More young women feel the power, and relief, after breast reduction surgery

NEW YORK – The women walk into the surgeons’ offices with photos cued up on their mobile phones.

Miley Cyrus. Keira Knightley. Bella Hadid.

“I want my breasts to look like this,” they say. They have already spent hours on YouTube watching plastic surgeons’ infomercials; on Instagram poring over before-and-afters; and on TikTok, where an army of ordinary women post about their breast reductions.

Sometimes, a woman walks into her initial consultation with the bralette she hopes to wear. Or she will say: “I can’t wait for my braless summer.” Or that she looks forward to shopping for a US$15 (S$19) bikini top at Target, something bright or floral, signalling a life so carefree, its wearer might never need fat straps or eye hooks again.

Breast reduction patients use words like “fit” and “strong”. They talk about “yoga boobs”.

Friends tell friends about their breast reductions.

Dr Donald Mowlds, a surgeon in Newport Beach, California, sees a photo on his feed of a group of women at lunch and realises he has operated on all of them.

Dr Kelly Killeen, a surgeon in Beverly Hills, said one of her patients flashed her breasts to a friend at the make-up counter at Neiman Marcus, and the friend walked across the street to make an appointment.

Ms Jamie Hanzo, 26, who lives in New Orleans, uses the same plastic surgeon as her mother.

Ms Tiffany Dena Loftin, who is 35 and a labour organiser in Atlanta, was emboldened to undergo breast reduction after scrutinising the naked breasts of her friend Jamira Burley, 36, over FaceTime: her bandages, her incisions, her bruised nipples.

Ms Loftin does not like hospitals. Needles terrify her. But Ms Burley said: “Tiffany, the relief and joy I’m feeling are also available to you on the other side of your fear.”

After liposuction, breast augmentation is the most popular cosmetic surgery procedure in the US, with about 300,000 women choosing implants each year. But the growth area in cosmetic breast surgery is in making them smaller.

In 2023, more than 76,000 American women had elective breast reduction surgery, a 64 per cent increase since 2019, according to the American Society of Plastic Surgeons. (That number does not include gender-affirming top surgery or breast reconstructions after illness.)

The increase is reflected across all age groups, but especially among women younger than 30, who are enthusiastic consumers of plastic surgery in general, including face- and forehead lifts, procedures favoured mostly by women their mothers’ age.

Girls younger than 19 represent a small but fast-growing part of the market.

“I had big breasts my whole life,” a teenager’s mother will tell Dr Mowlds in his office. “Here’s my daughter. She has questions.”

Reduction surgery deemed “medically necessary” and covered by insurance represent a far smaller group than cosmetic operations, but the broad trend lines – a recent, sudden increase, especially among younger women – are the same, according to an analysis by the Health Care Cost Institute.

Not only do more women want to be small, but they also want to be smaller.

Dr Jerry Chidester, a plastic surgeon in Salt Lake City, said his patients used to ask for C cups. Now, they want Bs. He often does five breast reductions a week, mostly on young, post-partum mothers.

American women are perpetually at odds with their bodies, which reliably fall short of the perfection embodied by models and influencers. Some 70 per cent of women worldwide dislike the size of their breasts. This may be because a woman’s breasts are subject to constant evaluation and critique.

Always on view, breasts allude to a woman’s naked body. They evoke in others thoughts and feelings about her femininity, her sexual availability, her age, her weight, her attractiveness, her maternal role.

Breasts can be objects of fascination, desire and fetishisation, but also revulsion and derision.

Large breasts draw more attention – positive and negative – than smaller ones.

A 2013 market survey by a lingerie-maker put the average American cup size at DD, a factoid that circulates widely online. The majority of breast reduction patients are bigger than that. The weight of large breasts can cause back, neck and shoulder pain. They can impede mobility and fitness.

So, to decide to reduce them, to make them lighter, smaller, easier to carry and cover – more discreet – can be seen as an act of self-love and empowerment; a woman’s prioritisation, finally, of her comfort and independence over what others have traditionally found sexy.

Or it can be interpreted as self-loathing, an agreement with a sexist culture that can also regard larger breasts that are not youthfully round and upright as repulsive: droopy, flabby, jiggly, hard to contain.

Or the choice to undergo breast reduction can be, in some paradoxical way, pragmatic. Perceiving, rightly, that she cannot change the culture she lives in, a woman might find that the easier path to loving her body is to alter herself.

Doctors say their patients seem willing to live with the scars, which encircle the nipple, course down the lower part of the breast like a longitude line, and sometimes trace the ribs under the breast where an underwire might sit.

During their FaceTime sessions, Ms Loftin talked to Ms Burley, who lives in Oakland, California, about what she was sacrificing – being conventionally pleasing to men – and about whether her boyfriend would recoil from the scars or privately resent the dramatic change in her shape.

But Ms Burley just seemed so much brighter, Ms Loftin said, that she was inspired to call a surgeon too.

Ms Loftin is grateful to her partner, who paid for her consultation, and accompanied her to every appointment and through her recovery. If he had conflicting feelings, he kept them to himself.

And many women are undeterred by the possibility that the surgery might impede breastfeeding. According to one research review, women who have had a reduction are more than three times more likely to be unable to breastfeed.

Ms Cheyenne Lin, who is 26 and a substitute teacher in Fresno, California, is married and said she probably wants children some day, but most women in her family have struggled to breastfeed.

“So when they said, ‘You might not be able to breastfeed,’ I was like, that was not even on my list of concerns,” Ms Lin said. She had her reduction surgery in July.

Ideas about breast perfection infuse the worlds of young girls. Teenagers with large breasts frequently struggle with low self-esteem and eating disorders.

Young women learn to cover themselves up under extra-large hoodies and T-shirts. They compress with double jog bras, and stop figure skating, dancing and running track. They hear the negative words directed at their bodies – droopy, deflated, “stretched the hell out” – and turn these descriptions on themselves.

Before her reduction, Ms Lin’s breasts were “kind of pancake-like, kind of flat and saggy”, she said. She began to hate them so much that she averted her eyes when she towelled off after the shower.

Ms Loftin believes her breast reduction is a signal of her confidence and autonomy. To spend her own money to live in a body that works better for her is power, no matter what the older women in her life tell her about how beautiful and perfect she was before.

Women in her friend groups “don’t need the expectations of Western beauty or male beauty to live up to. This is my body. I’m not doing this for men”, she said.

For a woman to withdraw from the male gaze, to assert herself in her refusal to be ogled, to relieve her own pain, to be able to comfortably train for a marathon or dance at her birthday party – that is liberation.

But it is a personal, individual one, said Ms Sarah Thornton, 59, a sociologist who had “bulky and cartoony” D cups after breast reconstruction due to a double mastectomy. Eventually, she had another surgery to reduce the size of her implants.

“If women are going to have an emancipated rack,” she said, “then men need to change.” NYTIMES