Contemplating Breast Surgery

If you have large breasts, you are all too familiar with the frustrations that may come with having
big breasts. You know what it feels like to have people "talking to your chest." Perhaps you avoid
days at the beach or pool because you feel self-conscious of your large breasts. Have you ever
turned down offers from friends to shop for clothes due to the embarrassment you feel when shirts and
dresses don’t fit across your chest?

If you answered "yes" to any of these questions, you’re not alone.
Many women feel restricted by their bodies and actually avoid certain
activities that others enjoy because of this discomfort. They don’t
remember the last time they felt carefree at the beach. They don’t even
try on sexy lingerie anymore because they know it won’t fit quite
right. All of this because they are not comfortable with their own
breasts.

What might life be like without large, heavy breasts? Maybe you’d
notice people paying attention to you and not just your chest. Maybe
you’d exercise at the gym without pain. Maybe you’d stand taller
because you wouldn’t feel self-conscious about your breasts. There’s a
good chance that you’d notice a difference in the way you feel, the
way you move, and how you carry yourself.

How Breasts Develop

How Breasts Develop | Latham and New York, NYThink back to your adolescent years for a moment, back to when
it all began. Some girls developed breasts early and some were late
bloomers. Either way, it seemed that very few were pleased with the
rate of their development. Some girls, embarrassed, changed for gym
class in bathrooms down the hall instead of the locker rooms to hide
the fact that their breasts were more fully developed than many
of the other girls’. Other girls, equally ashamed, tried to hide their
underdeveloped breasts and wondered when on earth they would ever
catch up to the others.

These girls were simply caught in various stages of breast development.
Breast growth is one of the earliest indications that puberty has
begun. The process begins with the secretion of hormones from the
pituitary gland at the base of the brain. This gland controls bodily
functions such as growth and ovary production. As a result, more
estrogen is produced and breast development begins. It’s common for
breasts to begin to grow sometime between the ages of eight and
twelve. Whenever the onset of breast development, it’s likely that
breasts will continue to grow for approximately four years after girls
begin menstruating.

Breasts develop in five separate stages. The first stage is actually
the flat chest that children have before development begins. Stage two
begins when children begin to bud, meaning that their breasts form
small peaks as nipples swell and tenderness sets in. The third stage of
breast development starts when adolescents begin to build fat in their
breast tissue. Breasts grow more rapidly in this stage than in any
other. Often, it’s during this time that girls begin to menstruate. After
this point, breast size does not usually increase much; instead, during
stage four, the shape of the breasts changes as the nipples begin to protrude. Only during the teenage years will nipples point straight
ahead and not sag at all. Stage five is full maturation, and breast
development is complete. This entire process should conclude around
age seventeen or eighteen. Permanent breast size should be evident at
this point.

Why Some Woman Have Large Breasts
All of us have the same basic breast anatomy, so why does breast
size vary so much from woman to woman? The answer is deceptively
simple—fat! It’s true, we all do have roughly the same amount of
breast ducts and lobules, which allow lactation to occur, but we do have
different amounts of fat deposited within our breasts.

Awoman suffering with
large breasts needs to know
that she has options. With
new techniques in breast
reduction with minimal
scars we can offer relief
of the physical discomfort
associated with large
breasts and dramatically
improve self-image.
— Alain Polynice, M.D

Genetics
Breast size is generally determined by genetics. In fact, breast size
has much more to do with your genes than it does with your
hormones or diet. This fact can be confusing, though, if your breast
size greatly differs from that of your mother’s or your sister’s.
Understanding genes is sometimes tricky because they’re complex.
Your genes are derived not only from your mother’s, but also from
your father’s side of the family. You may have a breast size similar to
many of your close female relatives, or you may take after your great
Aunt Betty.

Estrogen
Estrogen is a hormone which surges during puberty, ages 11-15,
and during pregnancy. Any increase in estrogen levels causes breasts
to enlarge. Although breasts do become enlarged during pregnancy
because of the increase in estrogen, they often shrink and sag after childbirth or after breastfeeding ceases. Usually breasts will regain
some of their previous fullness a few months afterwards.
The use of oral contraceptives or post-menopause estrogen replacement
pills may enhance breast size due to their estrogen content.

Weight Gain
Gaining weight will typically cause the breasts to become bigger.
However, breasts usually return to their previous size once weight
is lost.

Evolution of Cosmetic Breast Surgery
It’s believed that the first breast reduction surgery was performed by
an English doctor, William Durston, in 1669. Since then, a variety
of innovative and skilled surgeons have perfected breast reduction
techniques that maximize results and minimize risks.

What is Breast Reduction Surgery?
Breast reduction surgery, also referred to as a reduction mammoplasty,
is a surgical procedure which involves reducing the size, weight, and
mass of the breasts. This is accomplished by excising fat, skin, and
glandular tissue. The skin is then pulled together and sutured. As a
result of this surgery, the breasts are smaller and more shapely.
Although the intent of breast reduction surgery is to decrease the
size and weight of the breasts, the procedure also lifts the breasts to
correct drooping. This procedure is most commonly performed on
women who have large, pendulous breasts, which may be causing
both physical problems as well as social embarrassment.

The number of women seeking breast reduction has remained steady over the past few years. According to the American Society
of Plastic Surgeons (ASPS) more than 100,000 women have breast
reduction surgery annually.

Reasons for Breast Reduction Surgery

Physical Reasons
Most people seem to think of large breasts as a symbol of beauty
and attractiveness. However, many women with large breasts consider
them more of a curse than a blessing. They complain of a variety of
physical ailments, including neck, back, and shoulder pain, bra strap
grooving, skeletal deformities, rashes underneath their breasts, trouble
breathing, difficulty exercising, and poor posture.

Emotional Reasons
Physical symptoms are not the extent of a woman’s plight if she is
burdened with large breasts. Often, these women also experience
a range of significant emotional issues from self-consciousness to
self-esteem problems because their breasts have been the topic of teasing
and objectification since puberty. Because these women view their
chests as unattractive or the source of too much attention, they work
hard not to reveal this area to anyone else, especially those whose
opinions they value most. This means that they often don’t feel
comfortable changing their clothes in front of others, which may
cause them to avoid sports activities or fitness centers or even sex
sometimes. Are you one of these women?

Are You a Candidate for Breast Reduction?
If any of this sounds familiar and you are in good health overall,
you may be a candidate for breast reduction surgery. Breast reduction surgery has helped thousands of women—from teenagers to ladies in
their eighties—feel more comfortable physically and emotionally. To
be a breast surgery candidate, you need to be in good general health.
If you do have a medical diagnosis, such as diabetes, you may still be
able to have your procedure performed, but you’ll need to follow your
surgeon’s recommendations.

My advice to women
considering breast surgery.
Do the research. Find a
good surgeon. Do it. I have
no regrets. This surgery
changed my life. I have
confidence again.
— Liz, 32

Most plastic surgeons recommend that women wait until they are
at least eighteen to twenty years old before they consider undergoing
breast surgery of any kind to make sure that their breast development
is complete. The exception to this rule is teenagers who suffer from
virginal breast hypertrophy—the condition of having developed large
breasts at a very early age, usually during grade school. When this
condition is present, many surgeons will feel comfortable performing
a breast reduction to increase the adolescent’s quality of life and
decrease any related physical symptoms.

When Breast Reduction Surgery Might Not Be for You
If you are currently pregnant or breastfeeding, you are not a breast
surgery candidate right now, in part because of the adverse effects
anesthesia could have on your unborn baby. In fact, it’s a good idea
to delay breast surgery until after your last child breastfeeds because
the results of your surgery could be reversed with another pregnancy
or period of breastfeeding.

If You Are Overweight
You may not be a candidate for breast surgery if you are obese or
overweight. Many surgeons will not perform breast surgery until
patients have reached a stable weight because surgery results will not be optimal; further, the results would be lost after a dramatic weight
loss—sagging would occur.
Also, your insurance company may refuse to pay for your surgery
if it learns you have not tried to lose weight first. A good starting point
may be a weight loss program consisting of a nutrition plan and
exercise regimen that your doctor recommends. This way, you’ll know
for sure if you actually require a breast reduction or if you just needed
to loose a few pounds to feel good about your body again.

If You Smoke
If you are a smoker, you are not an ideal candidate for any type of
surgery. Nicotine restricts blood flow in smaller blood vessels and as
a result the blood cannot move oxygen efficiently to help the body
heal from surgery. At the very least, a plastic surgeon will recommend
you to stop smoking for several weeks before and after the procedure.
Excessive alcohol consumption, marijuana smoking and steroid use
will also increase your risk of complications during and after surgery.

If You Have Major Health Concerns
Generally speaking, it’s not safe to undergo any kind of surgery if
you have any major medical condition, but often it can be controlled
enough to make breast surgery possible for you. Your surgeon can
usually refer you back to your general practitioner who can often
create a plan to prepare you for surgery. You may need to closely
follow your doctor’s instructions for a designated period of time,
though, before he or she will consider surgery safe for you. Once your
doctor is confident in your ability to safely have surgery, you will be
released for your breast procedure.

If You Develop Keloid Scars
Some individuals are prone to develop keloid scars—fleshy masses
of scars. Unfortunately, this condition is very difficult to treat and
those who are aware of their vulnerability to keloids should seriously
reconsider undergoing breast surgery. Most people who are at risk for
this condition already know it because they probably have developed
keloids at some earlier point in their lives.

Making the Decision
Surgery is serious—it poses risks, discomfort, and a significant
recovery period. Breast surgery is not something to take lightly or
commit to impulsively.
Despite the inconvenience, many women who have undergone
breast reduction surgery report that they would do it all again. They
say they have a whole new lease on life once they recover from their
procedures, finding themselves able to exercise in ways they never
could before and being more active than ever. They continually
discover new physical activities they enjoy and often meet new friends
in the process. These women also report that their personal lives
dramatically improve with their newfound confidence. They state
that their lives are much more fulfilling.

Previous: Table of Contents
Next: Chapter 2. Choosing a Plastic Surgeon

*Patient Results May Vary
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