Large breasts. They’re everywhere you look: on TV, in magazines, spilling out of bikini tops and low-cut sweaters, desired by most women (and men), celebrated by the media ad nauseum. So if you were cursed with itty bitties and are tired of stuffing your A cups, it might surprise you to know that some women built like a brick house pay good money to take a load off their chests.

Also know as reduction mammaplasty, breast reduction surgery was performed on over 145,000 women and nearly 23,000 men in 2006. (Yes, guys can need it, too; nearly half of all men suffer from gynecomastia, a condition in which one or both male breasts appear large due to fat or excess glandular tissue.) With an average national cost of $5,500, the procedure is not inexpensive. However, it’s one of the few that some insurance companies will cover if you can provide evidence that overdeveloped breasts are causing you pain or other physical ailments.

We don’t wonder why men with flabby chests might want breast reduction surgery, but why do some women tire of their voluptuous builds? Because while Hollywood and society at large might send the clear message that big is better, D cups experience their share of misery.

Physically, big-breasted women have difficulty participating in activities that most of us take for granted. Exercising is literally a pain due to the jostling that the breasts endure. Sleeping on the stomach might be impossible. Add the back and neck stress from carrying around extra chest weight and grooves left in tender shoulders by bra straps and you can see how having a big chest is not always as much fun as Baywatch would have us believe.

Socially, big breasts can complicate relationships. Ask any overly endowed woman what most men notice first and chances are it won’t be her smile. Women don’t always treat their large-breasted peers any better. Yet the reality is that women leered and sneered at for their generous assets often simply can’t find clothes that aren’t too tight, too low cut, or have buttons that won’t pop off under the strain of a big bosom.

A breast reduction can bring relief. Reduction mammaplasty patients report the highest satisfaction rate among plastic surgery recipients, with up to 95 percent of those polled saying they are happy with their new look. Recovery is usually uneventful and the results are permanent. Though it does leave scar tissue, breast reduction surgery does not increase the incidence or interfere with the detection of breast cancer. In fact, smaller breasts are easier to check for lumps and can make mammograms less painful.

However, there are some caveats. If you plan on having children, discuss with your doctor the possibility of losing the ability to breastfeed. Though not a certain outcome, especially if the nipple is left attached, there is no guarantee you will still have this capability.

If losing weight is also a goal, wait until you’ve slimmed down before having breast reduction surgery. Shedding pounds afterward, especially around the middle, can cause your new breasts to sag.

A breast reduction is major surgery with all its attendant risks. Infections are not an uncommon complication. Nipples that lose feeling or actually wither and die because of interrupted blood supply are much rarer.

Usually, the repositioned nipple remains attached to underlying tissue, maintaining the blood and nerve supply, but sometimes when breasts are very large or droopy, the surgeon must completely remove the nipple beforehand, conduct an anchor reduction, and then regraft the nipple higher on the chest. You and your doctor will decide before surgery if you’re willing to trade nipple feeling and function for your target cup size.

The procedure is almost always performed under general anesthesia and takes anywhere from 90 minutes to three or four hours. This is followed by a couple of hours in the recovery room and usually a stay overnight.

Most surgeons use the “anchor” incision, so-called because it’s shaped something like one. Popular for its easy access to large amounts of tissue, the anchor cut circles the areola, extends downward in a straight line from the bottom edge of the areola to beneath the breast, and follows the natural curve of the crease.

After the surgeon removes all the fat and glandular tissue necessary to achieve the target cup size, he pulls the nipple up and tugs the skin above it down and around to shape the new breast. Voila! Smaller higher breasts, a D cup now a C or B.

Usually, the repositioned nipple remains attached to underlying tissue, maintaining the blood and nerve supply, but sometimes when breasts are very large or droopy, the surgeon must completely remove the nipple beforehand, conduct an anchor reduction, and then regraft the nipple higher on the chest. You and your doctor will decide before surgery if you’re willing to trade nipple feeling and function for your target cup size.

If the anchor cut sounds too invasive, a couple of other options that result in less scarring might be right for you. A select few surgeons now offer less-massively-breasted women the new so-called lollipop technique, an incision that circles the areole and extends downward to the crease but stops there. If you don’t need a lift along with your reduction, liposuction might be the answer. For lipo breast reductions the surgeon inserts the cannula, the small narrow tube used in liposuction procedures, through an incision in the armpit and sucks out the fat through the tube. 

• a ride home
• someone to stay with you and cook, clean and fetch what you need for the first one or two days
• a wedge pillow
• several ice packs
• prefilled pain and antibiotic prescriptions
• prepared meals you can heat up quickly
• a quiet, comfy spot at home other than your bed equipped with remote, books, magazines and snacks

For the first 24 hours, apply ice packs to your breasts and sleep in an upright position to reduce pain and swelling. Your incisions might leak and bleed some, which is completely normal, but if leakage is excessive or has a foul odor, call your doctor right away. You might have an infection.

Now for the really pleasant stuff: red or white bumps or scabs mean something is up and you should call your doctor. Blisters, burns, infection, and allergic reaction are also possible but rare. Treat them with medicated ointments or antibiotics and a half gallon of Rocky Road.

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Right after surgery you might not feel like jumping up and down for joy, but neither should you lie abed all day. Keep moving; it’s good for recovery. However, avoid sexual activity (too stimulating) for at least one week and sleeping on your stomach (too painful) for two,weeks. Take it easy on your new friends in general for at least six weeks. That means no heavy pushing, lifting, or other strenuous activities. The girls have been through a lot and need time to heal! Even if you’re careful, periodic sharp pains are normal for up to six months. Numbness or extra sensitivity in the nipples and other parts of the breast is also common but usually goes away.

Surgical bras definitely do not come from Victoria’s Secret, but at least they’re comfortable, with front openings and seams that will not rub against the incision. Once your doctor gives the okay to ditch the surgical bra you will need to wear a sports bra for about a month. Need we mention you’ll want to avoid underwires for quite some time? Ouch.

If all goes well, you should be able to go back to work in two weeks.

Long term? Don’t fret if at first that new, smaller chest is not all you had envisioned: It can take up to a year for breasts to settle into their new shape. A little asymmetry is normal. Incision scars might be red and bumpy for quite some time but eventually should fade to flat white lines. At any rate, no one but you and a few select others will ever see them, even when you wear a bathing suit or low-cut top.

Don’t worry if you feel a little depressed. That’s normal, too. Gone are the large breasts that once brought such grief, but for a few weeks or months, you might actually miss your old buddies and wonder if you made the right choice.

Focus on your new freedom. Many women report that almost instantly, backs and necks stop aching following breast reduction surgery. Self-esteem blossoms because for the first time in their adult lives, they don’t have to endure insensitive remarks or wonder if they’re admired for their brains or their breasts. Owners of normal-size breasts can jog, play tennis, and participate in other sports without pain.

Enjoy!

Alternatives

Unlike their flat-chested sisters, who have always had Kleenex and push-up bras at their disposal, big-breasted women have few figure-enhancing options to turn to. Oh, there’s the sports bra, but that only reduces jiggle, and there are plus-size blouses, but who wants to live in a tent? There simply is no nonsurgical way to make a big chest flatter, lighter or easier to handle. When an overabundance of mammary tissue is the problem, there is only one way to get it off your chest. You’re gonna have to go under the knife.

--Kathy Murdock