{"id":1335,"date":"2024-09-22T11:26:12","date_gmt":"2024-09-22T03:26:12","guid":{"rendered":"https:\/\/www.kafeizha.com\/?p=1335"},"modified":"2024-09-22T11:26:12","modified_gmt":"2024-09-22T03:26:12","slug":"%e5%b0%8f%e8%83%b8%e8%86%9b%e7%9a%84%e5%8a%9b%e9%87%8f","status":"publish","type":"post","link":"https:\/\/news.tomjun.com\/?p=1335","title":{"rendered":"\u5c0f\u80f8\u819b\u7684\u529b\u91cf"},"content":{"rendered":"

\u65b0\u95fb\u6765\u6e90\uff1a<\/b>www.nytimes.com
\u539f\u6587\u5730\u5740\uff1a<\/b>The Power of a Smaller Breast<\/a><\/font>
\u65b0\u95fb\u65e5\u671f\uff1a<\/b>2024-09-20<\/p>\n

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\u539f\u6587\u6458\u8981\uff1a<\/b><\/p>\n

The women walk into the surgeons\u2019 offices with photos cued up on their phones. Miley Cyrus. Keira Knightley. Bella Hadid. I want my breasts to look like this, they say. They\u2019ve already spent hours on YouTube watching plastic surgeons\u2019 infomercials, on Instagram poring over before-and-afters, and on TikTok, where an army of ordinary women post about their breast reductions. \u201cAsk me,\u201d they say. Whether their nipple sensation has changed. What their boyfriends said. Whether they cared.
\nSometimes a woman walks into her initial consultation with the bralette she hopes to wear. Or she\u2019ll say, \u201cI can\u2019t wait for my braless summer.\u201d Or that she looks forward to shopping for a $15 bikini top at Target, something cute and bright or floral, signaling a life so carefree its wearer might never need fat straps or eye hooks again. Breast reduction patients use words like \u201cfit\u201d and \u201cstrong.\u201d They talk about \u201cyoga boobs.\u201d
\nFriends tell friends about their breast reductions. A surgeon named Donald Mowlds, in Newport Beach, Calif., sees a photo on his feed of a group of women at lunch and realizes he\u2019s operated on all of them. Kelly Killeen, a surgeon in Beverly Hills, says one of her patients flashed her breasts to a friend at the makeup counter at Neiman Marcus and the friend walked across the street to make an appointment. Jamie Hanzo, who is 26 and lives in New Orleans, uses the same plastic surgeon as her mother.
\nTiffany Dena Loftin, who is 35 and a labor organizer in Atlanta, was emboldened to undergo breast reduction after scrutinizing the naked breasts of her friend Jamira Burley, 36, over FaceTime: her bandages, her incisions, her bruised nipples. Loftin doesn\u2019t like hospitals. Needles terrify her. But, Burley said, \u201cTiffany, the relief and the joy that I\u2019m feeling is also available to you on the other side of your fear.\u201d
\nAfter liposuction, breast augmentation is the most popular cosmetic surgery procedure in the country, 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 percent increase since 2019, according to the American Society of Plastic Surgeons. (That number doesn\u2019t include gender-affirming top surgeries or breast reconstructions after illness.) The increase is reflected across all age groups, but especially among women under 30, who are enthusiastic consumers of plastic surgery in general, including face- and forehead lifts, procedures favored mostly by women their mothers\u2019 age. Girls younger than 19 represent a small but fast-growing part of the market.
\n\u201cI had big breasts my whole life,\u201d a teenager\u2019s mother will tell Dr. Mowlds in his office. \u201cHere\u2019s my daughter. She has questions.\u201d
\nReduction surgeries deemed \u201cmedically necessary\u201d and covered by insurance represent a far smaller group than cosmetic operations, but the broad trend lines \u2014 a recent, sudden increase, especially among younger women \u2014 are the same, according to an analysis by the Health Care Cost Institute.
\nNot only do more women want to be small; they want to be smaller. 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, postpartum mothers.
\nAmerican women are perpetually at odds with their bodies, which reliably fall short of the perfection embodied by models and influencers. Seventy percent of women worldwide dislike the size of their breasts. This may be because a woman\u2019s breasts are subject to constant evaluation and critique. Always on view, breasts allude to a woman\u2019s 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 fetishization. Also revulsion and derision. Large breasts draw more attention \u2014 positive and negative \u2014 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.
\nSo to decide to reduce them, to make them lighter, smaller, easier to carry and cover \u2014 more discreet \u2014 can be seen as an act of self-love and empowerment, a woman\u2019s prioritization, finally, of her own 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 aren\u2019t youthfully round and upright as repulsive: droopy, flabby, jiggly, hard to contain.
\nOr the choice to undergo breast reduction can be, in some paradoxical way, pragmatic. Perceiving, rightly, that she can\u2019t change the culture she lives in, a woman might find that the easier path to loving her body is to alter herself.
\nDoctors 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, Loftin talked to Burley, who lives in Oakland, about what she was sacrificing \u2014 being conventionally pleasing to men \u2014 and about whether her boyfriend would recoil from the scars or privately resent the dramatic change in her shape. But Burley just seemed so much brighter, Loftin said, that she was inspired to call a surgeon, too. 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.
\nAnd 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. Cheyenne Lin, who is 26 and a substitute teacher in Fresno, Calif., is married and said she probably wants children someday, but most women in her family have struggled to breastfeed.
\n\u201cSo when they said, \u2018You might not be able to breastfeed,\u2019 I was like, that was not even on my list of concerns,\u201d Lin said. She had her reduction surgery in July.
\nIn 2012, an English plastic surgeon named Patrick Mallucci published in a medical journal his article \u201cConcepts in Aesthetic Breast Dimensions: Analysis of the Ideal Breast,\u201d an attempt to define breast perfection. He compared the effort to Leonardo da Vinci\u2019s delineations of the human face into thirds and fifths. How could surgeons hope to reshape and upgrade women\u2019s breasts, Mallucci argued, without knowing what they were aiming for?
\nIt was the era of aspirational voluptuousness: The Kardashians were peaking and the celebrity gossip site TMZ reported that \u201cKate Upton\u2019s Boobs Defy Gravity!\u201d In 2007, plastic surgeons performed nearly 350,000 breast augmentations, a record, and the procedure remained the most popular in the nation until 2021.
\nMallucci based his analysis on an examination of 100 photos of topless women that ran on the website of the tabloid The Sun, reasoning that their breasts reflected a consensus on attractiveness. Many Sun readers considered the photos to be soft porn (and The Sun later ceased publishing them), but Mallucci pushed back when I called him and pointed that out.
\n\u201cThose girls were selected by an editorial board,\u201d he said. \u201cYou can critique, but all they represent are naturally attractive breasts.\u201d
\nIn his article, Mallucci described, in the language of poles, curves and angles, what these breasts had in common. They were rounded below the nipple, not too round above it and the nipple sat high on the breast. On \u201cunattractive\u201d breasts, he wrote, the nipples pointed downward.
\nDr. Killeen remembers learning about Mallucci\u2019s standard as a medical resident, and fuming. Most women\u2019s breasts just don\u2019t look like that. \u201cI hate the word \u2018ideal,\u2019\u201d she said in an interview. If an ideal breast is attainable only through surgery, she added, \u201cShould it be ideal?\u201d
\n\u201cListening to men tell us what our body parts should look like was disgusting,\u201d she said. \u201cI was like, What is happening here? Is there any situation where there\u2019s a bunch of women discussing \u2014 with no input from men \u2014 what their personal, sexual body parts should look like?\u201d
\nOnly about 20 percent of plastic surgeons are women, and patients considering breast reduction describe frequently encountering a sexist professional culture. On the Reddit board r\/Reduction, women post about surgeons who make comments about their weight, express their own preferences for \u201ccute and round\u201d breasts and defer to husbands or partners in the examination room. Suma Kashi, who is 41 and lives in Los Angeles, recalled talking to a prospective surgeon who said, \u201cI don\u2019t think your husband is going to like this.\u201d
\n\u201cWhat does my husband have to do with this?\u201d Kashi said in an interview. \u201cCome on, man. Please.\u201d
\nThese ideas about breast perfection infuse the worlds of young girls. Teenagers with large breasts frequently struggle with low self-esteem and eating disorders. When Cheyenne Lin was in sixth grade, she said, she was standing in line at recess when a teacher yanked her shirt collar, which had drifted down her shoulder, up to her neck. Rae Wolk, a college student from Bedford, Mass., joked with her friends in high school that she was \u201cdrawn wrong.\u201d
\nYoung 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 \u2014 droopy, deflated, \u201cstretched the hell out,\u201d in the words of one plastic surgeon I spoke to \u2014 and turn these descriptions on themselves. Before her reduction, Lin\u2019s breasts were \u201ckind of pancake-like, kind of flat and saggy,\u201d she said. She began to hate them so much that she averted her eyes when she toweled off after the shower.
\nSince puberty, Loftin said, she has had \u201cthis notion, this sort of stigma, that growing breasts was a bad thing.\u201d When her body started to develop, her mother accused her of having sex \u2014 she wasn\u2019t \u2014 and \u201cI felt like I was being punished,\u201d Loftin said. Even when her friends admired her body, Loftin shrugged them off. \u201cAny attention was bad attention,\u201d she said.
\nWhat clinched her decision to get a breast reduction was the day she saw herself as she imagined others saw her. On the morning after her 35th birthday, a friend texted her a short video of her party the evening before. In it, Loftin was singing and twerking at a Los Angeles karaoke bar. She was wearing a halter top. And all Loftin could see in the video were her own breasts.
\n\u201cI was watching how much movement my breasts had, when I was intending to shake my ass,\u201d she said, starting to laugh. \u201cThe point of the dance is not to move your titties. But that\u2019s where my gaze was drawn because of how large they were. And I wasn\u2019t sick of myself, but it made me feel\u201d \u2014 here she paused for a moment \u2014 \u201cover it.\u201d
\nThe video, she said, was the push she needed \u2014 a reminder that \u201cI\u2019m actually large and top-heavy. I\u2019m uncomfortable with it. And I don\u2019t like it. And it\u2019s in my way.\u201d
\nIf a single procedure can alleviate back pain and headaches, promote mobility and fitness, and also enable a woman to un-selfconsciously wear a tube top, is it a medical procedure or a cosmetic one? For the patient, of course, it can be both. But from the point of view of an insurance company, it\u2019s one or the other, reimbursable or not.
\nMost insurers want proof of medical necessity: back, shoulder or neck pain; grooves in the shoulders from bra straps; skin rashes. They require evidence that the patient has tried nonsurgical remedies, including pain relievers, physical therapy, and custom support bras. And most plans include minimums for the number grams of breast tissue that must be extracted based on a woman\u2019s breast size, height and weight.
\nSuma Kashi is 5 feet 2 inches tall and before her reduction was wearing an H-cup bra. When she was initially considering surgery, she weighed 178 pounds, and her insurance company told her that she would have to get 755 grams \u2014 more than a pound and a half \u2014 per breast removed to qualify for reimbursement. But to get her to her desired C cup, her surgeon estimated that she would need to remove much less: 415 grams per breast. Kashi tried to reduce what the insurance company called her \u201cB.S.A.\u201d \u2014 body surface area \u2014 by losing 25 pounds. Even so, her claim was denied.
\n\u201cThey just kind of set impossible guidelines,\u201d she said. She ended up paying out of pocket: about $23,000. Jamira Burley, on the other hand, was 5 feet 5 inches and weighed 185 pounds before her reduction. She wore a 34DDD bra and her insurance covered her surgery. She now wears a B cup and, after additional weight loss, weighs 155.
\nCheyenne Lin couldn\u2019t have paid for her breast reduction on her own. She hated the way her breasts hung down to her belly, how one was a full cup size larger than the other, and she hated the limitations on what she was able to wear. \u201cWhen you go bra shopping for bigger boobs, they\u2019re like, \u2018Here are your options. Black and tan,\u2019\u201d she said. \u201cI guess they don\u2019t want us to feel pretty.\u201d
\nBut mostly she was hurting. Starting around her sophomore year in college, she had constant searing pain between her shoulder blades. The difference between the size of her breasts had affected her posture, placing uneven weight on her back. She couldn\u2019t go hiking with her friends or snowboarding with Jaylen Lin, the exchange student who became her husband. Lin began to feel that she couldn\u2019t participate in her own life; Jaylen even had to help her remove her clothes from the dryer. At 21, she said, \u201cI felt like I was trapped in the body of someone in their 70s.\u201d She was diagnosed with depression.
\nLin does not come from an affluent family. She was covered by Medi-Cal, California\u2019s Medicaid program, and her general practitioner wasn\u2019t interested in helping her navigate the route to the reduction surgery, she said. When she Googled the surgeon who accepted her insurance in Fresno, his ratings were so low she didn\u2019t make the call.
\nJaylen\u2019s parents in Taiwan stepped in after he spoke with them on the phone. They helped the couple find an insurance plan with an out-of-network option and gave the Lins a credit card to pay Dr. Killeen\u2019s $15,600 fee.
\nBefore the surgery, Jaylen\u2019s father sent the couple a text. \u201cIt said, \u2018Don\u2019t worry about anything. Dad will take care of it.\u2019\u201d Lin expects her insurance to reimburse between $2,000 and $4,000 and considers the gift from her in-laws life changing. Her back pain is gone. She hasn\u2019t taken antidepressants since her surgery.
\nWhat does it mean to want to be small? Do smaller breasts reflect a refusal to inhabit any longer the fantasies of men? Tiffany 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.
\nWomen in her friend groups \u201cdon\u2019t need the expectations of Western beauty or male beauty to live up to. This is my body. I\u2019m not doing this for men,\u201d she said. An earlier generation might have needed male approval for their physical selves. But for her, \u201cthat\u2019s not true. And I don\u2019t want to look like that.\u201d A month after her surgery, Loftin went to the E.R. with a breast infection, leading to additional surgeries. Even so, she has no regrets.
\nCheyenne Lin considers her reduction an explicitly political act, a salvo in the culture wars around reproduction and motherhood. By potentially sacrificing her ability to breastfeed, she is prioritizing her own health and happiness over the evolutionary role she is expected to play.
\nMore than half of women ages 18-34 say they don\u2019t want kids or aren\u2019t sure. With the Supreme Court and state legislatures curtailing reproductive rights, \u201cwe already have so many people trying to take our bodily autonomy away,\u201d Lin said.
\nSarah Thornton, 59, a sociologist who lives in San Francisco, was a B cup before her double mastectomy. After breast reconstruction she had Ds, which felt huge to her \u2014 \u201cbulky and cartoony,\u201d she wrote in \u201cTits Up,\u201d her recent social history of the breast. Eventually, she had another surgery to reduce the size of her implants. But she wouldn\u2019t call the decision a liberation, necessarily.
\n\u201cI went from an uncomfortable implant that I really hated to a smaller one that\u2019s placed slightly differently,\u201d she said.
\nHaving immersed herself in women\u2019s ideas and feelings about their breasts during the four years she researched her book, Thornton supports whatever decision a woman wants to make about her top half. But she worries about casting breast reduction solely as feminist emancipation. For one thing, she said, \u201cplastic surgery is a consumer option. There\u2019s usually a lot of money involved.\u201d For another, women\u2019s body dissatisfaction, circulating virally online, is \u201cpernicious\u201d and \u201ccontagious,\u201d Thornton said, contributing to the idea that there\u2019s always something about women’s bodies that needs to be fixed.
\n\u201cNothing you do will ever be good enough, and if you\u2019re doing anything for purely aesthetic reasons, you\u2019re never going to be completely content with how you look,\u201d said Rae Wolk, the college student.
\nSmall breasts may not draw as much attention on the subway or the street as bigger breasts do, but they are also a fashion. Whereas big breasts signal motherhood and sexual availability, smaller breasts can convey youth, girlishness, puberty, thinness, androgyny. Bralessness, an uncovered nipple, can titillate as much as cleavage can. Wolk feels that her smaller breasts make her more feminine, more like a \u201ccoquette,\u201d she said.
\nThey can also indicate class. In March, a meme circulated on X and has been viewed 32 million times. \u201cMEN,\u201d it said. \u201cWhich do you prefer? The aristocratic elegance of the small breasted woman OR the Nietzschean pro-sex, pro-beauty large breasted woman?\u201d Thornton agrees that smaller breasts signal the self-assurance of affluence whereas breast augmentation can signify social ambition \u2014 a desire to attain wealth and status via the attention of men.
\n\u201cUpper middle class women have different kinds of value they can draw from,\u201d she added. \u201cThey may have a college degree. They may come from a little bit of money or support. They can call Mom or Dad. They have \u2018taste.\u2019\u201d
\nFor 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 own birthday party \u2014 that is liberation. But it\u2019s a personal, individual one, said Thornton.
\n\u201cIf women are going to have an emancipated rack,\u201d she said, \u201cthen men need to change.\u201d
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