Breast reduction is not a cosmetic procedure --it is a medical surgery to allow women to lead healthier lives. Misconceptions about the procedure no longer need to keep women from choosing to have breast reduction.

"I can't see any positives for having large breasts," says April Borry-Black, director of the Health Center at Susquehanna University in Selinsgrove, Pa., who recently underwent reduction surgery. "I had a reduction for a lot of reasons, mainly due to back problems. Nowadays, younger women are wiser than society as a whole and they realize their purpose in the business and professional world. They also understand that breasts are not needed to fill those roles."

According to Dr. Thomas Bitterly, director of plastic and re-constructive surgery at Geisinger Medical Center in Danville, Pa., "Breast reduction surgery has been around for many years now. However, we have seen an increase in the number of women seeking a reduction because women have become more knowledgeable about the procedure."

"The major misconception is that breast reduction is cosmetic plastic surgery," says Dr. Bitterly. "It is not just patients who feel this way, some physicians and insurance companies don't see the medical reasoning behind the two- to four-hour procedure. Another misconception is that just because it is plastic surgery, it's not major surgery--when that cannot be farther from the truth. My happiest and most satisfied patients are those who have breast reduction surgery"

Media portrays mixed messages when it comes to breast size. Fashion models are typically small breasted due to their body size and weight. On the other hand, swimsuit and pornography models are generally large breasted. What are these images trying to tell us?

"Too many women are exposed to women in the media who are unnatural and not of normal proportions," says Salvatore Cullari, media body images researcher and psychology professor at Lebanon Valley College in Annville, Pa. "For example, most women in the media are 10-15 percent below their normal body weight and such distortions provide viewers with a warped sense of normalcy. This is true with healthy breast size as well."

Emphasis on breasts and their size varies from country to country. "For example, breast reductions are common in France, where overlarge breasts are considered by many to be unattractive," says Dr. Patricia Heck, anthropology professor and chair of the department at the University of the South in Sewanee, Tenn. Dr. Heck teaches a medical anthropology course as well as the anthropology of gender.

Who is having breast reduction surgery? "I've seen patients from teens to women in their seventies, says Dr. Bitterly. "Younger girls have the procedure because they are too big and cannot participate in sports and activities. Women in their thirties and forties have back and shoulder pain that they physically cannot handle anymore and older women choose this operation to relieve some of the stress on their spine after menopause."

"Women think that men want large breasted women when men actually want girls that more average," says Cullari. "Psychologically, men and women both like traits that are in the average range. People whose traits are in extreme categories are not seen as attractive."

Borry-Black says, "Ask yourself what makes you happy vs. what makes someone else happy. The ultimate question is what fulfills you as a person? It's just amazing how different I feel and look now. I wish I would have made the choice to have a reduction years ago. I can't wait to get back into things like biking and tennis to really see the difference."