I love breast reductions. And for those who are oversized or just droopy, breast reductions and lifts can be life changing. Exercise changing. Posture changing. Mentally changing.
The NY Times article had a bit of a different bent. In discussing the “Power of the Smaller Breast,” Sept 2024, they state,
Breast reduction is all the rage in cosmetic surgery. Are women asserting their independence or capitulating to yet another impossible standard of beauty?
The article started by talking about Keira Knightly and Bella Hadid. It talked about women bringing in bralettes they hoped to wear, or how they want to do a reduction so they can go braless. My thoughts on this will be below, but large breasted women aren’t coming in wanting to be flat.
The stats are interesting. I have always done a lot of breast reductions and lifts (and breast implant removals and lifts, which have the same effect- smaller lifted breasts). I am a board certified plastic surgeon who did an additional fellowship in breast surgery. I am a female plastic surgeon who specializes in breast reductions and lifts doing the smaller lollipop scar (a vertical breast lift, not the larger scar of the anchor inferior pedicle technique). I LOVE this surgery.
But national stats are showing a huge increase in breast reductions in recent years. In 2023, 76,000 women did breast reductions, an increase of 64% from 2019 according to my national plastic surgical society, the American Society of Plastic Surgeons. (This doesn’t include gender surgery or breast reconstruction). Though nationally increasing breast size is still more popular. Breast augmentation used to the be the number one surgery done by plastic surgeons. With concerns about implants and changing cosmetic ideals, breast augmentation dropped to the number two in popularity, with about 300,000 women doing breast augmentation each year.
Also interesting? WHO. The biggest increase in breast reductions was in women under age 30.
The article had lots of talk about the “ideal” breast. It talked about the issues for women with breasts- hard to dress, hard to exercise, hard to be taken seriously. It talked about how surgeons are seeing women come in and want smaller breasts after reduction- not going for the “C” but wanting a “B”.
It quoted reddit boards, where women went to see male plastic surgeons. I used to think there was not a big difference between female and male plastic surgeons, but over time I have grown to believe women understand women better. Not only do studies show women patients do statistically better with women surgeons, after reading some of these quotes, it clearly is deeper.
…Women post about surgeons who make comments about their weight, express their own preferences for “cute and round” breasts and defer to husbands or partners in the examination room. Suma Kashi, who is 41 and lives in Los Angeles, recalled talking to a prospective surgeon who said, “I don’t think your husband is going to like this.”
“What does my husband have to do with this?” Kashi said in an interview. “Come on, man. Please.”
The NY Times article then focuses on the young patients, and why they do breast reductions. PLEASE READ MY BLOG I wrote years ago about timing of breast reductions and what to think about. BLOG. All of the things the article talks about for young women- covering their bodies with clothing, hunched posture, inability to do sports, the psychologic toll, depression, having to wear two bras- is all real. There is a reason I think the surgery is life changing.
But there are negatives. The cost. The recovery. The scars. The effect on future breast feeding. Insurance companies have become tougher in meeting their criteria.
What is the psychological? The women in the article stated “they aren’t doing this for men.” They discuss how having smaller breasts is them taking control of their confidence and autonomy. They feel their body is more powerful. They state they don’t need to meet the expectations of Western beauty or male beauty. One point the article stated was smaller breasts were actually a sign of affluence. They cite a meme in March 2024 on X which asked which was preferred, “The aristocratic elegance of the small breasted woman OR the Nietzschean pro-sex, pro-beauty large breasted woman?” Thornton agrees that smaller breasts signal the self-assurance of affluence whereas breast augmentation can signify social ambition — a desire to attain wealth and status via the attention of men.”
Wow. That is a lot to unpack.
My thoughts?
Breasts are a multitude of things. I cannot look at the bigger world view of expectations and power. What I do see and know after doing this surgery for years and years, is that when I see a large breasted patient who wants a breast reduction, after I show her all of the scars and discuss the risks and costs and recovery and potential issues, when that patient does a breast reduction, they are happy. I hear quote after quote from my personal patients of how it has changed their life. Breathing. Posture. Neck pain. Jaw pain. Headaches. Being able to wear a bathing suit/bra off the rack/sundress. Exercise is easier. “I would have never lifeguarded…played rugby…felt confident in this dress….given my bridesmaid speech before my breast reduction.”
Life changing.
I disagree with the New York Times making breast reductions a thing of “beauty standards.” Of all the surgeries I do, doing a breast reduction or just a breast lift IS A FUNCTIONAL THING. There are incredible benefits as I have alluded to before. Making your breast smaller makes imaging of breasts easier for mammograms and monitoring. If you have dense breasts, making the breast smaller will lower your risk of breast cancer. Does a perky breast look better? Sure. Does a smaller breast generally make someone look thinner? Yes. But there are real health benefits.
Do I think everyone needs a reduction? No. But I think for the right people it is amazing. I’m glad to see the NY Times bring it to the forefront. The most common quote I hear from my patients, particularly if they are older? “I wish I would have done it sooner.” Sounds like young women are getting the memo.