Dear Courtney,
Everything you described — the burning in the shoulders, the upper-back fatigue, and the way it spikes on days without support — lines up very closely with something a lot of women (cis and trans alike) deal with when their breast size, posture, and support aren't in balance.
When breasts develop quickly, especially dense ones, the pull on the upper-back and shoulder muscles can cause what's often called *postural strain*. The muscles between your shoulder blades and the ones that anchor the shoulders forward can become overworked, inflamed, and irritated. That kind of strain can absolutely produce the burning sensation you mentioned, and it often worsens if someone is trying to hold themselves smaller or hunched to be less noticeable.
That doesn't mean anything dangerous is happening — just that your body is sending a very clear message that the way it's being loaded right now isn't sustainable.
But there's one piece that I want to gently highlight:
Daily pain bad enough that you sometimes need to lie down, combined with dense, heavy breast tissue and significant posture compensation, really is something your doctor should be aware of.
They can check for things like:
- Muscle strain
- Nerve irritation
- Whether your spine or shoulders are being pulled out of alignment
- Whether a physical therapist could help you correct the underlying pattern
None of those checks require you to be "out," and you can frame it exactly the way you did here: *"My chest development has changed my posture, and now I'm having daily upper-back and shoulder pain."* It's a very normal conversation, and doctors see this in women all the time.
Everything you're planning — better support, winter layers to stay stealthy, posture awareness, stretching, and gentle strengthening — is exactly what most providers would start with anyway. But given that the pain is daily and occasionally severe, having a professional evaluate it means you won't miss something important or let it become chronic.
And your point about feeling more able to stand naturally after facial surgery makes sense. Many of us unconsciously fold ourselves inward until we feel safe enough to expand. If FFS helps you feel freer to stand upright, that alone may reduce a lot of the strain.
You deserve to *feel good* in your body, not just endure it. Talking with your doctor can help make sure this gets addressed early, before it becomes something that follows you for years.
