Are we talking road or mountain bike shifters here? My sis in law (sil) got a roadbike with 105 or tiagra (lower end shimano shifters where the gear changer is on the inside and it's very uncomfortable for her. I got the ultegras on mine and she immediately commented that that was much more comfortable for her. Then of course, i ride salsa 'paco' bars (short and shallow style bar. You should perhaps find out if a switch to a higher end shimano brake lever (ultegra or dura ace) would do the trick. This would probably, then, not require the other change outs you talked about. Just a thought, if it applies.