8: one out of every 8 women has a lifetime risk of developing breast cancer. The death rate is decreasing, with larger decreases reported among younger women (50 years). Again, the decrease is attributed to earlier detection through screening, increased awareness, and improved treatments. Fibrocystic breast disease, fibroadenoma, fat necrosis and hematoma are all benign breast conditions that may lead to biopsy due to the fact that cancers cannot be identified by palpation alone. That’s why it is common sense to get anything usual checked immediately by a doctor. If it isn’t cancer your mind will be put at rest. If it is, it can be treated as quickly as possible.

Questions to Ask: #visityourdoctor

If you answer yes to any of these questions, go see a doctor:

1. Do you see or feel any lumps, thickening or changes of any kind when you examine your breasts? For example, is there dimpling, puckering, retraction of the skin or change in the shape or contour of the breast?
2. Do you have breast pain or a constant tenderness that lasts throughout the menstrual cycle? If you normally have lumpy breasts (already diagnosed as being benign by your doctor), do you notice any new lumps or have any lumps changed in size or are you concerned about having benign lumps?
3. Do the nipples become drawn into the chest or are they inverted totally, change shape or become crusty from a discharge?
4. Is there any non-milky discharge when you squeeze the nipple of either breast or both breasts?
5. Do you have a family history of breast cancer which leads you to be concerned, even if you don’t notice any problems when you examine your breasts?
6. Have you had recent trauma which resulted in a breast lump being formed?

My own two cents

Breast tissue and implants
There is some extra’s to be said about the difference in breasts. Big breast react differently than small breasts. Firm breasts are different than breasts that have softer tissue. It seems that manipulation/massage of breasts turns out healthy so we shouldn’t be too hesitant to experience the things you like.

The energy of a blow on taut breasts tends to travel thru the tissues in a different way then the same blow on breasts with less elastic tissue. The elasticity of the tissues absorbs the energy of the blow.
breastImplantsd515.jpgIf there are other materials inside the breasts (salt water or silicone) that will also change the way the energy of a blow travels through breast tissue. If they are really filled and almost ‘hard’ you can imagine that the energy of the blow gets trapped between the whip/cane/ruler and that the tissue maximum load is reached sooner. This is especially true for subglandular placed implants, more than submuscular placed implants. Also, the chance of rupture (be it a really, really small chance) is even less for submuscular implants.

The direction of the blows to the breast also influences their noxiousness. The tendons which hold the breasts up are of course mostly attached to the top… So I always recommend people to direct heavier blows to the bottom curve of the breast in an upward motion. We do not want to add extra stress to the supportive muscles and tendons. (perhaps an added bonus: the bottom of the breasts is typically more sensitive).

Whipping implements
A blow with a flat object like a ruler has less “pointy” load then, for instance, a cane. Heavier objects tend to bruise deeper and give a bigger chance of tissue damage. Thinner and harder implements tend to ‘cut’, especially when one hits with speed.
A bit like the diameter of the chords we that was discussed before.

So not only the implement itself also the speed upon impact is a deciding factor. The faster the more pain and damage (it is, in the end, the damaging of cells that creates the pain-signals).
Also, the way you wield your whip has a deciding effect. Do you pull back your whip just before or after the moment your whip lands? Or do you really land the whip on the skin? Then the full energy of the whip will find its way deeper into the tissue. The first technique tends to remain more superficial, more stingy, the latter tends to bruise deeper and often feels more thuddy.

Having said this sounds maybe as if I would state that you need to be really really careful with breast but that is not what I am saying. I often quote Betty White:

“Why do people say “grow some balls”? Balls are weak and sensitive. If you wanna be tough, grow a vagina. Those things can take a pounding.”

But let’s remain a realistic stance. Porn is entertainment and we don’t learn how to drive by watching the Transformers. Think for yourself and respect the fact that those girls and boys resemble top athletes and did take their (sometimes long) learning curve and off camera preparations.

A body is often stronger than we think. When we listening to a porn actress on fetlife she clearly states that she has not ever heard of any breast problems due to the (ab)use… and those breasts are hit with various implements, bound with really thin leather straps. Those breasts are really suffering for their and our pleasure in the ‘approach’. 🙂 Both tighter bondage and harder hits were dealt to her breasts and her implants.

Biology first
So let’s think biological. We enjoy breast torture because they tender. And tender flesh can be bruised easier. Do take into account that the blood flow in breasts is not as good as the blood flow in -let’s take a random body part- the buttocks. So they will heal more slowly and because bruises can start a negative vicious circle akin to the shin splint where the body’s attempts to heal do obstruct the blood flow, therefore creating new problems. So especially if you combine firm breast bondage and impact-play you shouldn’t do that over a longer period of time because repair needs room and oxygenated blood ( hence the <20 minutes. Perhaps directing your attention elsewhere).

We don’t know of any conclusive studies so we can not give definitive answers.
So maybe not you, but your dominant should read this article. The techniques of the Dom(me) decide what happens to the breasts and his skill makes a difference. If one knows the techniques and has practiced a lot on pillows :-), the chances aren’t that big that you will do things you will regret to the titties of your girlfriend.

And of course the question “how much pain is still healthy?” is still unanswered. I tend to always tend to not ask for “how much” but rather I ask for the qualitative differences in pain. There is “good pain”, “sweet pain”. And then there is pain that is somehow “not right” or “too much!” I would advise you to want to follow that distinction and listen to your body. Enjoy the ‘torture’ and communicate that to your partner. We tend to loose that qualitative possibility when we are drinking more or use more of drugs like XTC or coke. So I wouldn’t advise the tougher breastplay intoxicated, both for you and for your partner.

So dear S (and other readers) have a lot of fun with your breasts,

Moderation is the key to indulgence…


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Published by KinkindeRelatie

A Kink Aware and openminded (relationship) coach. That does not mean you have to talk about kink, but at least here you don't have to be silent about it.

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