Transcript | Ep. 152: How to Get a Breast Reduction

S: Oh, you know, you grow up as a young girl looking at women's bodies and like, oh, I want boobs. That would be awesome. And then they start growing, and then you're in sixth grade and they keep going past a double D and you're like, OK, you can slow down, you can stop even, like, that's plenty. And then like in a year, they're a G and beyond. And it's like just an entirely different thing than I was prepared for, the like pornography condition of my body by the whole world.

[theme music]

Caroline: Today’s episode starts with a subject line. A while back, we got an email from the Unladylike listener you just heard. We’re calling her S. Subject line: “How dareth a lady seek to reduce dem titties?”

Cristen: Oh, my favorite Shakespeare play!

Caroline: Yes! S was in her early 20s and had just met with a surgeon about getting a breast reduction. She wrote: “the pain from my chest weight is constant and inescapable. It’s in my lower back and hips, shoulders, upper chest, upper breast tissue, underboob tissue, and neck.”

Cristen: S was sick of the chronic pain and also sick of the ogling. Of feeling reduced to her boobs. So S asked if we’d look into breast reductions and she was especially eager to hear other unladies’ experiences with them. And as always, Caroline, unladies delivered.

Caroline: Yeah, and there were a lot of glowing reviews! A listener named Kaycie called her breast reduction the best decision of her life. “My confidence has absolutely skyrocketed. I’ve never been in less physical pain, I can wear clothes I’m actually excited to wear, I can actually exercise, the list just goes on …”

Cristen: Another listener named Mary sang similar praises about her breast reduction. In an email, Mary said she considered the surgery a feminist act of reclaiming “my body, my sexuality and my mental health.”

Caroline: And Cristen, I didn’t know before this episode that breast reductions are one of the most common plastic surgeries in the US. And because of that chronic pain factor, they’re often covered by insurance.

Cristen: Getting that weight off your chest can relieve a lot more than the physical discomfort, too. Multiple studies have linked breast reductions with improved well-being, self-esteem, and body image as well as lowered rates of anxiety, depression and eating disorders.

Caroline: Now, we are not suggesting that there’s anything wrong with having big boobs or that voluptuous unladies out there should want to make them smaller. We’re also not suggesting that breast reduction surgeries are a cure-all. Listener Kelly got one 20 years ago and is still processing. She tweeted that the main reason she did it was constant harassment from men and she wrote, “I don’t know if I would do it today. I’d probably be punching them in the face, instead.”

Kelly: And that's the thing, when I look back, that makes me the angriest is that so much of this decision was based on how I looked to other people. And that is just fucked up.

Cristen: So today on the show, with help from Kelly and S, we’re finding out what happens when unladies DO dareth to reduce dem titties…

[stinger]

Cristen: Typically, breasts start developing between 8 and 13 years old, and their arrival can really throw you for a loop mentally and emotionally.

Caroline: Yeah, the vast majority of cisgender girls report at least one boob-related concern, like them bouncing around while you’re exercising, not knowing what kind of bra to wear and, of course, boobs attracting unwanted attention.

Cristen: Check, check and check for Unladylike listener Kelly.

Caroline: Well, so as you know, today we are here to talk about your boobs.

Kelly: Yeah. This is not uncharted territory for me, unfortunately or fortunately, I don't know.

Caroline: Or us!

Cristen: Kelly grew up Mormon in Utah in the 80s. When she was 10, she realized .. she didn’t look like the other girls at school.

Kelly: I definitely had the biggest boobs. You know, they were all getting training bras, and I didn't even like… that. That word was never in my vocabulary until I read Judy Blume or something, like, I didn't even know.

Caroline: It seemed like EVERYONE had something to say about Kelly’s chest. Some of her classmates were jealous.. Grown men leered at her.. Even her mom’s friends joked about how her boobs were bigger than theirs.

Kelly: I was definitely getting looks, and I would get these sort of weird sideways comments like, “You're such a woman.” And I didn't understand it at the time. It was years before I realized what they were actually saying. I thought they were complimenting me on how intelligent and, you know, witty I was. So from boys my age, it would just be “How big are your boobs?” or you know reaching their hands out like they were going to grab them or something like that. Just really blatant and unapologetic.

Caroline: Well, how did - how did you feel about your boobs when you were around that age, like outside of what people were saying to you?

Kelly: I think there there was a strange sort of pride. That I was maturing faster than my classmates. And I grew up Mormon, and so, you know, really was just ingrained in me from the time I was born that I was going to be a mother and have children. And so for me, it just it just meant that I was closer to what was supposed to be my ultimate goal. Kelly [00:06:19] So I really just thought that I was becoming a woman. And what else could I possibly want in the world?

Cristen: By the time Kelly was in high school, she’d outgrown double D bras, but they were the biggest she could find. And her cups ranneth over. Boob spilled out over the top and past the underwire on the bottom.

Caroline: When Kelly would take her bra off at the end of the day, she’d have gouges and red marks from all the squeezing and pulling.

Cristen: So when did the experience shift from sort of this initial phase of, “Hey, yeah, this just means that I'm o-t-w, on my way to being a woman. See you girls later,” to maybe internalizing some of that stigma.

Kelly: So most Mormon girls aren't allowed to date until they're 16. And so it wasn't really until I hit 16 that I was really shopping for dresses for, you know, for for dances or for school events. And I think that's probably when I started really realizing that I was not just like blessed, but that was actually, you know, it became a curse at that point, and I found this two-piece dress that I fell in love with. It was, I'm pretty sure it was a Jessica McClintock dress. And I was just so thrilled that it was two pieces and that I didn't have to buy the same size because I bought a size six skirt and a size 10 top, but then had to have like a V-shaped velvet insert that went in between the lapels ..So when I put this dress on that, the top of the bodice probably hit me like mid boob, and so my grandmother had them make one that was like four inches longer so that it covered my cleavage. And, you know, and then the top, which was much, much bigger and still had to be modified to fit me. And that's the first time. I think Like, it really clicked for me. And even then in that dress, oh boy, I got a lot of attention.

Caroline: Once Kelly noticed the boob ogling, she couldn't un-see it.

Kelly: I always felt like property because men at church would just, you know, they'd come up to me and they'd say, Hey, sister, and like, shake my hand. But then there would be another hand on my shoulder that would just be on my shoulder a little bit too long. And I just it made me uncomfortable, but I felt like that was my problem. And so like, I think even from the get go, it never occurred to me that my boobs belonged to me. They seemed like this separate entity. And that just got worse as I got into college.

Caroline: Well, when did you first think or learn about breast reductions, like how did you start to consider it?

Kelly: I think it was my sophomore year.I had a roommate who had a breast reduction and she told me about it. And I didn't know there was such a thing, but she. She basically she told me I should get one.

Caroline: And what was that conversation like?

Kelly: I am sure that it started with me being frustrated about finding something to wear, or I probably was wearing like a button-up shirt that was gaping, and I was trying to safety pin it, and she just was like, “You should get a breast reduction. I got one.” And I was like, “What? What?” And she said that she had a breast reduction when she was, I think, just 18 and that it changed her life and I should get one and I would never regret it.

Cristen: So I’m also curious, in that moment when you are presented with a potential life-changing — the way that she's presenting it — solution to this thing that is really giving you a lot of grief. So how did you feel in that moment?

Kelly: I think I was insulted. Because she was basically saying there was something wrong with my body, and I mean, it's not like I didn't already hear that or think that. But that there was something so wrong with my body that I should have major surgery to fix it. I think that's the thing that really. You know, it was it was like a slap in the face because I. I suddenly went from feeling like I was accepted by her and she was, you know, a popular person in in my in my program and it it suddenly it suddenly felt like I wasn't accepted by her that I was something that she was going to fix or something that she just saw problems with.

Caroline: Well so, what was the what was the tipping point? How did you go from feeling insulted to then actually wanting to get a breast reduction?

Kelly: I was in this play. I was playing a prostitute. And it was um, y’know. I was wearing something that was all about my boobs. But I was just so thrilled to be in this play and to be doing what I loved. And it was on stage at the end of the show and I walked past a friend of mine and instead of saying what he was supposed to say, he said, “Nice boobies,” and waved this stick at my at my chest and I think I said to him, “Eat shit.” And it was maybe the third time I'd sworn in my entire life, and

Cristen: It's a good one.

Kelly: I mean, that is quite the comeback, too. And I just I went from having this like absolute feeling of elation, of the applause, of the end of the show, of feeling really good about myself being really excited and happy to just feeling completely reduced to this set of boobs that was attached to my chest that I didn't have any fondness for anyway. I mean, I hadn't. I'd never masturbated. So I was getting no pleasure from my boobs at all, ever. They were a constant source of distress. And I was just mortified because again, I thought that we were these colleagues and having this experience, and all he was doing was looking at my boobs, and it just was like, “That's it.” And I went home that night and I called my mom and I said, “I'm getting it.”

Caroline: We’re going to take a quick break.

Cristen: When we come back, we get more details on what breast reductions actually entail — and Kelly goes to a surgeon.

Caroline: Stick around!

[stinger]

Caroline: We’re back, and before we return to listener Kelly, we wanted to find out more about breast reduction surgeries

Cristen: Yeah, breast reductions have been around it turns out since the 19th century. They were the product of surgical innovation. That's when technology enabled them to not only remove tissue but ALSO reconstruct breasts to look "natural." Which male doctors defined as symmetrical, youthful and lifted, your classic idealized perky boobs, Caroline.

Caroline: Yeah, and I mean the mental image stuck around. The guy who introduced modern breast reduction techniques in the 1950s based his incisions on bra patterns from Frederick’s of Hollywood!

Cristen: Oh my god wasn’t that the era of cone bras, though?! I’m not so sure about this… Today, most breast reductions are a three-hour, outpatient procedure. Surgeons remove extra fat, skin and tissue — that’s the reduction — then they lift the breast. That also involves moving the nipple up as necessary. Ultimately, the surgeries aim for breasts that are more proportional to your body and relieve the chronic pain.

Caroline: And insurance often covers reductions when your breasts restrict your activity, and cause pain and skin irritation. But they usually want to see some proof that you’ve exhausted every other option. For instance, listener Mara tweeted at us: “A friend of mine is going through the process of getting one. The first time she tried she was told to lose weight first….she is an average sized American cis woman…”

Cristen: It’s actually super common for doctors to tell patients to try to shed some pounds first —

Caroline: And the advice is two-fold: one, if you lose weight all over, you might also lose some boob weight; and two, if you lose weight after the procedure, your new boobs might end up being smaller than you’d planned.

Cristen: And 3, medical fatphobia. Lets just say it!

Caroline: True. True!

Cristen: To get approved by insurance, you’re also going to need evidence that you’ve tried any number of treatments. Everything from seeing physical therapists and orthopedists for back and shoulder pain to dermatologists for chronic skin rashes to chiropractors and massage therapists.

Caroline: Then, they'll want to know how much tissue the surgeon plans to remove. The minimum is usually 200 to 350 grams — which is equivalent to a can of Coke coming off each boob.

Cristen: Which brings us back to Unladylike listener Kelly. When we left off, she’d just decided she wanted to get a breast reduction.

Caroline: Kelly went to her OB-GYN for a consult, and he asked her if her chest was causing her any pain. Kelly said no. She’d just gotten so used to it, that she shrugged it off. So Kelly’s insurance said, well dang lady, that sounds like an elective surgery to us, so we’re not gonna cover it!

Cristen: Kelly though was undaunted. The second time around, she sought out a plastic surgeon instead of her ob-gyn, and went for a breast reduction consult with a plan

Kelly: I just went in there with all of this bravado and just pretended to talk about my boobs like I didn't have all of this emotion and and anxiety and shame built up around them and told him that, you know, I wasn't able to dance because my boobs were too big and that I was in pain all the time, that my neck hurt and my shoulders hurt. And the bra straps were digging into my shoulders. And he, you know, submitted it to the insurance company and. And that was it. It was approved. And the next summer, I had the surgery.

Cristen: Kelly doesn’t remember exactly how much tissue was removed. She does recall, though, that the amount was double what the insurance company required.

Caroline: What was recovery like?

Kelly: It was a breeze. For one thing, I didn't have to go to work. You know, I was a college student on summer break at my parents’ house. I didn't have to cook or clean or I didn't have to do anything. So I just took drugs and watched and read books. It was great.

Caroline: Living the dream.

Kelly: It was great. And I remember when I woke up and I and I lifted up the sheet to look down at my boobs and even with all the bandages, I was like, “Oh my God, they're so small.” I thought they took it all off like that's how visually different it was when I looked down. It was like, I don't have boobs anymore at all when I was a little bit nervous. And then, you know, the Percocet kicked in again and I was fine. But then, you know, I was walking around after the surgery, and I couldn't wear a bra for probably a few months, and I didn't need to. And it was amazing.

Caroline: Well, did it affect at all how men reacted to you?

Kelly: a lot of the male classmates took it personally that I would dare remove any of my boobs. They were like, No, don't remove the. Like, literally would say to me, Why did you remove your boobs like that? Like, they had anything to do with it, like it was anything to do with them.

Caroline: uh Cristen, y’know what that sounds like?

Cristen: Caroline, say it with me:

Both: How dareth a lady reduce dem titties!!

Kelly: Oh, and here's the really fucked up thing. When I did become sexually active, I would then get criticism for the scars from my breast reduction surgery. Like one partner actually said to me, “What is that?” And I explained that to him. And he's like, “Well, I don't think the doctor did it right. You should go back and have him do it again.”

Caroline: Oh my godddd.

Cristen: I hope you told him to eat shit too.

Caroline: THAT fucking guy! I mean, it’s a surgery — you will have scars, but they’re on the underside of the breast, and they will start to fade over time.

Cristen: Also, the size and shape of any scarring just depends on how much tissue is being removed during the reduction.

Caroline: In terms of. Like what you expected, what you hoped, what you feared, even, going into the surgery, how did all of that measure up to reality after the surgery?

Kelly: I was pretty fucking happy. I I could buy clothes, I looked better when I looked in the mirror because I wasn't wearing baggy clothing that just made me look big, which was the worst possible thing a woman could be is fat. And so I just was really, really happy about it. And I would say to other people, “It's the best thing I've ever done.” And I was a little bit worried about being able to breastfeed because I was still thinking that I was gonna go back to the Mormon church and get married in the temple and have six children someday. And that was so that was my only real worry,

Caroline: And it’s a totally valid worry! The chances of a reduction affecting your ability to breastfeed depend on how significant of a reduction you need and the surgical technique used. So surgeons can do one of two things with your nipples during the reconstruction: one, they’ll stay attached and just get repositioned — this makes it more likely that nerves and milk ducts will stay attached, as well. Two, the nipples are removed entirely and placed back on as a skin graft. But this is the less common route.

Cristen: Now if your nipples do stay attached during the reduction, chances are, you’ll be able to breastfeed — but it might be more difficult. For instance, you might have a lower milk supply and need to supplement with formula.

Kelly: like women don't have problems breastfeeding anyway for a hundred thousand reasons that have nothing to do with them. That again, becomes all about our worth as people, whether or not our boobs can provide nourishment to another human being, like, what the fuck? Kelly [00:46:29] And it was years before I even got to the point where it occurred to me that my body could exist for my own benefit and pleasure. And it's still something I struggle with, and so I still might get the reduction. But I don't know. I don't know that I necessarily would. I would definitely not get it for the reasons I got it before.

Cristen: How would you describe your relationship with your breasts today?

Kelly: I don't hate them. After having sex with people who knew what they were doing and who were good at what they were doing and discovering my breasts as an erogenous zone, I definitely feel differently about them in that way. And I enjoy them in that way as well. You know, if I do want to flip into a very sexual place with my wife, I'm I'm down with that. I actually love that. I, I like to flaunt them. I, you know, I like to wear sexy underwear and I like to, you know, serve it and just be like, Yes, I have enormous boobs. What are you going to do to them? And so other than that, I'm probably pretty ambivalent. I'm settling into a place now where I am appreciating my body more for the fact that I am very able bodied and that I can do a lot of the things that I like to do in my body. And so I've sort of come to this place of acceptance about my boobs. I don't think I hate them. I still do have some amount of self-consciousness about the scars and I think that in general, it's like the same way I feel about the rest of my body is that I am trying to just discover the joy in my body being able to to be what it was fucking meant to be, which is my body, my fucking body, my body to move me through time and space, my body to be able to create and to be able to to find joy in movement and in breath. And and I am in in more of a place of acceptance as far as that goes.

Caroline: We’re gonna take a quick break.

Cristen: When we come back, we meet listener S, who inspired the whole episode!

Caroline: Stick around!

[stinger]

Cristen: We’re back, and it’s time to come full circle and talk to listener S.

Caroline: When S originally emailed us, she was dealing with intense pain from her G-cup breasts. She’d just met with a surgeon for a breast reduction consult. And even though there's a 20-year gap between S and Kelly’s breast reduction journeys, their paths to getting there are strikingly similar

S: They were the most interesting thing about me, they were so cool, they were like a superpower. But then also like. As I got older, stop looking at me, I just want to exist, I'm not trying to be a show for you, I'm just trying to get from school to my mom's work.

Cristen: So the novelty wore off, it sounds like.

S: Yeah. You are just peppered by little microaggressions over time, and, I definitely loved them at first. But as the pain grew. And then I started to realize what was causing the pain, they were a constant weight, spiritually, emotionally in every way like. S [00:58:53] They became objects I dis-associated from, I guess, like they were on me. They were part of me, but they weren't like me. You know, I'm the personality and like what I choose to do and not my chest.

Cristen: By sixth grade, S started to get curious: She’d heard of “boob jobs,” but what about … making them smaller? S got to googling, and was horrified at the surgical descriptions she found — she thought surgeons always just took the nipple right off! And like we mentioned earlier, they don’t, they usually just cut around the areola and reposition it.

Caroline: So, S put the idea of surgery out of her head. But as her chest grew from a DDD in 7th grade to a G in 8th, she gave up running because it was too painful. Even lying in bed was uncomfortable. Her boobs would pull and stretch her skin. And if she did wear a bra, no matter how supportive it was, it would dig in.

Cristen: The pain got worsened as she got older. At 19, S started physical therapy for a problem with her shoulder.

S: And I thought it was because I was in college and a left-handed person and so like vigorously writing too much. And I do hunch over like a gremlin when I write with my left hand. But at that first PT, the therapist was like, “Your spine is twisted because one of your feet is longer than the other.” And I’m like “OK, sure.”

Cristen: The physical therapist gave her exercises to do, but it was just a band-aid solution. From there, S made a dizzying array of appointments — with a chiropractor, acupuncturist, more physical therapists — all in an effort to manage the pain she was in. But not one of them mentioned that the pain she was experiencing might be due in part to her breast size. NOT ONE!

Caroline: It got to the point where S’s mom intervened.

S: My mom is in several book clubs, but one of them was with a woman who had gotten a reduction and her daughter had also gotten a reduction from the same surgeon. And my mom was like, “Hey, you're in so much pain. How about we meet him and see how it goes. Like just little meet and greet, no commitment.”

Cristen: S agreed, but before they went, she needed to prove to the insurance company that her chest size was in fact causing physical pain so that they would approve the surgery.

S: I'm filling out the forms and my mom is there with me and I'm like, I don't think I have any restrictions. And she's like, “You actively avoid running and jumping, like that's not something that most like 20-year-olds have to worry about.” It had become my normal.

Caroline: S went to meet with the surgeon, and it was eye-opening.

S: He was like based on your measurements, you qualify like I've I've helped girls who are less endowed than you. So I understand why you would be in pain S [00:40:25].. And I think I just like. Burst into tears. ..I just start bawling. I think because like, you know so many people have told me they're jealous of my boobs. So many people have said that they're so great that they're like. Wow, so cool, like you're so lucky. Like, what a gift to the world. Like, I don’t think anyone said that part. But it felt like I was giving up on them S [00:46:37] and the fact that this doctor is like validating this as like something that like I can get for myself. Screw anyone who is disappointed, I can do this for my body, for me.

Cristen: S went in for the surgery. Three hours later, she was down to a DD and on her way to her parents’ house to recover. Then, something wild happened: S sat up straight!

S: So then I'm home and like waddle over to pee and I'm sitting on the toilet like, Oh, this is. My chest and shoulders, just like chilling, like not having to strain to stay here. because I would like to sit with elbows on my knees, you know, support myself on the toilet for years and not even think about it. And now I'm just like sitting here like, huh. I was doing that.

Cristen: Did you notice any difference after after you were fully recovered in the way that people reacted to you or to them, because I mean, double D's still, you know, so it's still plenty of boob.

S: Mm hmm. I think though like it's it's just fits my body. Like, if they were smaller, it would look.. like my stomach is like a little bigger than them as it is. And like, that's perfect. We're Hispanic, we're a little little curvier, you know? S [00:48:10] Like they they were not sexy. They like they hung very low and like my nipples like pointed at the floor in my 20s and now they don't. And like that's nice, so... It's really hard for me to even think about my everyday experience before the surgery with the weight, like I just like new-chaptered it, like it truly was a weight.S [00:38:01] I can't even wear a bra now because my body, just like instantly like seizes up, stresses out, like ugh, constriction, like I can wear bralettes, but I can't wear like a padded or structured bra, or I’ll go into like PTSD, I guess. Physically. And I just go for walks and hikes anyway. Just free boob.

Caroline: Free boob. Sitting here right now talking to us. How do you feel right now about your decision to get the surgery?

S: No regrets. Very happy I did it. I'm able to not spend so much of my waking energy like trying to accommodate them.S [00:03:39] and I am so grateful I did it. Almost every day, almost every time I think about it, sometimes I wish I'd gone further, like taken em all the way off. But I am just so happy I did it because now they're like truly a part of me again and like. The small little scars left behind are there, because I like went and had this procedure done like for me, you know, so for my like back and neck and shoulder and hip issues. And then also just. I'm whole again.

CREDITS

Caroline: Big thanks to all the Unladylike listeners who wrote in, and especially to Kelly and S for sharing their stories.

Cristen: Y’all can find us at instagram, facebook and Twitter @unladylikemedia. You can also email us at hello@unladylike.co. And you can support Caroline & me directly by joining our Patreon; over there, you’ll get instant access to nearly 100 existing bonus episodes, and a new bonus episode every week, including our recent and maybe highly contentious convo on the feminist politics of veganism. You can find it all over at patreon.com/unladylikemedia.

Caroline: Nora Ritchie is the senior producer of Unladylike. Michele O’Brien is our associate producer. Gianna Palmer is our story editor. Shruti Marathe transcribes our tape. Our music is by Flamingo Shadow, Amit May Cohen and Sarah Tudzin. Mixing is by Jared O’Connell. Sound design and additional music is by Casey Holford and Andi Kristins. Executive producers are Peter Clowney, Daisy Rosario and Unladylike Media.

Cristen: This podcast was created by your hosts, Cristen Conger

Caroline: And Caroline Ervin of Unladylike Media.

Cristen: Next time we’re gonna be butterflies in the sky I can fly twice as high. Take a look. It’s in a book. it’s NOT reading rainbow with Levar Burton. We’re going to be talking with Glory Edim.

Glory Edim: I think my my bookshelf and the things I read are very entwined with my own self-preservation and my own healing and in trying to be like grounded in myself. You ever hear like a really good song and you get like a shiver, you know what I mean? Like the same thing that happens with books like I’ll read a like a really good sentence. And I’m just like, Oh my gosh. Like, it’s like hits something that’s like internal and just, so visceral. Like, I love that feeling, so I seek it out.

Caroline: Glory is the founder of Well-Read Black Girl, a book club and online community that celebrates the uniqueness of Black literature and sisterhood. We are chatting with Glory about the power of reading.

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