Monday, August 18, 2003

Downsizing on the upswing

From Hollywood to our hometown, breast-reduction surgeries prove bigger isn't always better

By Gina Daugherty
The Cincinnati Enquirer

A woman walked up to Denise Biely at her recent 30-year class reunion and told her how much she had envied her in high school. She said she had long coveted Biely's breast size, a double-D.

Biely, of West Union, told her she would give anything not to have them. Though she wore a size double-D bra, her breasts were actually larger. It's just that she couldn't see spending $50 for a size F cup.

In the 1970s when women were burning their bras and going without them, there was no way Biely could have done that. Over the years, her bra straps left deep grooves in her shoulders. Eventually, they led to chronic back and neck pain, for which she underwent five surgeries.

"You know the pencil test, where if you can hold a pencil under your breast you a need a lift? I could hold a telephone under my breasts," Biely says.

Finally, the surgery she had to alleviate her back pain wasn't on her back, it was on her breasts. Dr. Robert Hummel, a plastic surgeon with the Plastic Surgery Group on Red Bank Road, removed five pounds of Beily's breast tissue. When she woke up, Biely says, immediately she felt 70 percent better. "It was like a miracle."

Breasts have been the gold standard of femininity in this country at least since Jane Russell's girdled silhouette became a pop culture icon in the 1940s. Since then, Americans have had a mostly bigger-is-better attitude.

You can't see advertising, television, videos, music or magazines without being overexposed to breasts - a little cleavage here or reverse cleavage there. Within the last 12 years, the average bra size has increased from 34B to 36C, according to NPD, a market research firm that collects data for bra manufacturers. Some of that can be attributed to an increase in implant surgery. Other explanations include the hormonal effects of birth control pills and a biggie-size diet.

Stars downsize, too

In April, Queen Latifah underwent breast reduction surgery, downsizing from a size E to a double D.

Actress Drew Barrymore, 28, went under the knife at the age of 16 to give her figure a sleeker silhouette. Even Pamela Anderson, the quintessential rock 'n' roll groupie, downsized her considerable implant assets. Both women said they wanted to look "more natural."

And many members of Hollywood's "A" list of actresses are smaller than breast-implant counterparts. Actresses such as Cameron Diaz, Reese Witherspoon and Gwyneth Paltrow have remained decidedly "natural."

"Both groups of women, those who want larger breasts and those who want small breasts, really want the same thing," says Hummel, who performs about 35 breast reduction surgeries per year. "They want a more attractive breast shape and they want the volume to be proportional to their bodies.

"Those who want an augmentation feel their breasts are too small and it makes fitting into clothes and bathing suits difficult. The same with people who want a reduction. They say if they had a C-cup breast, they would feel better physically and psychologically. They are pretty much looking for the same thing - you are seeing women at both ends of the spectrum."

According to the American Society for Aesthetic Plastic Surgery, breast implants are the second most common plastic surgery procedure, with 249,641 performed in 2002 in the United States. Liposuction is the most common plastic surgery procedure. But since 1997, breast reduction surgeries are up 162 percent, the largest increase of the top five surgical procedures. With 125,614 performed in 2002, breast reductions were the fifth most common plastic surgery procedure.

Lisa Coors of Mount Lookout, a dedicated runner and spinner, likes to exercise and be active. Because she wears a size B cup, she can pick out cotton bras, sports bras and built-in bra tops without having to worry about having enough support. And she prefers it that way.

Some of her friends, though, are not so lucky. A running partner of Coors' has to wear two sports bras when she works out to keep her breasts from bouncing and making her feel uncomfortable.

"She has to wear them so tight, she can't even breathe," Coors says. "I can't even imagine. It's nice because I don't even have to wear a shirt over my sports bra. Personally, at least breast-wise, that's the one thing I am happy about with my body. Women say they need big breasts, but I wouldn't want them."

Coors appreciates that men don't stare at her chest. "They have to look you in the eye, because there's nothing else to see," she says.

Horror stories shared

Biely wishes she could have been so lucky. She remembers walking home from junior high school holding her books in front her chest so the boys wouldn't notice she had breasts and wore a bra. By the seventh grade, Biely wore a C-cup. She remembers being stared at a lot. She and another large-breasted girl would share horror stories about how the boys made them feel dirty and embarrassed, and they would wish their breasts would go away.

When she would play darts, as funny as it sounds to her now, she was limited because of her breast size - they inhibited her from throwing well. And when she applied eye makeup, rather than cross her right arm over to apply the left side, she would have to switch hands. Otherwise, her breasts got in the way.

Hummel said the top reason women see him for breast reduction surgery is pain. They have pain or discomfort in their back, neck and shoulders. Even their rib cages take a lot of strain.

Though breast reduction surgery comes with its own pain - usually lasting about two to 10 days - and scarring, the procedure has an excellent patient satisfaction rate. Biely was so pleased, she wrote a song to Hummel, calling him her B-cup hero to the tune of "Bye-Bye Birdie."

Among the lyrics: "Still I'm proud of my perky B's/Gone forever are the double D's. When the fluid and swelling's down, I may show the whole darn town," Biely wrote.

About the surgery

Breast reduction surgery takes about three hours and can be done as an inpatient or outpatient procedure.

In the long term, there is no way to do a significant reduction without leaving a scar, says Dr. Robert Hummel, a plastic surgeon with the Plastic Surgery Group on Red Bank Road.

During the procedure, extra breast tissue is removed and the nipple is repositioned. Scarring will be around the nipple, down the crease of the breast (although it does not usually show) and there will be a vertical scar from the nipple to the crease under the breast.

"Most patients are happy to accept the scars if they can enjoy the benefits of a smaller breast size," Hummel said. "And the scars fade with time."

Breast reduction surgery is often covered by health insurance. Each insurance company requires that a certain amount of breast tissue be removed in order for the procedure to be covered. The average total cost is about $6,000, depending on where you have the procedure done.

Top 5 cosmetic procedures

Liposuction, 372,831 in 2002

Breast augmentation, 249,641 in 2002

Eyelid surgery, 229,092 in 2002

Rhinoplasty, 156,973 in 2002

Breast reduction, 125,614 in 2002

Source: The American Society for Aesthetic Plastic Surgery



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