BY AARDE WRITES for WEEKLY VOLCANO 12/5/25 |
Hey Aarde,
I have always been big-chested and, in my younger years, was grateful for it. But as I have aged I have begun to hate it. My back hurts all the time, and my bra straps are digging in. I have been considering a breast reduction but am a bit scared. What are your thoughts on this topic?
Sincerely
Chest Quest
Hey Chest Quest,
You have come to the right place. Not only do I personally know a few women who have had this surgery, but I have also had the surgery myself. Granted, it was way back in 2001, and it was performed at a military hospital, but that does not mean I do not have a valid opinion.
First, let us tackle the definitions of elective versus medically necessary. While it is reasonable to conclude that a generous bust nearly always brings discomfort, most insurance companies require proof that one is currently in pain and that the procedure is prescribed for health reasons. The most common associated pains include back pain, shoulder pain, skin irritation, posture issues, and nerve pain or numbness.
On the other hand, the elective route is based on the consideration of enhancement. The goal is to improve or upgrade one’s body image, quality of life, physical function in sports or other activities, or to achieve better balance when weight is disproportionately distributed. I remember having a tough time in middle school holding a baseball bat properly, which impeded my otherwise championship-level participation (kidding). Other women often find that one breast develops more rapidly, and they elect for the surgery to maintain a more symmetric appearance. A common elective complaint is not being able to find shirts that fit the length of one’s arms, the spread of one’s back, and the volume of one’s chest. Another grievance is the grooves that develop from those over-the-shoulder boulder holders (please go to Google and type in “Bette Midler, Otto Titsling” and thank me later). And let us not forget the experience of receiving unwanted attention from the male gaze.
Before continuing, I must add a caveat, the purpose of the following is directed toward female-identifying individuals. Here are some considerations:
- If you plan to have children, there is a chance that your milk ducts and nerves will not be preserved, which could inhibit you from breastfeeding.
- If body image is your primary concern, know that you may carry some visible scars.
- Are your expectations realistic? “Perfectly perky” is a common expectation and can be obtainable, but gravity is always going to be the winner eventually.
- Are you comfortable accepting scarring? Scars can bring insecurities that could affect the joy of uninhibited intimacy or require more trust and care within an intimate relationship.
- Have you tried non-surgical options first, such as physical therapy, posture correction, supportive bras, or weight loss? Be sure to seek a size-inclusive surgeon if the last point was triggering.
- If you have excess weight you have considered losing, you might find that a lot of your breast tissue changes when you do lose it, which could alter the overall shape and gravity of your breasts post-surgery.
- Are you emotionally prepared for the way shifts in our appearance can reshape how we, as women, move through the world and how the world responds to us? It can be a disorienting journey and affect your emotional state more than you might anticipate.
- Do you have a strong support system and the ability to take the time off that you will need to heal? This is a major surgery, and recovery can be challenging, especially if you have children or pets who rely on your physical presence.
Most women are thrilled with the results and say that they would choose the surgery again and again. They report an improvement in their quality of life, saying that not only do they get instant relief from their chronic back, shoulder, and neck pain, but they can also exercise more comfortably, their clothing fits better, their self-esteem is enhanced, and even their anxiety is lessened. Scars fade, and sensitivity issues usually stabilize after a year or so, and if you have the gumption to go through with it all, you will find yourself left with a new set of twins, and some women feel a surge in secure sexuality with their new bodies.
I suggest scheduling a consultation with a surgeon. Here are a few questions to help you find the right doctor: - Are you board-certified in plastic surgery?
- How long have you been performing breast reductions?
- Do you specialize in reconstructive procedures? Which surgical technique do you recommend for me, and why?
- How do you handle the most common complications?
- What is your revision reoperation rate?
- Can I see similar before-and-after photos of your patients?
- Can I read verified testimonials?
- Can you direct me to the facility’s accreditations and infection rates?
Then schedule another consultation with a different surgeon. Find the one who answers in a way that leaves you feeling comfortable, safe, and heard. Focus on their qualifications, experience, surgical approach, outcomes, and aftercare to really dial in who you trust with your body. You deserve that. Whatever you choose, know that you are beautiful the way you are, but if you are not comfortable and your experience is leaving you feeling unfulfilled, your decision is supported. Do not be afraid to ask questions and to take your time making this big decision. You know your body best. Listen to it.
Do you have a question for Ask Aarde? Email it to jdaarde@gmail.com
