With VBH, growth of the nipples usually also occurs, and these can be very large. In severe cases of VBH, especially caused by imbalance of sex hormones, including androgens in female adolescents, hypertrophy of the clitoris can also occur. The excessive size and weight of the breasts may be associated with other problems. It is common for women to complain of headaches, neck, back pain, numbness and tingling in the fingers. Because of the weight of the breasts, bra straps can cause notched or grooved in the shoulders coming to cause permanent scarring chronic irritation. Severe rashes under the breasts are common, especially during periods of warm weather. The degree of hypertrophy varies from woman to woman. In severe cases it is possible for some women to have breasts that weigh well over 9 kg each. The heaviest breast was 30.5 kg (medical research). Citation needed
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