Up until 2001, it was illegal in my home state (and a lot of other places, even ones that would seem to be more enlightened) for a massage therapist of either sex to touch a female client's breasts.

Massage has lived in the shadow of prostitution for so long that most massage schools still don't teach anything regarding the upper anterior female torso and very few therapists offer breast massage. The literature on the subject, while growing, is still quite limited. If not for the patience of a couple of female friends, I might have had a lot of trouble learning how to give a satisfactory breast massage—it required patience, anatomy books and a constant call-and-response of "How does this feel? Better? Worse?"

A frustrating thing about the ban on touching a female client's chest is that there are certain muscles that are next-to-impossible to massage while trying to deftly avoid touching the breasts. The breast overlies the pectoral muscles and the saw-shaped muscle which laces between the ribs. These muscles may get tired out or sore in the course of working out or lifting heavy objects. Many of these muscles are used in the act of breathing and coughing or heavy breathing may also tire them out. Of course the pectoral muscles and other nearby structures also support the weight of the breast itself and this can be fatiguing as well.

This type of massage also works the glandular and adipose tissue of the breast and may help to drain wastes from the tissues and bring blood and nutrients to them. Massage has been shown to break up scar tissue and speed healing, so many physicians and surgeons now recommend massage for women who have undergone surgical procedures on the breasts. There is also some clinical evidence that breast massage may reduce the risk of breast cancer in women who are at high risk.

Women who are fans of receiving breast massage tell me that it is incredibly comforting and pleasant, in an absolutely non-erotic way. Breasts are so obsessively sexualized in our culture that it is nice to get to spend some time taking care of them in a non-"way-hey-hey" sort of manner.

Staying Cool: Breast Massage Without Titillation

The law in most places requires that breast massage must be performed in a very non-sexual, professional and reserved manner. This is completely understandable—breast massage is one of the only times that a professional may handle those precious organs in a pleasant manner—it is best if done in a respectful and mature fashion.

That said, breasts are an erogenous zone for many women, and all the professionalism and tact in the world can not change that. Many women will opt not to receive breast work, even from a therapist they trust completely, for that very reason.

While ethical massage practice requires a completely non-sexual approach to this very intimate form of touch communication, it should be pleasant for both client and therapist. There is nothing unethical about a client enjoying breast work, nor with her telling the therapist that it feels good. Some clients may even receive a mildly erotic charge at having their breasts handled in such a manner—this runs up to the line of ethics, but it seems unnecessarily prudish to discourage a client in this sort of enjoyment—as long as this remains within the bounds of an ethical client-therapist relationship.

That's Great! Now, How is it Done?

There are many different techniques for performing breast massage. This information is based on my own experiences.

In this portion, I will occasionally use the words superior, meaning 'toward the head' and inferior, meaning 'toward the feet.'

Breast massage may be performed draped or undraped (meaning with or without a sheet covering the breasts). Most times, if a woman is comfortable receiving breast massage, she is comfortable having her breasts exposed during the procedure, but the therapist should always ask. Certain portions of the breast massage will not be feasible if the breasts are draped.

With the client on her back, start by placing one hand beneath the breast (inferior), the rib muscles will be under that hand. The other hand should be placed above (superior, closer to the collarbone) the breast. Both hands should be palm down. Gently petrissage or knead the muscles with an alternating rhythm. It is a good idea to ask how much pressure is comfortable, as this is a move which can become uncomfortable very easily. During all of these procedures, use slow, smooth strokes.

While alternating pressure between your two hands, shift them clockwise or counterclockwise slowly to massage the muscles on the sides and middle of the ribcage. Begin by working on the very margins of the breast, then repeat these procedures, moving the hands onto the breast. Once again, let me emphasize the importance of not overdoing it on the pressure—most of the motion should come from the hands and forearms, not from the shoulders and back.

The breast lift is an optional maneuver which almost all clients enjoy. Placing hands superior and inferior to the breast once again, lift the breast (gently!!!) toward the ceiling. Go slowly and smoothly and do not drop the breast, release gently when the breast is at full stretch—it should be allowed to flow smoothly back to its natural shape. Most clients adore this stretching feeling, and it is supposed to be very healthful for breasts, promoting the elasticity of the tissue and helping to drain toxins away from the area. Some research also indicates that the breast lift may encourage the development of supporting fibers, thus promoting firmer breasts—even though this may seem a bit counterintuitive. A few clients do not enjoy this maneuver, however, finding it uncomfortable. If the client likes this procedure, you may repeat several times.

The breast lift may be difficult to perform on some smaller-breasted clients. On some very generously endowed clients, it may be necessary to use some strength—always lift with your legs. (I am not being crass! This would be an embarrassing way to throw out one's back!)

Finish the breast massage by working with the pectoral muscles: whichever hand is closer to the client's head should be placed on the pectoral muscle (just inferior to the collarbone). Place the other hand on the breast just above (superior to) the nipple and gently press the breast away from (toward the lower ribcage or in an inferior direction) the pectoral muscle. Now, use the superior hand to knead the pectoral muscle firmly but gently. Some massage therapists also finish with a light kneading in a concentric spiral beginning at the edges of the nipple and working outward.

After massaging both sides in this manner, move to the head of the table. Place each hand about at the collarbone then slide the hand in the direction of the ribcage with a steady, slow pressure. Stop sliding before reaching the nipples (the law in most places requires that we do not touch the nipples) and hold pressure for several seconds. Some kneading may be combined in this maneuver. During each move, ask the client how much pressure she prefers and what feels best.

Throughout these procedures, it is a good idea to use very little massage cream, oil or lotion, if any at all. You may wish to apply a small amount at the outset and a little more after the breast lift, particularly if your client has dry skin, but too much may make some of these massage moves very difficult to perform.

Booby Traps and Booboos: What NOT to do.

Okay, we are all adults here (Unless you are not! In which case—do your parents know you are reading this stuff?). If a woman is trusting you to take care of her breasts, you need to behave in a completely mature and responsible manner.

If you are a straight woman performing breast massage, the most likely drawback may be a slight awkwardness. I am told that this goes away pretty quickly. For men or lesbians, massaging breasts is a little more of a sensitive area. There may be some tension or nervousness, especially at first—it is the therapist's job to dispel this.

To this end, watch what you say: never offer any unsolicited comments about a client's breasts and never make any comment that could possibly be construed as off colour, not even a little bit. This is true even if the two of you are on intimate terms—remember, this time is for her health and her pleasure, not for some prurient ends!

Be gentle! Breasts may be very sensitive, never slap, drop or pinch them—do not handle breasts roughly. Even so, if you are too gentle, you may achieve nothing more than tickling your client. Strive for a happy medium and frequently ask how different maneuvers feel.

Before ever offering breast massage as a professional service, check the laws in your area. Always make absolutely certain you have appropriate signed paperwork where appropriate.

A Totally Serious Note About Breast Lumps

If you are performing breast massage and encounter a suspicious lump, inform the client in a calm, measured way. It is important not to alarm your friend or client! Many breasts may be somewhat coarse in texture and they contain small tubes which may feel somewhat like lumps. If you are not specifically trained to feel for lumps, breast tissue can be a little bit confusing, but it is better to be safe than sorry.

Be careful how you report this to your client—my own preference (this has not come up many times) is to say something like "you have a little spot here, have you noticed this?" and ask the client to feel it. Unless they tell you (for sure) that they know it to be nothing to worry about, do not massage over it. If she is unsure about a suspicious lump, encourage her to get it checked out by a doctor, you may save a life!

Tit for Tat: A Few Personal Observations From Yours Truly

This is a weird time for massage in our culture. People are finally starting to catch on to the idea that massage is not necessarily sexual and many voices in the world of massage journalism and advocacy go so far to the opposite extreme that they can often sound strident. My own lampoon of them goes something like: "Massage isn't sexy! In fact, it doesn't even feel that good! In fact .. no, wait, it DOES feel good. Just ... not that good ... Okay, it is good... not too good, though!"

We live with the specters of the mind-body split, inability to love our bodies, the thoughts of sex as 'dirty,' and the myriad horrors of sexual cruelty, violence and general unpleasantness—it is no wonder that people are a little confused.

The fact is this: I love doing breast massage. I also love breasts, but the act of doing breast massage is strangely unconnected with this. It would be disingenuous for me to claim that I could work on a woman's breasts and completely disconnect myself from any attraction I might find for her breasts, but I find it is really quite easy to be professional and to have a calm but pleasant demeanor while doing breast massage.

During a breast massage, some clients may ask questions (such as "Are my breasts normal?" "Is it usual for one to be bigger than the other?" and of course, "Is this awkward for you?"), which I answer honestly ("Yes," "Yes," and, "If you are comfortable, I am comfortable" in order). Some ask me to feel for lumps, which I do anyway as noted above.

Some women are very self-conscious about having small breasts. If a client makes a self-deprecating comment such as "Can you find anything there to massage?" or calls herself flat-chested, it is possible for a massage therapist to make a positive, non-sexual comment such as "Your breasts are fine," or "There is nothing wrong with your body."

I do not sell breast massage—meaning I neither advertise nor push it. If a woman wishes to have her breasts worked on, I have a check box on the intake form which she can check. I feel that it is important for a therapist to let a client know it is available, but getting overly enthusiastic risks making the client suspect that the therapist is some kind of perverted boob-fiend ... a very bad suspicion for a prospective client to have.

Note: If you are in fact a perverted boob fiend, you probably don't need to be massaging the breasts of someone you aren't intimate with—or at least make sure the client doesn't realize that you are in fact a perverted boob fiend!


References:
The information for this article was largely from massage school, private practice and years of reading Massage Magazine. Additional information was from:
Jordan, Kate "the Evolving Practice of Breast Massage" Massage Today online http://www.massagetoday.com/columnists/jordan/
Smith, Beverly, "Breast Massage Reduces Breast Cancer Risk" online at http://www.free-beauty-tips.com/breastmassage.html
Curties, Debra, "Learning Breast Massage" Downeast School of Massage, article online at http://www.downeastschoolofmassage.net/forum/curties2.htm