I was sitting topless on crinkly paper in a room with white walls and toothpaste-green privacy curtains hanging from the ceiling to separate the hospital beds. “Women pay thousands of dollars for breasts like these,” the plastic surgeon told me. Were doctors supposed to say that? I didn’t think so, but it didn’t matter. In a few hours, he would be carefully, meticulously making incisions along the anchor-shaped lines he’d drawn on my breasts. I was 18 and getting a breast reduction, or medically, a reduction mammoplasty.
Together, my 34DDs weighed in at more than four pounds, a heavy burden for my five-foot-one frame. I knew long before I decided on surgery that I wasn’t built to carry around that much weight. And my body reminded me of that fact every day—with neck aches so painful I couldn’t turn my head; with the deep grooves my bra straps made in my aching shoulders; with the chafed skin that sports bras left under my bouncing breasts, raw skin stinging before scabbing over.
Study after study names these as common discomforts among women with big breasts, but when you’re a teenager with DDs surrounded by As and Bs, the last thing these problems seem is common. How could I explain to my smaller-chested friends why I didn’t want to try out for the cross-country team? “My breasts bounce too much” might seem laughable to someone who’d never experienced intertrigo, the fancy name for the painful, oozing infection that exercise caused in the skin under my breasts.
Regardless of the negative effects of macromastia, the medical term for excessively large breasts, insurance providers consider it a cosmetic operation unless patients meet a lengthy list of symptoms—all physical, none psychological—and many require doctors to try fitting patients with a better bra and other therapeutic measures before resorting to surgery. Perhaps that explains why, when I emphasized the emotional baggage of my breasts during consultations with my surgeon, he guided our conversations back to the physical issues.
Despite the insurance difficulties, breast reductions increased by 157 percent between 1997 and 2013, according to statistics from the American Society for Aesthetic Plastic Surgery. Anecdotally, Brian Labow, the director of the Adolescent Breast Clinic at Boston Children’s Hospital, tells me that he’s seen an uptick in teenagers wanting breast reductions over the past 11 years. He used to see two or three teens a year for symptoms of macromastia, he says. Now, he sees more than 100, though not all of them opt for surgery. Originally a hand surgeon, Labow says that when he first went into pediatric plastic surgery, he didn’t imagine he would ever have to do breast surgery.
Doctors don’t know why more women, and in particular more young women, are opting for breast reductions. Some studies suggest that people are reaching puberty earlier, and the obesity epidemic is affecting breast size, Labow says. “And then there’s the whole environmental estrogen story,” he adds. Environmental estrogens, often called xenoestrogens, are substances that mimic the hormone our bodies naturally produce, which is known to influence breast size. These chemicals are often found in pesticides, plastics, and meat from animals that have been given steroid hormone drugs to speed up growth. “Is there estrogen in our soy? Is there estrogen in our various food products, chicken or cows? Are we putting in artificial or synthetic estrogen? I really don’t know.”
Perhaps it’s that the surgery itself is getting easier. “This is almost a day surgical procedure,” Labow says, recalling a patient who came in at 5:30 p.m. for her reduction and went home the same night. When I had my reduction done nine years ago, surgery lasted approximately four hours, and I stayed in the hospital for another 24.
I spent the night in the hospital, and in the morning, the doctor carefully unwrapped my bandages and removed the drainage tubes. Sitting up for the first time since surgery, I marveled at the lightness of my chest. I laughed out loud. I hadn’t even realized the effort it took to sit up before, I said, and my doctor smiled. “Well, we took out two pounds, you know,” he said. “That’ll weigh you down.”
When I saw my new, smaller breasts for the first time after a week of initial recovery, my reflection showed two green, yellow, and purple bruised squares with dried blood around stitches. “I look like Frankenstein,” I told my mom, laughing. I’d been warned that the fullness and roundness of my breasts would come back gradually.
I wore a surgical sports bra that zipped up the front for the next three months, avoiding exercise and lifting anything heavy. To minimize scarring, I wore silicone gel sheets that stuck to my breasts and held the incisions together, preventing them from spreading. Today, my scars are barely noticeable.
It’s been nine years since I became a size 32C. Luckily, I didn’t experience any breast regrowth— I now wear sports bras only when I’m working out, and they no longer leave my skin raw. My neck doesn’t hurt, and my shoulders don’t ache. I can wear dresses that fit, no duct tape necessary. For some teens, maybe counseling or a better-fitting bra is the right answer, but, as Park tells me, “breast reduction patients are some of our happiest patients.”