How can I accept this change and make the next step?
July 8, 2010 4:10 PM   Subscribe

How can I reconcile with an upcoming drastic change to my appearance? I'm not necessarily having second thoughts, but I'm scared of the change.

I asked a question a bit ago about breast reduction surgery. I've already met with a surgeon and tried to see if insurance would cover it (they won't). Now the next step is financing, which isn't an issue, and to set a date for surgery. I just can't bring myself to make the next step, not that I don't want to, it's just that I'm scared. This is such a big change and this is something that's been a part of my identity for so long. Of course I'm looking forward to being able to wear most clothes and not being known as "the girl with big boobs" so why am I so fearful? Has anyone been through something similar, with breast reduction or with another type of surgery or change?

Also another thing that makes me hesitant is that the surgeon said that in 1 out of 100 cases, the nipple dies and falls off! Ah!
posted by MaryDellamorte to Health & Fitness (20 answers total) 4 users marked this as a favorite
All my life, I was a strong proponent of long hair, not just on me but on principle. Time was, I couldn't imagine doing without my own hair, short of losing it to a terrible disease that would give me worse problems to think about. What with one thing and another, I decided to get it cut bob-short last year, and instantly I thought: Wow. This is it? This is great! The back of my neck feels all spiky! I should've given it all to Locks of Love!

What I'm saying is that there's a possibility that the physical change is just what you didn't know you wanted. I do know someone who had a reduction, and it was like night and day for her, all the relief. (It's the nipple issue that would concern me, very strongly, but I can't speak to that risk at all.)
posted by Countess Elena at 4:19 PM on July 8, 2010

Can the surgeon (or perhaps a friend) photoshop pictures of you from various angles (either clothed or unclothed) so you can get a better sense of before vs after? Posting this on your bathroom mirror might help you get used to the idea of how the "new you" will look.
posted by carmicha at 4:21 PM on July 8, 2010 [1 favorite]

For whatever its worth, I had a friend who was self-conscious about her big boobs. She always wore baggy clothes, and had lousy posture as she slumped forward.

She got breast-reduction surgery. She didn't advertise that fact, but everyone commented on how she must have lost weight (true, in a sense), and how she looked great. She stopped slumping and stopped wearing those enormous sweaters.

So, yeah, it's a big deal, but based on the sample group of 1 of women I know who have done it, it's 100% successful.
posted by adamrice at 4:42 PM on July 8, 2010

Are you absolutely sure your insurance won't cover it? Did you try and get denied because "it wasn't necessary"? If so, appeal it! Insurance companies nearly always deny the first time because they know people will give up. But fight for it and you might win.

I had a breast reduction last September. I don't really recall having any sort of angst about the change in my appearance (to be fair, I'd lost 90lbs in the year and a half before that, so my appearance didn't really feel like me anyway) and now I don't even remember what I looked like with big boobs. And I certainly don't care or miss them. I love my tiny B cups.

I was told that the nipple/areola has a greater chance of necrosis if you smoke and don't quit before surgery. I smoked two weeks before surgery and started again a week after. I still have both of mine, and they both work perfectly (although he twisted one of them a bit and my previously horizontal nipple piercing is now at an angle. Hilarious!). I also don't know of anyone personally who has lost a nipple from a breast reduction surgery.

I know it's a scary thing, but seriously. Best thing I ever did for myself. Possibly moreso than the gastric bypass surgery (simply because the small boobs haven't made me anemic).
posted by elsietheeel at 4:46 PM on July 8, 2010

Response by poster: Elsietheeel, how do you appeal the decision? They did say that they didn't deem my surgery as "medically necessary."
posted by MaryDellamorte at 4:50 PM on July 8, 2010

Also another thing that makes me hesitant is that the surgeon said that in 1 out of 100 cases, the nipple dies and falls off! Ah!

Not to further scare you, but there are additional risks to any surgery: death or brain damage from anesthesia, infection, scarring, disfigurement, etc. No surgery is trivial.

Before going the surgical route for anything, be sure you've explored all alternatives.
posted by orthogonality at 4:51 PM on July 8, 2010

Write a letter explaining why you think the surgery is medically necessary for you. Give details of any pain, the duration, what exacerbates it, what you've tried to do to treat it, and how it affects your life. They denied my mother a panniculectomy when she first tried to have that covered by her insurance, we wrote a letter detailing exactly why she needed it, and they approved her. They denied my first visit to the bariatric surgeon, saying that my BMI wasn't high enough, I wrote a letter explaining my need for WLS, and they let me go. Insurance companies don't want to spend money and they (correctly) assume that most people either don't know they can fight a decision or are too lazy to fight it.

Bonus: If you're any sort of civil servant you can point out that you plan on being insured by their company for the rest of your life, so they can pay for the surgery now, or for years of physical therapy and pain medication, and then possibly spinal surgery!
posted by elsietheeel at 5:17 PM on July 8, 2010

A relative of mine (in her 40s or early 50s) got her insurance to pay for BRS with the justification that her breasts were so large that it was not possible to get a clear mammogram image for cancer screening. Breast cancer treatment must be enormously more expensive than a straightforward reduction surgery.
posted by brain at 5:52 PM on July 8, 2010

I'm familiar with insurance battles due to my long association with a group for people with birthmarks (I have a Port Wine Stain on my face) - what you often need is a doctor who will send them medical stuff, and a lot of patience/determination. The experts in insurance battles also say never to use the word "cosmetic," for whatever that's worth.

Have you tried to make your chest smaller with clothing? I ask mainly because a lot of the birthmark community is very into makeup - I can get rid of most of my birthmark (other than the hypertrophy) with half an hour and $30 of supplies. It's like trying on a new identity without actually doing the pain and the space-age devices and so forth. It's also deeply weird, for me - I plan on doing the laser surgery mostly because of the thickening as I get older. And I expect to be in therapy, because, wow, changing your face?

One thing I do want to mention - for people who know you, they probably won't be quick to notice what, exactly, changed. Most of my friends and family say they don't "see" my birthmark - they can always tell when I'm not wearing my glasses, but they give me that "did you cut your hair" look when I put makeup on. I find this comforting, your mileage, etc.
posted by SMPA at 6:51 PM on July 8, 2010

Response by poster: I think my change would be immediately noticeable to people who know me. I'm tiny with huge boobs and that is always the first thing people notice about me. I'm a 32G. And there's no way to make my chest look smaller with clothing unless I want to look like a bag lady, which I refuse to do. I've even tried minimizer bras which don't really do much, and they're uncomfortable.
posted by MaryDellamorte at 7:03 PM on July 8, 2010

Best answer: Perhaps it would be helpful to know that any kind of serious, permanent change makes you feel this way. I know it feels particular to this situation, but I think it's a default human reaction to a fundamental personal change. Like: once you do this thing, you will be fundamentally different, there will always be a story you will feel compelled to tell, as if to annotate your own existence, because it's more than just what's written on the tin now. (That's always how I feel about it when it happens: "Crap. Now I'm always going to have to be the girl that did X, or the girl who had Y.") There's a real sense of loss in that process, losing your former self, even when the new self is better off. It's like your story is being added to, and it's uncomfortable.

I think the fear of altering our basic identity gets in the way of our decision-making a lot of the time. Because something is so much a part of how we see ourselves, we will deny ourselves opportunities that would define us otherwise. Lately I've learned that it's worth it to question that rock-solid identity, even though it's uncomfortable.

In sum: what you're feeling is perfectly normal. You will lose something that defines you (and that's exactly what you want!). It will feel weird for a while, but in the end you will develop a new sense of yourself. This time you'll have more control over it.

I'm not really sure how to overcome that fear, frankly. When I've had this experience I haven't really had a choice about it, so I was forced forward. Perhaps you can just accept this feeling, and allow yourself to sort of grieve for your current sense of self. Celebrate it, revel in it. Mark this transition in your life the way you would mark any other major transition. Personally I find building something (literally or virtually) that describes how it all feels is incredibly helpful. (That's art therapy.)

It's something you want to let go of, but that doesn't necessarily mean the letting go is so easy. You're stepping off a cliff, and that's a scary thing to do, even when you're pretty positive there's a nice soft landing in store for you.

Give yourself a break. :)
posted by Hildegarde at 8:17 PM on July 8, 2010 [3 favorites]

I'm a 32G and can make my breasts practically disappear with the right clothing and bra. Not oversized clothing either, just well fitted items in soft and drapey fabric that skim rather than clinging or hanging off the front of my bra. One of my long-time work colleagues saw me in a showy top at a social event a while ago and blurted out "omg, your boobs are HUGE!" She'd never noticed before. So I bet your breasts are not as noticeable as you think and I bet people's reactions won't be as extreme as you think either.

I also bleached and dyed my hair bright pippy-longstockings-red once and no one at work noticed for 4 days. My hair is very dark brunette and hangs half way down my back. People are not that observant!
posted by fshgrl at 8:34 PM on July 8, 2010

You are smart to carefully consider this--it is no small undertaking.
I had THE most common plastic surgery...rhinoplasty. I think I understand your ambivalence.

I had a love/hate relationship with my nose. I suspect you feel the same about your breasts. On the one hand I knew my nose made me "unique" (it was sort of like a combination of Anjelica Huston's nose and Princess Di's nose...very very long, hooked and non-standard. My nose sometimes photographed very well, but then again, from other angles (not to overstate it) it was horrifying. It sometimes felt like the bane of my existence and I wondered how much my attitude(s) about it held me back in life. How can I explain this..I almost enjoyed this "dichotomy" for many years and I convinced myself my nose was mine and it was character building to keep it. I finally faced the issue of changing it when I had severe sinus issues. The surgeon said "I can file down that hump and straighten your septum, if you want". ooooookay. I figured I might go for that. Well, like you, I got cold feet. But then, after the seed was REALLY planted (insurance would pay for the septum straightening) I looked at other doctors. I wound up having a full rhinoplasty and it was very drastic..not subtle. (This surprised me, I thought the surgeon had understood what I wanted). When I saw the results, I didn't like it at all and I longed for my old nose. (sorry this is such a long story..but I'll get to the point soon). I found out later that my surgeon had a terrible time with the surgery because my nose was over-resected (an error was made and he took off too much of the hump). LUCKILY for me they had a new implant material on hand and they gave me a gore-tex "implant". I found all this out later.
SO! there was nothing I could do but live with this new "ingenue" nose that I did not expect. Something funny started happening, however, even though I pined for my old nose. I really started getting more friendly with everyone. I started feeling very confident and developing a more outgoing personality. This was a very marked change. I am still not thrilled with the new nose--because to me my nostrils don't match this super small nose--it does look "done" to me and if I ever get together enough money I might look into what could be done for a revision..a revision is ridiculously expensive, however, so it is pretty unlikely.
To review: 1. I loved and hated my nose
2. I rationalized a medical reason to go through with it (the straightening improved my breathing considerably).
3. There were huge complications that I only became aware of after receiving the surgical report.
4. I was surprised by the results and did not like it.
5. I discovered the new nose made me feel more confidence ..even though I didn't particularly like it.
6. If I could I would change it back---I would! yet..I do realize I have felt better emotionally with a better looking nose.
7. My life has definitely improved because of the change...even though I am not 100% satisfied.

Hope all this helps. In a nutshell you won't find out how improved your life could be unless you go through with it, but also you may have results that you are not completely satisfied with.
(It is next to impossible to get anywhere with a malpractice lawsuit when it comes to cosmetic choose your surgeon well!)
posted by naplesyellow at 9:07 PM on July 8, 2010

At the end of the day, any change to something that's been a part of you your whole life (or most of it) isn't going to be easy. That's normal and natural, especially when it's permanent -- our bodies are enmeshed in our identities. I've always been tall and skinny, and if I suddenly gained forty pounds it would likely have a bizarre impact on my personality (or at least my view of myself.)

From the surgical side, there are risks, as you acknowledge. So really, you need to make a judgement call: are the benefits you're trying to obtain likely to happen, and worth the risk of the worst-case scenario? I know one person who has been through this same surgery and is much happier for it, and one person who hasn't done it for reasons similar to yours and therefore didn't have to face their fear -- but still has to face the issues that made her want to do it in the first place.

Ultimately it's your judgement call, and yours alone, but the good news is that the decision can make itself: if you simply decide to wait another day/week/month, and what you go through during that period isn't sufficient to push you back into doing it, then you're good as you are -- and if you keep wanting to do it during those periods, do it.
posted by davejay at 11:10 PM on July 8, 2010

To me, a change in your body is less stressful than a change in your whole environment (like moving). After all, we go through puberty, get our hair cut too short, get that surgery scar, suddenly gain or lose a lot of weight, worst, there may be a bit of a shock at first, but you'll quickly adjust. And, I would guess, feel a new "lightness of being". Good luck and good health to you.
posted by serena15221 at 11:12 PM on July 8, 2010

My wife had a breast reduction well before I met her, probably 15+ years ago. She's fairly petite and very athletic and her very large breasts just constantly got in her way. She's thrilled she did it and has never looked back - and her B cup breasts look perfect on her small, athletic frame. The only downside is that her nipples are pretty unresponsive sexually, which she dislikes - but she's still very, very happy she did it.

I have heard that it makes it more difficult to nurse, should you ever have babies, but I'm not sure if this is true. Could be worth looking into before you make your final decision.
posted by widdershins at 6:10 AM on July 9, 2010

Wow -- that nipple statistic is kind -of scary. By comparison, the chances of having one's uterus rupture during vaginal labor after a c-section is 1/1000, but the vast majority of OB's fight you hard to avoid the risk . . . Supposing your nipples are fine, will they have sensation after surgery? Soon, or will it take years to come back and never come back completely? And does it matter to you if they never have sensation again?

In any event, all the anecdata I've heard about breast reduction has been positive, providing you don't plan to breastfeed (and I think you said you weren't in your original post).
posted by MeiraV at 8:12 AM on July 9, 2010

Not to push the idea of more surgery, but I met a woman who'd had a mastectomy and reconstruction for breast cancer, and the surgeon was able to create a new "nipple" by twisting skin and tattooing on an areola.
posted by needs more cowbell at 9:07 AM on July 9, 2010

I had a breast reduction after high school / before college. I'm 5'2" and always looked heavy because I had to wear oversized tops which then hung away from my body because they were pressed outwards from my breasts. I went from a 38 DD to a 34 C. I would never, ever, EVER go back. Best decision I've ever made in my life. It doesn't just change your shape, or what clothing you wear; it changes--for the better--how you participate in activities you were involved in previously, your ability to exercise, your posture, your sleep, your *breathing*...

Yes, it's surgery, and yes, all surgeries carry the risk of complications. But that risk is truly minimal, especially with the right surgeon. If you haven't already, ask your surgeon for the phone numbers of previous breast-reduction patients (many consent to discuss their experiences with people who are concerned just like you are). Many of those patients also give consent to have before/after pictures available to pre-op patients.

Do it.
posted by tzikeh at 4:17 PM on July 9, 2010

Oh - most insurance will cover it if having large breasts is causing intense pain or any kind of bending to the spine or scapulae.
posted by tzikeh at 4:19 PM on July 9, 2010

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