The Case of the Missing Areolae: Race and Breast Reduction Surgery
1 Writing about female breast reduction surgery brings to one’s attention ideas about possibilities and desirabilities. Yes, surgery means cutting the body, but to “reduce” through cutting requires some thinking through. What is being reduced, materially and non-materially? Obviously the size. Also the content, yes? The content of what? The outer visible thing we call a breast, yes. Also tissue, etc. inside. But is there also something else being reduced? The woman’s sense of who she is? Or is that being expanded? And then there is desire. Whose desire is it that goes into play when a woman opts to have surgeons reduce her breasts, especially when there are deep, continuing questions about female agency? When historians, feminists, and physicians, as well as writers in popular magazines, write about breast reduction surgery on the female body, they vacillate about the surgery’s desirability. Varying and sometimes conflicting perceptions of patients, surgeons, and the health insurance industry all weigh in. Not having devised a truly objective method to define an “overly large” breast, the insurance industry has weakly made a stab at clarity and specificity post hoc, so to speak, by allowing payment for the procedure only in the event of removal of a fixed percentage minimum amount of tissue, while giving secondary consideration to the affective complaints of patients. With regard to surgeons, whether female or male, considering the many cultural fixations about breasts, especially in the West, the impossibility of any objectivity on their part seems clear.
2 After all, what are breasts of a size more than flat but the primary indicia of the female sex? To therefore suggest that it is possible and even desirable to reduce this obvious sign of being female points to ambivalence about being female and ambivalence about femininity itself, individually and collectively.
3 Admittedly, she now comes to be aware of having had, after the fact, a great amount of personal conflict about those things on her chest. Why did she have them “reduced”? Oh, yes, she trotted out the requisite list of complaints, all true, about bra straps slicing into her shoulders, back pain, a constant sensation of being constantly pulled forward and down by the weight of those boulders on her ribs. Two sacks of potatoes like albatrosses around her neck. Then, of course, but at the least, the gaze of male eyes towards a point below her neck infuriated. But are there layers of some vague murmurings beneath as she tries to diminish male power over her existence by shrinking her awareness of the focus of their attention—away from her intellect?
4 In examining female breast reduction contextualized by race, I will touch upon the act of this particular kind of surgery, the motivations for performing such surgery, on the part of patients as well as on the part of surgeons, and the unquestioned agendas in the development of choices by surgeons in performing and developing new techniques.[1]In carrying out the research for this paper, I found the use of both “mammaplasty” and “mammoplasty” in the titles and text of books, articles, and on Internet sites. When quoting and referencing, I will retain the spelling the writer used. However, in my own comments, I will attempt to maintain the use of “mammaplasty,” thereby retaining the root “mammary.” Do the motivations, the development of choices, and the acts interlock with racial ideas? We are accustomed to consider the breast in toto, with perhaps momentary attention paid to the nipples for nursing or sexual reasons, our attention driven by the male focus.
5 But there’s one feature that usually gets ignored and that is the areola. Are there extensive perorations on areolae in newspapers, magazines, and billboards as there are on breasts and nipples? No. How many women even know the word? How aware are women, in preparing to have a knife put to their bodies, of what’s hidden in everyone’s ideas about human breasts?