How Breast Reduction Surgery Helped Me Become Myself

Like many adolescents anticipating or dealing with the fallout of puberty, my sisters and I had a healthy obsession with breasts. The three of us were four years apart, and we were all in different places on the breast-development spectrum: with none, with some, with a ton. Each of our breasts got nicknames. Mine, humiliatingly, were “Betty” and “I’m Ready To Grow” — names provided, of course, by my sisters. As the youngest, I didn’t get the honor of naming my own. I would sometimes wear a bra over my flat chest and wonder what it would be like to have breasts. My breasts finally came in — and then never seemed to stop growing. By seventh grade, I was already a C cup. Accustomed to being ignored by boys, I was now chosen as someone’s square-dancing partner (I grew up in the country) simply because I had big boobs. It was too much too soon. My sisters ended up renaming them “Lou” and “I Grew.” Bigger breasts hadn’t freed me from embarrassment at all; they only magnified and localised it. Men, I discovered, were inappropriately free with their opinions and stares. The obviousness of my breasts seemed to grant permission for people to make both good and bad comments. Always the avid diarist, at the age of 19 I distilled the feelings I’d been having since 6th grade: "I’m tired of people discussing my breasts, in public, as if they are common property." This sentence has been burned into my memory.

Clothes didn’t fit right, or they fit too right, and it felt pornographic to simply wear a top in my size. In junior high, when I wore a T-shirt with bold lettering across the front that my sister bought for me at a New York Flea market (so cool!), a guy in band class laughed and said I was obviously trying to make guys look at my chest. I felt humiliated, and I internalised that feeling. Puberty was tough on me in a lot of ways. I grew up with horrifically crooked teeth and huge breasts, so I quickly learned to smile with my mouth closed and drown my figure in oversized shirts. I’d wear Far Side T-shirts in a size XL and my sister’s hand-me-down bras. Even when I got braces, there seemed to be no distracting from my chest. I was not only striving to fit in; I wanted to be less visible entirely. In my journal, I detailed the pain and embarrassment I felt at the time: "I can’t run, I get embarrassed by physical activity. I can’t wear normal shirts often, or I look outrageous in them...or the comments women make. One of my mom’s friends saw my bras and said she wished her bras were that big. NO SHE DOESN’T." When I was 17, my braces came off and I got my first boyfriend (in that order). I joined swim team that year and was forced to wear a bathing suit that displayed my body more accurately than my camouflaging T-shirts. Around this time, I started feeling childish for wearing oversized clothing, so I reluctantly transitioned to clothes that actually fit. Having sex was new and often uncomfortable. My teenaged boyfriend asked me several times if large breasts (like the ones he saw in porn, presumably) were ever naturally perky, or if they were all like mine: over-large and under-inflated. I recall my mother taking me and my friends shopping for winter formal dresses, and I especially remember the drive back. All of my friends' new dresses were piled in the trunk, while I silently cried in the backseat because every dress I had tried on hadn’t fit.

By the time I was 18, I had a DDD cup. This is not even that large in comparison with what some women have to carry around, but it was painful, and I was constantly uneasy about my body. I couldn’t explain it, but I felt like I wasn’t meant to be born with large breasts. I didn’t like to stand up straight, and I felt ashamed when I caught someone staring. I didn’t want to go through life hating something so prominent on my body. I daydreamed about things being different — about having the kind of breasts that I felt fit my body, and that I would feel comfortable with. At this time, the list of things I hated about my breasts was longer than ever. "I hate the way they feel on my upper belly when they don’t have a bra on...I hate sweating there. I hate having dents in my shoulders from bras, and irritation on my skin, and I hate feeling so constricted by my bras...I hate the way my breasts are saggy and point downwards. The weight causes me to slouch, making me look and feel unattractive. I hate the way my breasts look. I hate having so much cleavage, too much. I hate not being able to wear a button-up shirt, or a matching set of bra and underwear, or a bikini and lots of things. I don’t like having huge, ugly nipples. They seem like the same colour as my too-large breasts. I hate how, when I lie on my back, my breasts spread out, like my nipples are parallel to my shoulders. I hate that when I lie on my side, one boob falls on the other. Or when I’m lying on my stomach...oh my god, I’m a few inches up, and my breasts come out by my arm." I then wrote, ruefully, "You know, in the '60s, I couldn’t have burned my bra." I knew breast reduction existed, but I didn’t know anyone who’d been through it, and there certainly wasn’t a surgeon who performed the surgery in our small town, which had a population of 3,000. Thankfully, I was deep into Live Journal at the time, and I discovered forums where women talked openly and, most revealingly, gratefully about their breast reduction surgeries. Finding stories of regret after the operation was rare — women mostly talked about the length and difficulty of recovery. They spoke of the lightness they felt, the pleasure they took in wearing clothing, the enviable ability to wear a regular sports bra instead of a sports bra over an underwire bra (my improvisation). One sentiment kept coming up over and over again: These women all wished they had done it years earlier. I was just 19 at the time. I worked up the nerve to visit my primary care physician, the same doctor’s office where I’d gone for vaccines, ear infections, and physicals, the same place where I’d pray my mother wouldn’t see my chart and discover I was on birth control. I worked up the nerve to ask my doctor if he knew anything about breast reduction, my cheeks flaming with embarrassment. He gave me a referral to the only surgeon in the next town over who took my insurance. During my first consultation, I talked timidly with the doctor, reading out the questions I’d scrawled in nervous handwriting. I asked about references, expected results, and what type of procedure he expected to use. He listened, not patiently, but vacantly, and assured me that everything would be fine. As I was putting my shirt back on, he patted my stomach and said, "Then we’ll just have to take care of this, and you’ll be perfect." I was shocked, totally unprepared for such insulting up-selling at the doctor’s office. I felt humiliated and embarrassed, like it was my fault that my stomach wasn’t totally flat. If I’d been older and more confident, I would have gone for a second opinion, or travelled to a larger city to get the surgery. Instead, I let my enthusiasm outweigh my misgivings about the doctor.

We decided that a C cup would be perfect on my body, so I let him file an insurance claim on my behalf and waited. I was told I was a good candidate, but that ultimately it was up to the insurance company. One night while waiting to hear back, I had a dream that the insurance company called me on the phone to let me know that the claim was denied, and I woke up sobbing into my hand. My insurance required that a certain amount of tissue be removed from each breast to deem it medically necessary. In my case, it was one pound from each breast. I lodged the typical complaints of back and shoulder pain, the main reason that breast reduction is covered by insurance. But truthfully, the number one reason I wanted it done was because of the psychological discomfort I felt. Back and shoulder pain is terrible, and a limited pool of available clothing is frustrating, but feeling uncomfortable in my own body was the most damaging thing for me. I wrote in my journal: "I’m tired of my breasts stopping me from doing the kinds of things I want to do. I’m tired of my breasts being more of an issue than my whole body." When I got news that my claim was approved, I was overjoyed. I bought post-recovery bras and a high back rest pillow. I took pictures of my old breasts so I would remember the way they looked, not just the way they felt and how uncomfortable I was carrying them around with me. My diary during this time was tumultuous and raw. Even though I made the decision that I wanted the surgery, I still struggled with concerns. I worried whether guys would like me even without large breasts — of course, before that, I was concerned if guys only liked me for my large breasts. I wrote: "I even wonder if I’m a wuss for getting rid of them so early." I kept having fitful dreams, including one where I’d already had the surgery, and one breast was healing well, but the other was swollen, purple and misshapen, with a piece of metal jutting out of it. When the day of the surgery arrived, we drove to the medical centre while it was still dark out. I don’t remember much of checking in or waiting to be called back by the nurses. All I remember is lying on a bed draped in a hospital gown, already hooked up to machines. The doctor sat me up and marked on my naked breasts where the cutting would take place, just as he had during my consultation months ago. He was only drawing on my skin with marker, but I felt myself go dizzy as I looked down. I told the doctor and he laid me back on the bed. When he lifted me up and it happened again, he was annoyed and told me we had to hurry. Once marked, I was left again to wait. The nurses came to collect me, wheeling me into the operating table where several people were bustling around. I remember it was around the holidays, and there was Christmas music playing over the radio. The nurse came over and secured my arms in slats, then the anesthesiologist placed a mask over my face and told me to count back from 10. I don’t think I made it past seven.

When I woke up, the very first thing I noticed was how light my chest felt. Through all the anaesthesia and stitches, I could still feel that. My recovery bra was on, and I could feel the drain tubes snaking out of my sides. My surgery was performed as an outpatient procedure, and the only thing I remember from the ride home was my mother buying me a smoothie and me struggling to keep a grip on it while we drove around our winding country roads. The next few days were a blur. There is a picture of me from this time with a wet rag over my forehead, my hoodie zipped open, exposing my surgical bra and the blood drains resting against my sides. I look pathetic, like a victim of a real sickness. It was during this time that I became overwhelmed, weeping for seemingly no reason. I’d watch TV in a daze, my body present but my mind sluggish and exhausted. I shuffled around the house. My mother gave me a whistle, which I would use in the middle of the night when I needed to go to the bathroom. You don’t realise how many muscles run through your chest until you need to raise yourself from a reclining position on a bed to a sitting position on a toilet. When I got my nerve up to peek inside my surgical bra, everything looked like a mess. My stitches were harsh and black and followed the slope of my new breasts. I’d had a typical keyhole procedure, where doctors remove part of the bottom of your breast. This creates an incision against where the lower breast meets the ribcage, as well as a scar going up to your areola, which has been cut, shaved down, and sewn around the edges to mimic a natural border. My blood drains trailed me everywhere like creepy red tentacles, demanding drainage every few hours. Breast reduction surgery requires that nerve endings and milk ducts are cut and put together again. In recovery, I could feel every time a nerve ending connected with its new neighbour. It felt like a jolt of electricity, a lightning-fast pinprick going through my flesh. My doctor advised me to gently rub the area that was in pain, which I would do surreptitiously whenever it struck. I went for my first check up on the fifth day. The doctor removed my blood tubes, pulling them easily out of the side of my rib cages as you might yank on a stray thread from a sweater. If I live 100 more years, I will never forget the eerie whistling noise they made as they slid out of me. Recovery came slowly, even though I was so young. I wasn’t supposed to raise my hands above my shoulders for weeks, and I was advised to lie on my back and not sleep on my side (and certainly not my chest). I was frequently tired. A friend from school came to visit me, but I was mostly isolated, focused on recovering and, as it turned out, watching reruns of Buffy the Vampire Slayer.

My only Christmas request that year was for a gift certificate to Victoria’s Secret. I got to live out my fantasy of shopping all the styles, not just the ones that ran large and had wide straps. I left the store with brightly coloured underwire bras that I was still too tender to wear — but thankfully, they were the right size. I experienced my first bout of true breast adoration at this time, waxing rhapsodic and overlooking the bad stuff, like you do when you’re in love: “My boobs are doing well. I’m in love with them. They’re so small and pert. They still hurt, especially in the morning, and there’s this one spot that just won’t heal and the band-aids always smell, but I love ‘em!” A few months into my recovery, when I was able to use my arms again and walk a little straighter, I went in for what I thought was a final check up. The doctor examined my scars and showed me how to press on them until they turned white, stimulating blood flow and reducing scar visibility. I looked away for a moment during the tutorial and he snapped for my attention. He dragged a pen along my breasts and I discovered with shock that there were places on my breast that I couldn’t feel, places on my body that I had no connection to. Then he pointed out that there was some excess skin and puckering on the scar leading from my breastbone to my areolas, and that he wanted to remove it. He made it sound like a quick procedure; I wouldn’t even be put under. I brought my CD player in case I got bored during the appointment.

The local anaesthesia was applied with needles, of course. Needles directly into my breasts, in my scars, in my nipples. It hurt terribly, and my anxiety ramped right up. Though I was soon numb, I still had the sensation of pressure on my breasts. The doctor hung a sheet between my vision and the surgical site, but I could still feel things. I could feel pulling, cutting, the sensation of thread going through my breast tissue and out again. It didn’t hurt exactly, but it felt traumatising. When he was done, he left the room and left me to put my shirt back on alone and find my way to the waiting room. I made it that far before bursting into tears, the only words I was able to get out were, “It hurt so bad.” Because of the timing of my secondary procedure, I had to go off to college while still stitched up. Once I arrived, I almost immediately headed to the school nurse to see if she could remove my stitches. I awkwardly explained my request, and she laid me on a cold reclining chair as if she wasn’t the least bit fazed. She was calm and efficient, neatly removing every last stitch, and though it didn’t hurt much, I found myself weeping while she pulled them out. It was difficult to explain everything I’d been through to get to that place, in that unfamiliar room, asking an absolute stranger to share the end of my recovery. When I left her office, I left with the breasts that I still have today, the ones I’d daydreamed about for as long as I’d had breasts. Before I’d left for college, I wrote about my expectations for the coming year: “19 was the year that I was lost, trying to find my way and myself. I started these changes, in my 20s I’m going to see the results. I’m going to become myself.” I have never once regretted having the surgery, though of course there have been complicating issues. During my initial consultation, the doctor said there was only a 50% chance I could ever breastfeed, and even if I was physically able to, I’d likely develop painful cysts and it wasn’t advised. At 19, the possible concept of breastfeeding held little concern for me. I wasn’t sure I even wanted kids, so the idea that I’d delay something I desperately wanted for the chance to breastfeed some theoretical child seemed silly.

Now that I am in my early 30s, in a stable relationship, and closer to the possibility of children than I’ve ever been before, it’s no longer an abstraction for me. I’ve had to reconcile my guilt about the fact that I will likely not be able to breastfeed should I ever have kids. I feel conflicted, but I do know that if I could go back, I’d make the same decision all over again. I’ve had my breasts for 13 years, and I feel like they’re fully a part of my body. They are my breasts. They’ve settled down, gaining and losing weight as I did (though always proportional to my body). I actually have more sensation in my breasts now than I did before the surgery, probably because the nerve endings aren’t stretched out across as great of an area. It’s been years since I’ve felt my nerves reconnect. There was a long period of time where I felt very uncomfortable with the scars. I would wonder if I had to warn a new partner about what they’d find when I was naked in front of them for the first time. I generously applied Vitamin E and sunscreen. I tried on one of those stringy American Apparel bathing suits and vetoed it because of the way my scars extended out on all sides. It felt too exposed and ugly. But my comfort with my scars has increased, and they too have become a part of my body. Recently, a friend who’s had top surgery recommended a good scar gel, knowing we shared similar scar patterns. I bought some and instead applied it to a stretch mark on my stomach that had been developing over the past few months. I’m honestly not sure if I want the scars on my breasts to ever disappear entirely. It feels like lasting evidence that, long ago, I listened to my gut and gave myself the body I always wanted. It feels like me.