Is smaller really better?
June 27, 2010 5:01 AM   Subscribe

Breast reduction: what's the emotional fallout?

I'm 5'5" and a general size 12-14 UK (I think this equates to a US size 10-12) and my breasts are very large - I'm 32-34 GG. This has caused the usual problems over the years - low self-esteem, clothes not fitting, back and shoulder pain etc but recently it's got much worse. I love the shape of my breasts - they are just too big and heavy for my frame and it's getting worse as I get older (now mid-thirties). I'm very active but this is literally and psychologically a massive weight on my chest and I'm tired of dragging it around.

I've considered breast reduction on and off since I was a teen and am now in a place where could could conceivably go for it. My SO is supportive and I don't plan to have children so am not worried about breastfeeding. However, I'm really worried that I'll hate myself for basically having mutilated a perfectly healthy body for the sake of an easier life. As a feminist I'm also massively conflicted about the cultural implications. I'm pretty sensitive generally and I'm scared that this could really mess with my head emotionally.

Has anyone grappled with this issue? I know that this particular procedure has one of the highest rates of satisfaction but most of the discussion I've found is to do with the physical effects of surgery and complications etc, I haven't found any references to the emotional side.

P.s. Advice about clothes and what not is ok but I've been dealing with this for 20 years and I'm well aware of Bravissimo, getting things tailored etc. I'd like to explore possibilities for a more permanent solution. (Asking through a sockpuppet so feel free to MeMail if privacy is required).
posted by socksister to Health & Fitness (32 answers total) 11 users marked this as a favorite
 
Best answer: I don't think you are "mutilating a perfectly healthy body for the sake of an easier life" you are dealing with something that is causing (and will continue to cause) medical problems (back/shoulder pain) and in doing so, doing something that will allow you to lead a healthier more active life. As far as being a feminist, being a feminist means doing what we feel is necessary with our body, not just conforming to society's opinion of what our bodys (and breasts) should be. I think talking things over with a doctor or several doctors, so that you better understand the procedure and what your breasts will look and feel like later will help you make what the right decision for you (be that have the surgery or not).
posted by katers890 at 5:49 AM on June 27, 2010 [13 favorites]


I'm with katers890. Don't let society/fellow feminists/anyone tell you what is/is not allowed. This is a matter of health. One of my relatives was in a similar situation and hesitated for years about having the surgery. Her posture got steadily worse. The back pain was intense and became worse the older she became (she was close to 40 when she had hers done). After the surgery, her posture improved, the chronic pain disappeared. She remarked that there were aches and pains she didn't know she had until the weight was gone from her chest (literally). She slept better, she was able to exercise more. It was much less about aesthetics, and more about her health and quality of life.
posted by jeanmari at 6:04 AM on June 27, 2010 [2 favorites]


First, excellent use of a sock puppet. Bravo.

Second, sounds to me like you should look for a breast reduction support group. The US has a ton of them, and I'm sure if you looked around a little you could find similar resources in the UK. There, you'd be able to hear about others' experiences in an environment designed for precisely that.
posted by valkyryn at 6:07 AM on June 27, 2010


It's not my own story, but my spouse's ex had reduction surgery in her early 20's and said it was the best choice she ever made. She struggled with a lot of the same issues you are considering, although she definitely wanted children (which she eventually had, though I'm not clear on whether she had to supplement the nursing...I do seem to recall her discussing someday wanting to with the doctor at the time).

Post-op, she was so happy to finally be pain-free. We were all living in San Diego at the time and the heat made the layering looks she had worn in college difficult. To be able to buy lightweight clothes that fit instead of clothes that were too baggy or required tailoring was such a simple pleasure for her. It changed so much more than just her physical structure, though.

(Don't discount the fact that living with chronic pain can effect more than just our physical state.)

I doubt it's a magic bullet for everyone, but it sounds like you are in a very similar place to where she was and once she recovered from the actual surgery the other worries she'd had just dissipated.
posted by squasha at 6:25 AM on June 27, 2010


Don't think of it as "mutilation" think of it as spot reduction or reshaping. You can only do so much with diet and minimizing bras and overly large breasts come with all sorts of baggage such as the sex bomb label and the promiscuous label and the airhead label. Being free of all that excess emotional and physical weight may be very liberating for you.

If you haven't seen it yet, you definitely need to watch the BBC documentary My Big Breasts and Me which followed 3 women grappling with ways to reduce their overly large breasts including surgery. I am "borderline" large myself and found the documentary interesting and thoughtful. By the way, did you know that British women have the largest breasts in Europe?
posted by Secret Life of Gravy at 6:36 AM on June 27, 2010


Also, like squasha, not my story, but a friend of mine in college had a breast reduction when we were 21, 22 years old, and it changed her life. FOR THE BETTER. She was better able to be active and exercise the way she wanted to and generally she was just in less pain in her back. As above, just buying clothes that fit and not having to special order bras (there was no store near her home or our university that had her size) was a simple pleasure.

Being a feminist is about making your own choices, about you having the ability to make your life better for yourself without society standing in the way for some stupid arbitrary reason. Taking care of yourself is the feminist choice.
posted by Medieval Maven at 6:36 AM on June 27, 2010 [2 favorites]


As a feminist I'm also massively conflicted about the cultural implications.

What kind of feminism would say women aren't allowed to do what they want with their own bodies?
posted by Jaltcoh at 6:37 AM on June 27, 2010 [10 favorites]


I would 100% not consider it mutilation. I would also consider back and shoulder pain to be a pretty big issue that will only continue if you don't do something to stop it.

I guess what you really need to ask yourself is: can I go another 30, 40, or 50 years with this kind of pain and nuisance? That might answer your question.
posted by itsacover at 7:14 AM on June 27, 2010


I have a cousin who had several pounds removed from each breast when she was in her early 20s. I don't think she ever regretted her choice to have breast reduction surgery, because even at that young age the rest of her body was suffering from them being so large.
posted by jscalzi at 7:21 AM on June 27, 2010


You know, overly large breasts are just a pain. I've thought about having it done, too, and as a pretty out and proud feminist, those types of questions have never entered my mind. What has stopped me is just the prospect of surgery and recovery. I will have it done someday for sure. A few friends have had a reduction and never regretted it. If guys had similar sized balls -- nut reduction would probably be offered as a free service. Let your health, your body and your medical professionals help guide your decision, in my opinion.
posted by amanda at 7:23 AM on June 27, 2010


I know three people who have had breast reduction. All three continue to see it as one of the best decisions they've ever made. Jeanmari's relative mentioned above could be any one of my friends.
posted by ThatCanadianGirl at 7:28 AM on June 27, 2010


Mod note: This is an answer from an anonymous contributor.
A close friend had a breast reduction operation. She was extremely unhappy afterwards because the reduction was not anything like as big as she had hoped. She felt that her wishes about her own body had been ignored by the (male) surgeon. Her experience contributed to significant MH problems. I would suggest that anyone considering this has a detailed conversation about exactly what measurements they should expect to be afterwards and what is possible if they are not happy. The scarring was also much worse than she had expected, though this was ten years ago so techniques are likely to be different I imagine.
posted by cortex (staff) at 7:29 AM on June 27, 2010 [1 favorite]


Best answer: I'm younger than you, but I'm 5'1" with 34GGGs and I've considered reduction surgery as an eventual option for quite some time. I haven't done it yet, nor had any consultations, because I'd really like to have children and want to avoid related complications, and I'm quite poor. But it's something I'm planning for, long-term. I'm a pretty hardcore feminist, down with the patriarchy, societal revolution and all that, and the size of my chest (and society's reactions to it) has factored strongly into my worldview.

It comes down to autonomy of choice. Your body is your own, to do with as you please, as a thoughtful, sentient being. Unfortunately, the world likes to tell us otherwise.

As a feminist I'm also massively conflicted about the cultural implications.

I understand, maybe, where you're coming from on this. Who is to tell us that our breasts should be any size in particular? We should be comfortable and glory in the wonder that is our body, right? Eschew makeup, hairstyling products, high heels, and push-up bras! The idea of changing our breasts to fit into clothing, to afford more than one bra a year, to be able to *not* have cleavage in anything that can be considered a "blouse", well, that's just conforming to society's preferences, and we should fuck 'em! And those damn doctors with the preferred nipple placement and lift and shape and blah de blah, they're forcing us to conform! So what if people stare and I feel vulnerable and can't jump on a trampoline and the first thing people notice about me is my breasts? That's their problem, right?

But, I don't think that's a good road to take. That way lies madness, feminists fighting among themselves, and legitimate medical problems in one's old age. My grandmother has slightly smaller breasts than myself, and now, at the age of 85, she's got permanent dents in her shoulders where her bra straps are. Her back is curved, and her balance is more off than ever. When I began to "blossom" as she put it, she took me aside and showed me those dents, and said that, if only she had been born in my mother's generation, the only thing she would change about her entire life would be to get breast reduction surgery.

We get braces not just for straight smiles, but to prevent problems in the long run with teeth grinding and jaw shape and orthodontists know what else; why can't we have breast reductions to prevent similarly crappy things in our future?

There are, of course, alternatives to breast reduction that you could undertake in order to mitigate these medical problems. If you work out consistently, and keep your back muscles quite strong, it helps with your chest. And, of course, if you lose fat throughout your body, you very well may go down a cup size or three. It's probably a good idea to be in shape regardless. But just because it's a healthy thing to do doesn't mean that it's the only thing to do.

Any sort of surgery that changes our appearance is an emotionally difficult thing that needs to be dealt with properly. I'm certain that the doctors you might speak to would understand this concern. It's very likely that it's something that they are prepared for. Since you say that you are a very sensitive, emotional person, I think it would a very good idea to go to therapy and discuss this issue with someone. Chances are, your doctors would have someone they can recommend to you. You may find that, in talking it out with a third party, your concerns will be mitigated. You may also find out that you don't want the surgery at all. I think that it's completely up to you; it's certainly not mutilation, and even if it was, it wouldn't be my place (or anybody else's) to tell you so, or care.
posted by Mizu at 7:39 AM on June 27, 2010 [10 favorites]


10 years ago was not that long...our friend had her operation done in 1991, and technique and excessive scarring was not an issue. I am so sorry your friend had a different experience.

I agree about the need for detailed conversation about the post-operative recovery. I also feel that anyone undergoing any elective surgery be extremely comfortable with their surgeon, regardless of whether they are male or female.
posted by squasha at 7:41 AM on June 27, 2010 [1 favorite]


I have two friends, one is 70 the other is 80. The 70 year old had breast reduction surgery in the 80's..the other one never had the surgery (but had contemplated it). The 70 year old looks good in her clothes and is doing just fine. The 80 year old's breasts are HUGE. She has to buy special clothes and walking across a room is a chore for her! Breast size increase with age..so you need to think about that. Between my two friends..I'd much rather be in the 70 year old's situation.
posted by naplesyellow at 8:14 AM on June 27, 2010


However, I'm really worried that I'll hate myself for basically having mutilated a perfectly healthy body for the sake of an easier life.

I'd suggest its useful to think of "mutilation" as something other people do to you, or perhaps what you do to make other people happy rather than yourself. Neither applies here.

I'd also question where a body that causes you regular pain and impedes your ability to do the things you want and feel good about yourself is "perfectly happy." this isn't causing you imminent danger of death, but surely there's a more nuanced measurement available.

People take cholesterol medicine because of measurements that say they're not going to have a problem now or maybe even ten years from now, but eventually. Many of us take anti-depressants to treat a malaise that doesn't cause us physical pain or impede us in any way other than personal satisfaction. Why is that okay but your solution not?
posted by phearlez at 8:38 AM on June 27, 2010


If you're hesitant about surgery, have you tried losing weight? I've been losing weight recently and I've lost 2-3x more weight off my chest than I have anywhere else. It might not go that way for you but I'd certainly explore that possibility before going under the knife. Even if you have to lose a little more elsewhere than you're comfortable with to get your chest to a size you're happy with, if you regain a little weight it may not all go back on your chest.
posted by missmagenta at 8:51 AM on June 27, 2010


As a feminist who has had this done I felt greatly empowered by the fact that I could choose to shape my body to my own needs.
posted by media_itoku at 8:59 AM on June 27, 2010


I don't know, as amanda mentioned I've never heard of breast reduction surgery raising feminist concerns--in fact, I've known a few men, including one ex (shudder) who were horrified by breast reduction surgery no matter what, because of, you guessed it, piggy aesthetics. Now that raised my feminist hackles for sure--and is kind of the polar opposite, so...

I mean, I see it sort of like this. If any other part of your body that didn't have feminized baggage attached to it--your knee, your elbow--was causing the rest of your body chronic pain that affected your daily life and what you could do, and the best solution appeared to be surgery, most people wouldn't be thinking about how it made them a poor feminist to do what needed to be done to feel better and live a healthier life. I think the culturally sanctioned aesthetic attachment here is a ripe ground for milling over your feminist feelings, for sure, but keep in mind as someone else said a body that makes it hard to walk or exercise is not necessarily perfectly healthy to begin with, and you possibly might be normalizing because, well, big breasts, we all love them and praise them in this culture, right? I don't mean to be condescending or guessing your feelings here, please forgive me--I'm just throwing it out there as something to think about.

And as many have already said and tend to in these threads, everyone they know who's done it was like "whoa, I didn't realize it was normal to not be in pain and achey all the time!" afterward and didn't regret it overall. My experience is the same; the three or so women I know who've done it were all so glad they finally did. Two were a lesbian couple and joked it was easier to make the decision because they didn't have to worry what men thought (that was a joke though, and obviously it's not like there aren't ladies who like big breasts too, just...), that it was a purely selfish decision. I hear often those kind can be pretty feminist since ladies don't always put their own needs first... (again, that's pretty tongue in cheek but)
posted by ifjuly at 9:22 AM on June 27, 2010


I have had doctors suggest breast reduction to me, and am also seriously considering it. I am surprised anyone would consider that anti-feminist. Aren't women's rights all about controlling their own bodies and making their own decisions? It seems anti-feminist to me that someone would be criticized for a decision that will so profoundly affect someone's life.

I do like the idea of a support group. I hadn't even thought about that.-

This year, when I had my annual mammogram, the x-ray technician said she had never known a woman to regret having reduction surgery. Since all she does is mammograms, that adds up to a rather large number.
posted by annsunny at 9:41 AM on June 27, 2010


"Mutilate" is a powerfully negative word, with connotations of disfigurement and damage. My mini-thesaurus gives me this:

mutilate - verb
1 "the bodies had been mutilated" mangle, maim, disfigure, butcher, dismember; cripple.
2 "the painting was mutilated" vandalize, damage, deface, ruin, spoil, destroy, wreck, violate, desecrate; informal trash.


You describe your body as perfectly healthy, but you are living with chronic pain, and you are having back problems that will only get worse. It's your breasts that may be the cause of future disfigurement.

I'm not being pedantic here; rather, pointing out a state of mind leaning heavily to the negative in a way that doesn't align with your reality.

The fact that this surgery will change your body in a way that will appeal to you aesthetically is only a side benefit. This is a move for better health, physically and mentally. Make no mistake. There's no virtue in leading a more difficult life.

You mention being pretty sensitive, and say that you are concerned that this will mess with your head emotionally. I think it would be a good idea to find perhaps an online support group or have a few sessions with a therapist to help you decide and/or prepare yourself mentally.
posted by moira at 9:43 AM on June 27, 2010 [1 favorite]


Best answer: However, I'm really worried that I'll hate myself for basically having mutilated a perfectly healthy body for the sake of an easier life. As a feminist I'm also massively conflicted about the cultural implications. I'm pretty sensitive generally and I'm scared that this could really mess with my head emotionally.

I understand these feelings because I used to share them. I was all about feminist body-acceptance and all that. Some of that began to change for me when some loved ones went through gender transitions, including some surgeries, and I saw how much their lives improved. Ignorant people often call gender reassignment surgeries mutilation and ask why people can't just accept their bodies as they are, but seeing the transformation in how comfortable my loved ones were in their bodies and how it improved their lives really ditched that whole "mutilation" notion for me, and helped open up the possibility in my mind that breast reduction would be OK for me.

Also, the bit about the "perfectly healthy body": I did not realize how much I did not have a perfectly healthy body until after my breast reduction last November, when constant neck pain I'd had for something like 15 years simply disappeared (seriously, I literally woke up from the surgery and it was gone and has never come back), and a chronic headache, also of 15 years' duration, was dramatically reduced. I basically chose the reduction because I was just tired of hauling the damn things around; I thought I might feel a little better but had no idea how much it would drastically and immediately change things I'd been working on improving for years, like posture and mobility, or how much pain reduction I'd experience.

I was astonished by how much better I felt in both dramatic and subtle ways. I thought I was mostly getting the surgery for reasons of aesthetics but it turned out to be a big health boost. Had I known, I'd have done the surgery years ago. My surgeon said that the surgery left my milk ducts intact so that I could nurse another baby if I wanted to (no, thanks--we're done) but even if I'd had to forego nursing it would have been worth it to me--think how happy my little bottle-fed babies would have been with a mom who wasn't in pain all the time.
posted by not that girl at 9:45 AM on June 27, 2010 [1 favorite]


I'm a feminist with a rather large chest who has considered getting a breast reduction. I've never thought for a moment that it would be anti-feminist to do so. What has stopped me so far, like Amanda, is the fact that it is major surgery with significant recovery time (I have never had surgery in my life) and whether my insurance company would actually cover it (in theory they should, but who knows.)

That said, everyone I know who has gotten it done has been very happy that they did it.
posted by SisterHavana at 10:32 AM on June 27, 2010


I've known four women who have had breast reduction surgery. Every single one of them believes it to be one of the greatest things she's ever done for herself. I'm a pretty strident feminist and I see no issue with it whatsoever; you're not reshaping your body to make other people happy, you're correcting an issue with your own life.
posted by KathrynT at 11:14 AM on June 27, 2010


Anyone know what the "MH problems" anon referred to are?
posted by amanda at 11:19 AM on June 27, 2010


amanda: mental health

I've been planning on reduction for almost 25yrs - ever since my mom gave me a pamphlet at 15. Her reasons were kind of anti-feminist/self-loathing in origin, oddly, but that didn't ultimately effect my perception of it.

All of the people I've known who had this surgery are happier and healthier than before. They all ended up becoming more physically fit and mentally relaxed. And they save so much money on clothes and underthings. Added bonus!

I wasn't sure about still being able to breastfeed, so I waited until I knew for sure if I'd need them for that or not. Now that I'm going through what will be my one and only pregnancy, that's answered. Which means at some point in the next few years, I'll finally get this weight off my chest (back, neck, shoulders, scalp, mind...) and I can't tell you how much I'm looking forward to it. I dream about it, even. This is even knowing they might look weird after, or lose sensitivity.

The one thing - and the anonymous comment addresses this - the one thing that I know I'm going to have to really focus on is getting a good match on the surgeon. It makes all the difference in the world. One of my acquaintances saw almost 10 surgeons to find the one with the best outlook and approach for her situation. Don't be shy about setting up multiple consultations. Your insurance should at least cover one second opinion, so if you can use online communities relevant to your area to rule a few out, that might help narrow things down. Some surgeons will do free consultations - make sure to bring all your most difficult questions to these, because you don't want it to be a gladhand session where you feel great about them then get a paid appointment and find out they're not right for you.

Don't worry about what other people think. Do what will give you the most healthy body and mind.
posted by batmonkey at 12:11 PM on June 27, 2010


As a feminist I'm also massively conflicted about the cultural implications.

Another person to say that I get where you're coming from, but if the size of your breasts is causing actual physical pain and keeping you from doing what you would like, then your reduction wouldn't be at all the same as, say, a nose job. It's not for appearance reasons. I don't know many feminists who dislike breast reductions for women who have these problems.

Yes, society is all messed up about breasts, and I'm sure I don't have to tell you about how having large breasts effects the way people see you. But you're not considering surgery so you can meet their stupid standards; you're considering surgery to improve your quality of life.
posted by Kutsuwamushi at 12:30 PM on June 27, 2010


I am borderline for insurance coverage of reduction (DD cup); unlike missmagenta's experience, weight loss has done nothing but make my breasts more prominent against a smaller torso. It has a lot to do with how much of your breasts are fat and how much are breast tissue - after I had my first mammographies, I could see that I have relatively little fat in my breasts and that's why the smaller I get sizewise, the bigger my breasts become in cup size.

I agree with pretty much everyone upthread. I've considered reduction for about 25 years and may still do it, as I'm tired of the clothing issues (whether altering patterns for my own sewing or buying stuff commercially) and the ways in which I think my breasts have affected others' perception of me over the years.
posted by catlet at 1:11 PM on June 27, 2010


I have large breasts that contribute to neck/shoulder/back pain, and I once had a physio seriously suggest breast reduction.

In the end I decided against it (for me) because of

a) significant risk of loss of nipple sensitivity affecting my sex life (I have very sensitive nipples)
b) my breast size would fluctuate with weight gain/loss anyway - ie, if I put on weight, my breasts could go up to presurgery size
c) risk of scarring.

I am a committed feminist, but I never thought of the decision to reduce my breasts as anti-feminist.

If a surgeon had been able to guarantee me no loss of nipple sensitivity, I probably would have had the surgery. As it was, I decided that (for me) the cons outweighed the pros - but feminism had nothing to do with it.

Breast reductions when your breasts are adding to neck/shoulder/back pain are all about reducing pain, thus freeing up physical and emotional resources to pursue creative, educational or work pursuits with increased vigour. What could be more feminist than that?

I would see a breast reduction to reduce pain as being in the same catagory as knee or hip surgery - something that makes you more able to live your life with more movement and less pain.
posted by Year of meteors at 2:28 PM on June 27, 2010


Please interview several surgeons before you commit. Ask for references and follow through on all of them. Try to find independent references (Yelp? Angie's List? Something else?) and follow through on those. I did not follow through on references on my surgeon and it's something that has greatly affected my life since the initial surgery nearly 20 years ago. If I had, I certainly would not have used that particular surgeon.
posted by Addlepated at 2:40 PM on June 27, 2010


I (and no doubt the OP) would probably love to hear about the kind of tough questions that could be asked during an initial consult if anyone wants to share.

Thanks, bstmonkey, all I could come up with was Mammary Harm?
posted by amanda at 4:20 PM on June 27, 2010


I am not current on what to ask the surgeon on first consult. I bet there's a list of questions at some of the breast reduction support sites. Maybe stuff about dog ears; percentage of patients with numbness, both in the nipple and around the breast and torso; realistic expectations of recovery times; percentage of patients with complications.

The meat, IMO, is going to come from references, and probably from unsolicited references. If you can find a third party site (reputable) with several reviews of the doctor, that would be extremely helpful.

This is something that you're going to live with for the rest of your life. Just like you'd research your tattoo artist or mortgage company, you should do as much due diligence on the person who's going to adjust your body as you possibly can.
posted by Addlepated at 4:46 PM on June 27, 2010


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