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Alison Stewart: This is All of It. I'm Alison Stewart, live from the WNYC studios in Soho. Thank you for spending part of your day with us. I'm really grateful you're here. On today's show, hit albums often feature session musicians and singers who work behind the cameras. Musician and music educator Franz Nicolay joins us to talk about his new book, Band, People, Life, and Work in Popular Music. Lifelong friends, actors Diego Luna and Gael Garcia Bernal, have reunited for a new project, the first Spanish language series on Hulu. They'll be in studio to discuss La Machina. Plus, we'll get a preview of El Museo de Barrio's new Latinx survey exhibit. That's the plan, so let's get this started with the plastic surgery procedure that's become popular with women under 30.

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Alison Stewart: October is Breast Cancer Awareness Month. We know that you should get checked or do a self-check and/or schedule a mammogram. It's just one of the ways that women can take control of their bodies, specifically their breasts. Another way is through breast reduction. It can lead to a decrease in breast cancer, but there, there's more to it. Young women have been opting for smaller breasts because of unwanted attention, a desire to be strong, or they might be tired of chronic neck and back pain. Last year, elective breast reductions rose by 7%. It's been a steady rise since 2019. In just five years, the procedure has seen an increase of 64%.

A recent article in the New York Times sought to put faces and stories to these numbers. Lisa Miller is the author of this piece titled The Power of the Smaller Breast. She's a correspondent for the Times Well section, and covers the intersection between health and culture, and she's here with us in studio. Hi, Lisa.

Lisa Miller: Hi, I'm so happy to be here.

Alison Stewart: Listeners, we want to hear from you. Are you thinking about a breast reduction? Why? Why not? Have you had one? If so, how do you feel about it? What were your reasons for the surgery? We want to hear from you. Give us a call or text to us. The number is 212-433-WNYC, 212-433-9692. We want to hear your stories about your breast reduction. Your article centers on younger women opting for breast reduction, and it notes that many young women are much more comfortable with cosmetic or plastic surgery. First of all, what demo are we talking about? What age?

Lisa Miller: Under 30, basically, although the increase is in all age groups, but the under 30s represent the driver of the trend.

Alison Stewart: Why did plastic surgery become normalized for this under-30 crew?

Lisa Miller: It's a really good question. I think there's this spectrum from tattoos to plastic surgery. Younger women are just more accepting of it. There's a lot about it on TikTok. There's a lot about it on Instagram. Women are much more open to sharing their body stories, showing each other their breasts. There's this anecdote in my story about a woman actually flashing her friend at the makeup counter at Neiman Marcus, saying, "Look at my new breasts." Then the friend goes across the street to the plastic surgeon and makes an appointment.

I just think there's a kind of intimacy and authenticity and, like, yes, what people call body autonomy, body positivity, that's very now.

Alison Stewart: Do you think that social media has an impact on that?

Lisa Miller: Definitely. All the plastic surgeons I talked to for this story said that young women would come in with pictures on their phones, sometimes of celebrities-- Keira Knightley, Miley Cyrus- but sometimes of their friends or an influencer. "I want my breasts to look like this. I want to be this." Also, ordinary women who've had the surgery will show as much of their breasts as they can on Instagram or TikTok or YouTube and walk viewers through the whole surgery, the recovery, the scars, the pain. Like, 'ask me anything' sessions so that it's very, very present and very interactive.

Alison Stewart: Breast augmentation is still the second most popular plastic surgery. What reasons women give for wanting smaller breasts?

Lisa Miller: It's a variety of things. I think that one of the things I learned doing this story is that it is never just one thing. A lot of women have pain. They have discomfort. They've lived with pain for a long time, or they've had mothers, aunts, grandmothers who've had very large breasts and just don't want to live like that. That's very real. There's also the fashion element, which is smock dresses, tube tops, camisoles. Like that very youthful, very small-breasted fashion is in right now and I think people want to be able to wear what's in the stores.

Most of the women I spoke to have had to wear special bras or large bras with lots of hooks and straps. They don't like that. It's hard to shop for a bathing suit. There's just a pragmatic aspect as well. Then there's the feminist aspect, which is that they want to step out of the male gaze. They want to stop being the object of male attention without their consent. When you have very large breasts, people are looking at them all the time, and they want to be able to reduce that attention and choose what is being focused on them when they want to.

Alison Stewart: What is the average cup size that people are seeking out?

Lisa Miller: There is no great number, but there is a number that circulates online that is derived from a marketing survey that a lingerie maker made a few years ago, and it's double D. Most of the women who go in for breast reductions are double-D or larger, so they really do have quite large breasts.

Alison Stewart: What are they searching for? Would they want to get a B?

Lisa Miller: It's interesting. One of the things that's changing is not just more women want breast reductions, but the cup size they want is smaller. It used to be that people would go into plastic surgeon and say they wanted a C cup, and now they go in and they say they want a B cup.

Alison Stewart: That's really interesting. We're talking about a piece that Lisa Miller wrote, The Power of the Smaller Breasts. Listeners, we want to hear from you. Are you thinking about a breast reduction? Why or maybe you've had one. If so, how do you feel about it? What were your reasons for the surgery? We'd love to hear from you. Give us a call. 2124-3396-9221-2433 WNYC. Doing some research on this, we came across the term 'ballet body' that was reported in a 2023 report from the Plastic Surgery Association of America. I'm going to read this. "The movement toward a more natural and athletic physique has gained significant traction in plastic surgery, which emphasizes a harmonious, proportionate, and elegantly body shape that reflects the grace and athleticism of a ballet dancer." Your thoughts?

Lisa Miller: My thoughts?

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Lisa Miller: I'm of an age where I remember that a ballet body signified eating disorders and, you know, too much focus on thinness, and so I, too, was surprised when I read that and I saw that it was being promoted as a positive thing. What the plastic surgeons I spoke to said was that women want to look 'fit'-- I'm using air quotes now. You can't see that- and 'strong.' Also using air quotes. There's this question of proportionality that plastic surgeons talk about a lot. This was a question that I asked them all the time. I am female. I go to the gym. I see women's bodies in all of their different shapes and sizes. I don't think there is a proportional norm based on my own personal experience.

I was asking them, what is this ideal? Who decides it? How is it established? What they do say is that these things are cyclical. There's a pendulum that swings back and forth, so bigger breasts were very popular in the early 2010s. Then now the pendulum is swinging back, so people want smaller breasts. Along with the health and independence motivations, there is a fashion motivation as well.

Alison Stewart: Let's take a call. This is Anna calling in from the Upper West. Hi, Anna. Thank you so much for calling All of It.

Anna: Hi. Can you hear me?

Alison Stewart: Yes, I hear you great.

Anna: Great. This is so funny that this is the topic of conversation right now because I actually had a breast reduction a couple months ago and also was sent this article by so many people. I have an entire note on my phone of quotes that really resonated with me from it. Just to choose one, I chose "Do smaller breasts reflect a refusal to inhabit any longer the fantasies of men?" That is something that just really resonated with me because I've had really large breasts since I was about 13. I just felt like I was suddenly catapulted into this world of being objectified and sexualized. It weighed on me in a way that I think I didn't even understand at the time, and that just continued.

Then I also got the physical symptoms and chronic back pain, neck pain, but the psychological impact, I think, was really quite large. It was extremely liberating to take control of my body and thus of how it's viewed and to take that away from men who are sexualizing me. It seems like a whole lifetime of people locking in on my chest before they even look at my face, and so yes, it's been a huge relief mentally and physically.

Alison Stewart: Anna, thank you so much for sharing your story. You talk to women who talked about their breasts being hypersexualized.

Lisa Miller: I did. It was a thing that I think people intuitively know that women with very large breasts are sexualized and objectified in a way that other women aren't. To hear stories like Anna's-- and I heard them a lot in the reporting of the story- the way very young girls actually are treated not just by men, but by their teachers, by their moms, by their brothers. Just presumptions that people make about their behavior and their age.

Alison Stewart: Like their behavior, how?

Lisa Miller: That they're sexually active. That they 'want it.' That they're 'fast.' There are these horrible stories about mothers saying, "You can't go out like that. Cover up." A girl told me, a woman told me that in fourth grade, her father went and bought her a bra. When she took it off at school because it was uncomfortable, she got yelled at when she got home. I think we know this intuitively, but it was very helpful to me to hear these stories from women about how it feels to walk through the world, especially as a young girl, and draw this attention without having any choice about it.

Alison Stewart: Let's talk about how you pay for this. How much is the average breast reduction?

Lisa Miller: The American Society of Plastic Surgeons says that the average breast reduction costs $7,000. I talked to a lot of women for the story and a lot of doctors, and no one I spoke to charged that little. It's often $10,000, $14,000, sometimes as much as $20,000. The number of breast reductions that are of that are covered by insurance, is very, very, very small. Insurance companies want a lot of proof that you have back pain, neck pain, shoulder pain, grooves in your shoulders, rashes, so proof of medical necessity. Also proof that you've tried other things before surgery, including pain medication, custom bras, physical therapy, exercise, losing weight.

Both the doctors and the patients expressed a fair amount of frustration that there isn't a clearer algorithm, clearer guidelines for who gets covered and who doesn't. Like even doctors said to me, "I've seen women who really should be covered and aren't. I've seen women who are in the normal range and are. It does seem murky and varies from company to company, and women have expressed a lot of frustration about it.

Alison Stewart: Some of the women you talk to, the younger women, how did they afford it?

Lisa Miller: Yes. One of the main women in the story, a young woman named Cheyenne Lynn, who's in her mid-20s, is married. She comes from not an affluent family and is saving and saving and saving to pay for her breast reduction. She'd wanted it since high school. She's a substitute teacher. Her husband has a dog walker. She just couldn't make rent and her car payments and also be saving on the side for her breast reduction. She was feeling worse and worse and worse, getting more and more into more and more pain. She was diagnosed with depression, and finally, her husband talked to his parents who live in Taiwan, and they offered to pay.

She just feels like this was a gigantic gift and generosity from her in-laws that she didn't expect. For her, it's changed her life. I mean, that's what she said.

Alison Stewart: We're talking about breast reduction with reporter Lisa Miller from the New York Times. She wrote a piece called The Power of the Smaller Breast. Taking your calls. We hear from you whether you've had a breast reduction, if you're thinking about it, or if you've had it, and how do you feel about it. We want to hear from you. 212-433-WNYC. Let's talk to Taylor from Queens, who's calling in to talk about his wife. Hi, Taylor.

Taylor: Hi. Good afternoon. Thank you for taking the call.

Alison Stewart: Go ahead. You're on the air.

Taylor: Oh, my wife is in her 50s, and we've been married for 25 years. In the past ten years, she has been really, really complaining about back pain. It was unbearable. She's 50, petite size, and her breasts just kept growing and growing. It was painful just to see her, something as simple as getting dressed. I had to help her get dressed at times. Plus, finding clothing was difficult, but the huge complaint was the back pain. It was unbearable, so two years ago, we really talked about it, and the insurance wouldn't cover anything. We ended up spending close to $12,000, and she had it done.

Now she is size B. She went down from 38 DD to size B. Mentally, she is much happier. I don't see the back pain anymore. She's easier for her to find the clothing that she likes. I noticed in our case, it was more of a medical necessity. She really went through all the hoops of having the studies and studies and more studies from all the doctors, and still the insurance company would say, "Well, that's not good enough. Give us more." Then in the end, it was like we just got to pay for it. Relying on insurance companies, they're going to grow out of proportion, and it doesn't make sense. Look at you. The paing is unbearable. It was affecting her knees also because I would see her walking sideways at times. Right now, she's 52.

Alison Stewart: Oh, wow.

Taylor: That's my thought. Many times, it's really more of a medical necessity than anything else.

Alison Stewart: Taylor, thank you so much for calling in. You check that list that insurance companies have that they're expecting you to check off. Where does BMI fit in? Of course, we're saying BMI has its skeptics on its own, right?

Lisa Miller: They don't use BMI. They use this other-

Alison Stewart: -calculation.

Lisa Miller: -calculation called body surface area, which it's related to BMI, but it's basically how big your breasts are in proportion to the rest of your body. Yes, that's the algorithm. I can't get inside those numbers. I don't know what they actually mean, but what the insurance companies want is for you to show that your breasts are really dramatically out of proportion to the rest of your body. What the doctors say is some women carry very large breasts comfortably and without any pain, and some women carry not as large breasts very uncomfortably and with a lot of pain. What they and the patients want is to be able to determine medical necessity between themselves, but the insurance companies don't want that at all.

Alison Stewart: Let's talk to Emma from Princeton, New Jersey. Hi, Emma. Thank you so much for calling All of It.

Emma: Hi, can you hear me?

Alison Stewart: Yes, you sound great. You're on the air.

Emma: Oh, great. Okay, perfect. First of all, thank you for this article. I read it-- when did it come out?- like a week or two ago. Let's see. When I was a teenager, I felt very large at a C cup. Then as I grew up, my cup size got bigger. Now I'm 54. The cup size is a double-D at this point. I'm averse to elective surgery for just personally. There's been lots of times where I wish I had smaller breasts because of all the things you've talked about. I haven't dealt with pain, so I'm really grateful for that. Being stared at in the breast instead of talked to. Someone is looking at my face, and I also just feeling a little sloppy in my clothes. There's lots of fashion items that I can't wear.

Recently, I've been thinking, "Oh, maybe a breast reduction would be nice. Like, it would be more convenient." I reject this idea that I need to have a surgery to get society to treat me in a way that I would prefer. Like, I think it's a society problem in a sense. I don't know if I'm contemplating or not, but I just wanted to share those feelings of I understand the desire to have a more conforming breast size that's less in your face. [laughs]

Alison Stewart: Yes, no, I hear your point. Thank you so much for calling, Emma. You raised a really interesting point for a lot of people. A lot of people, this is elective and why do I have to elect to have it?

Lisa Miller: I really struggled with this exact thing when I was reporting the story because I think this idea that you have to surgically change your body to be comfortable out in the world is asking a lot of women. I struggled with how to frame that as a liberation. What I came to after talking to a lot of people is that the experience of living female out in the world is an experience of wanting yourself to look a certain way, wanting to feel a certain way, and also internalizing and incorporating all of the thoughts and feelings that everybody out in the world has about your body. You can't help it.

It's just you live in the culture you live in, and so you have to make peace with that however you do. Some people make peace with it by saying, "These are my breasts. They are fine, and you all can think what you want about them." Some people resolve it by saying, "I don't want to participate in this way anymore." Both are totally fair responses to this problem, especially if you take aside the pain and discomfort part of it. There's a new book out, A Social History of Breasts.

Alison Stewart: That's All of It from WNYC. I'm Alison Stewart. My guest is Lisa Miller from the New York Times. She wrote a piece called The Power of the Smaller Breasts. Let's talk to Carol calling in from Manhattan. Hi, Carol.

Carol: Hi.

Alison Stewart: Hi, Carol. You're on the air.

Carol. I'm a plastic surgery nurse, and I was in a very prestigious practice, and we did everything, facelifts, breast augmentation, liposuction, everything. I must say, after 25 years, breast reduction was the number one loved, appreciated, and so thrilling to each of my ladies that had this procedure. From right after high school graduation or right before the prom or before they're getting married, and this is an intimate decision. This is not for anyone else but the woman or the girl who feels uncomfortable physically, emotionally, and thinks of the rest of their life with these breasts, if they're already a DD or a EEE and they're so uncomfortable.

Yes, they can be embarrassed in the locker room with their friends when they have to take a quick shower, but they don't go and do this surgery for that. They stand in the mirror after I've taken off their dressings and removed their stitches and the tears roll down. Sometimes, their mothers are in the room. The mothers are crying. This is for the female, the woman. Her emotions, her body, her personal self-esteem, how she feels, how she feels about herself and when she looks in the mirror, nobody else. When she looks in the mirror, and she puts on a blouse that will not open up, that she doesn't have to pin. When she can wear her prom dress like all the other girls and feel comfortable in her beautiful dress for the rest of her life. Number one on the hit parade in plastic surgery.

Alison Stewart: Thank you so much for calling, Carol. What are we talking about in terms of pain when you talk to the clients?

Lisa Miller: I think it varies a lot. I think it varies a lot by patient. One of the things I wanted to say about Carol was that everybody I talked to-- in response to what Carol just said- but every woman I talked to said that they wanted to buy a bralette at Target. I was like, "Why a bralette at Target? What?" I realized it's that. It's like, "I just want to go to Target, spend $15 on something pretty, lacy, simple, not straps, not hooks." I talked to a woman who did that a month after her reduction, and she was weeping in the dressing room, so this is really true.

Pain varies a lot from patient to patient. I saw one woman right after her surgery. I had breakfast with her. She looked dynamite. Just absolutely like she could go run a marathon. I saw another woman-- also exactly a week after her surgery- and she was hobbling like a person three times as old as she was, so I think it really depends. yes. Two weeks, I think you can be back to yourself.

Alison Stewart: Let's talk to Roberta from Inglewood. Hi, Roberta. Thanks for calling All of It.

Roberta: Hi. I had the surgery about-- I don't know- 12 or 15 years ago. I was in my early 50s at the time and it was when I can actually afford to do it. It was not going to be covered by insurance because they would have required a huge amount of physical therapy, more than insurance even covered. It would have taken months, if not a year, so I just went ahead and did it. I'm 5'2". At the time, I weighed about 108 pounds, and I wore a size G bra. It was just so out of proportion to my size. When I was younger-- I grew up in New York- I would walk blocks out of my way to avoid going past a construction site because of all the horrible comments the construction workers made.

At college, boys in my dorm made rude comments. The last straw was I went to buy a bathing suit and nothing fit and the sales lady told me to try a plus-size store. I mean, I'm 5'2" and weigh 108 pounds. It was crazy, so I did it. Didn't take off as much as I would have liked, but it was great. I do not regret it at all. It was worth every penny.

Alison Stewart: Thank you, Roberta.

Roberta: It was great.

Alison Stewart: We appreciate your call. As we wrap up, Lisa, is there anything I didn't ask you that you think is important with the story?

Lisa Miller: I mean, when Roberta talked about regrets, I think one of the regrets I heard most often was that women said they didn't go smaller and I thought that was interesting. Then the other thing is that I think we do need to talk about, there is a risk that you won't be able to breastfeed. There is a risk that your nipple sensation will change. There is a risk of infection. Like, this is a surgery. It does have consequences, and people do seem incredibly happy with it at the end.

Alison Stewart: The piece is called The Power of the Smaller Breast. It's by Lisa Miller. It's in the New York Times. Thanks so much for sharing your reporting with us.

Lisa Miller: It was really fun to be here.

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