At 17, Mariah Sorensen finally got the courage to ask about breast reduction surgery. Her back and shoulders ached. She hated running. She dreaded trying on clothes.
But the physician at the women’s clinic shrugged off her concerns.
“She just told me to get a better bra,” Mariah said.
A better bra? She couldn’t find any her size―which she estimated to be a 34H. She usually layered two or three sports bras just to feel comfortable.
Mariah ran into a common roadblock for teens who want a breast reduction―one that reflects misplaced concerns and ignores biology, says John Girotto, MD, a pediatric plastic surgeon with Spectrum Health Helen DeVos Children’s Hospital.
“The old-school discussion is you’re not allowed to have that operation until you are an adult,” he said. “But you’re an adult when you are done with puberty.”
Teens can get the same physical benefits as adult women from breast reduction―relief from back, neck and shoulder pain. And it can open up a range of sports and activities that they would otherwise avoid in their high school years.
Mariah eventually got the surgery. A year after her first attempt, she saw a new pediatrician for an annual checkup. When he asked if she ever thought about breast reduction, Mariah looked back in astonishment.
“I was so relieved,” she said. “So happy. I have always wanted to have the surgery. I never wanted a large chest.”
Now, with a bust 6 pounds lighter, she wishes she could have had the operation sooner.
The self-esteem effect
Psychological and social factors―as well as physical issues―drive most teen girls who seek breast reduction surgery, said Heather Hardiman, a clinical social worker in the Adolescent and Young Adult Clinic at Helen DeVos Children’s Hospital.
“For some of these girls, it’s been difficult. They develop very young, so at 12, they look like they are 18,” Hardiman said. “It does have a major impact on their social lives and their self-esteem.”
They struggle to fit into clothes, whether it’s a sports uniform or a prom dress. They avoid athletics. They often feel sidelined when they want to join the crowd.
At the same time, they become a target for unwelcome attention. Teasing from boys can range from flirtatious to bullying. The girls often downplay the teasing because they don’t know how to confront it, Hardiman said.
“Even though they minimize it, it’s something that makes them uncomfortable,” she said.
The surgery is not for everyone with large breasts, she added.
Obese teens might be referred to the Healthy Weight Center at Helen DeVos Children’s Hospital before a decision is made on breast reduction surgery.
“Fat tissue, you can lose (with weight loss). Breast tissue, you cannot,” Hardiman said.
But for teens whose lives and choices are limited by the size of their breasts, and who go into the operation with realistic expectations, she has seen it bring welcome relief.
The search for costumes
Mariah, a 5-foot-7 senior at Central Montcalm High School, remembers a time in sixth grade when she lagged her friends in development. But once she hit puberty, her chest size grew at a rapid pace.
By freshman year, she wore a double-D. Gym class became downright uncomfortable, physically and socially.
Although she avoided competitive sports, she found her niche in art class and theater. She performed in nearly a dozen school plays. But even in theater, her chest size posed a challenge as she tried on costumes.
In last fall’s play, a take-off on “Alice in Wonderland,” she took matters into her own hands. She crafted a Queen of Hearts dress from duct tape and a garbage bag.
But of all the reasons Mariah wanted breast reduction surgery, back pain stood out.
“I used to have terrible cramps in my back when I went for walks or rode my bike,” she said.
After the pediatrician referred her to Dr. Girotto in fall 2015, Mariah scheduled the operation for November.
“It was very painful but worth it,” she said.
Since then, she has enjoyed life with less back pain, more physical activity―and much more fun trying on clothes.
She had the surgery in her senior year, at age 19. She wonders what her teen years would have been like if she had the operation earlier. She thinks she might have attempted sports or tried out for cheerleading.
“I would have been able to enjoy my high school career more,” she said. “Now it’s almost over.”
For Marissa Mueller, a 16-year-old sophomore at Norton Shores High School, having large breasts meant sitting on the beach while her friends ran and played.
“I would have to hang behind,” she said. “I couldn’t do the things that they do.”
A petite teen who stands 4-foot-9, Marissa said her large chest became “really life-limiting.”
She got involved in choir, but avoided sports. Just bending over as she played with her two young nephews could leave her with an aching back.
And there were wardrobe issues. Shopping for dresses for a special occasion—like homecoming or a wedding—often turned into a frustrating, six-hour ordeal, said her mom, Christine Mueller. If the top fit, the dress typically would have reams of extra fabric everywhere else.
“She would have to go up four sizes, and she would be crying in the dressing room,” Christine said.
The Muellers discussed breast reduction surgery with their family doctor, who referred them to Dr. Girotto.
In December, at age 15, Marissa underwent surgery. Although family friends warned her that the operation would be painful, she found recovery easier than expected.
She emerged with a chest 5 pounds lighter. And no regrets.
“It was life-changing,” she said. “You don’t even notice how much you can’t do (pre-surgery) until you can actually do all these things.”
Over the winter, she began running. And on April 1, she ran her first 5K with her aunt.
The payoff shows up in many small ways, too. It’s just more fun to be active in daily life, she said.
“My friends are really supportive and happy for me,” Marissa added. “They all knew it would boost my self-esteem if I would be able to do more things with them.”
Both Marissa and Mariah showed big gains in self-confidence after the operations, their mothers said.
That’s true for many teens, said Hardiman, the social worker.
“Their self-confidence goes up because their body aligns with what they think it should look like,” she said.
However, Hardiman advises keeping expectations realistic. Before a teen goes into the operating room, she should think realistically about why she wants a breast reduction and what she hopes to gain from it.
“Sometimes, you may think it’s going to solve all my problems or fix my self-esteem or make me have more friends,” Hardiman said. “I think if they have other issues going on, those need to be dealt with before they have surgery to change their bodies.”
Hardiman also wants to make sure teens aren’t acting on a whim. Interest in breast reduction rose when actress Ariel Winter, who plays Alex Dunphy on the TV comedy Modern Family, went public about her decision to have the surgery last year at age 17.
Hardiman looks for signs they made the decision on their own―although parental support and consent also are required. She finds most teens have already given the issue plenty of thought. They come in quite certain they want to take that step.
“They are persistent,” she said. “They are consistent. And they are insistent.”
“These are happy patients,” agreed Dr. Girotto.
When Marissa first thought about breast reduction, she hesitated a bit. She worried other teens would criticize her.
“I didn’t want to be the center of attention because of it,” she said.
To her surprise, she encountered little reaction, outside of her closest friends who knew about the operation. She suspects others may just think she lost weight.
“It stayed very low-key,” she said. “Nobody really noticed it.”
Now, she encourages other teens interested in the operation to consider it.
“It’s going to change your life in such a positive way,” she said. “It makes everything so much easier.”