When Too Much of a Good Thing Is Not Such a Good Thing

“Lucky that my breasts are small and humble, so you don’t confuse them with mountains” – Shakira

“Lucky that my breasts are small and humble, so you don’t confuse them with mountains” – Shakira

Voluptuous women seem to have it all: the perfect man, the cover of magazines and the envy of the small and insignificant breasted. No wonder more than 400,000 women undergo breast augmentation surgery each year, making it is the second most performed cosmetic surgery in the United States today. As a gynecologist, I spend my day examining breasts and discussing breast health, and from what I hear, it’s the rare woman that is happy with the size, shape or firmness of her chest. But these days I am actually having a lot more discussions about making breasts smaller.

Women who are naturally well-endowed are commonly considered to be the lucky ones; they don’t have to go through the pain and expense of surgery to get what every other woman so desperately seems to want. But many of my patients would happily give up their enormous breasts to get rid of the chronic back and shoulder pain that results from supporting breasts that weigh pounds instead of ounces. And forget sexy lace and demi-cups; the support systems in their bras rival the infrastructure of a large skyscraper.

For many women, going under the knife to reduce the size of their breasts is an opportunity to gain control of their bodies and their lives. In fact, most that opt to undergo breast-reduction surgery do it because of discomfort rather than as a means of enhancing their appearance. Some are so miserable that they want to go the opposite extreme and ask for tiny breasts. My plastic surgery colleagues understand that these patients are so desperate to be comfortable they are willing to put aesthetics aside, but they encourage them to pick a final size that is proportionate to body type.

Typically, women who undergo breast reduction are between the ages of 35 and 40, but as cosmetic surgery has become more acceptable, I am seeing an increasing number of teenagers and older women undergoing reductions.

One of my patients first contemplated breast-reduction surgery when she was 17. At 5’2", her E cup breasts made shopping a nightmare and caused chronic shoulder pain. She finally went through with it at age 19. Now a size C, she feels totally confident, and picks clothes based on what she likes instead of what best camouflaged her breasts.

Fear of complications and “the down time” kept another of my patients, a busy divorce attorney and mother of 3, from having breast reduction surgery until she was 61. Her recovery was uncomfortable, but more than worth it. She loves to play tennis again and no longer sleeps wearing a bra.

It’s rare for a patient to regret her decision. According to plastic surgeons, women are most often dissatisfied with their post-reduction size when they lose significant weight and end up with smaller breasts than they intended. So for best results, women should be at their ideal body weight prior to surgery.

Like any operation, the decision to undergo breast-reduction surgery shouldn’t be made lightly. There is always the risk of a complication, and, even in the best of circumstances, there are visible scars. While some women lose nipple sensation or the ability to breastfeed, there are new techniques that minimize damage to nerves and glandular tissue.

While society has its own ideals about the perfect breast, the bottom line for women considering breast reduction is to work with an experienced surgeon to achieve comfort without forfeiting function and appearance.

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