It is not just breast enhancement women in the west opt for. With increasing obesity, women seem to eye breast reduction surgery as a way of becoming more comfortable.
Large breasts may seem like an asset to some, but for those who have them, they can cause a lot of discomfort and hence such do opt for breast reduction.
According to the Canadian Institute for Health Information, 5,181 women had breast reduction surgery in 2006 at in-patient facilities in Canada.
The procedure, technically known as reduction mammoplasty, involves removing fat from the breast to make it smaller, more firm and lighter.
"Breast reduction is a very common operation for plastic surgeons around the world," says Dr. Nasim Huq, a Niagara Falls, Ontorio-based doctor who has performed the procedure on more than 80 women. "With the increased prevalence of obesity, people are a little heavier. The surgery has become more safe and more popular."
Tatum Rusak, a 30-year-old mother of two and owner of a home-based business, says the procedure appealed to her because she had trouble wearing nice clothes and finding bras to fit her 38H breasts.
"I had to go to specialty stores to find bras, they all cost over $100 — it was crazy to have to spend that much," she says. "They would only last a few weeks and would then be garbage - they just don't support that big a breast."
The procedure typically takes about two hours, and is performed under general anesthetic.
The most common way of performing breast reduction surgery is the "Inverted T," where one incision travels along the bottom of the breast, and another goes upward to the nipple.
For smaller breasts, only a vertical incision is used, with no transverse cut along the breast. This technique is often used with liposuction, but is more difficult to do when a larger volume of the breast needs to be removed, says Dr. Huq.
The downside of the operation can include issues such as scarring and possible reactions to anesthetic, which can happen with any operation, writes Kim Edwards for CBC News.
Having adequate support before and after the operation helps women to deal with its emotional and physical after-effects.
"Before the surgery I had some friends who went through it and coached me. I relied a lot on that. After the surgery, my mother took the kids for one week so that I can just relax and take care of myself. My surgery was on a Friday so my husband was home for two days with me ... mostly just reaching for things and lifting things and just helping me around the house .... After that I was home by myself. I was fine," says Sandra.
Rusak is pleased with the results of her breast reduction, but she experienced complications following the surgery. Her husband took her to the emergency room, who then referred her to the plastic surgeon who performed the procedure.
"The incisions opened up, where the T meets," she says. "There was a triangle under each breast that was opened, that was bleeding, yucky and painful. I went to [the plastic surgeon] the next day. They said it is fairly normal."
The recovery time is also something women considering the procedure should take into account. Most people are back to their jobs (if they are desk jobs) within two weeks, but they are not able to do heavy lifting for four to six weeks after the procedure.
Some women who have had the procedure have trouble breastfeeding. Dr. Huq recommends that women do the surgery after having and breastfeeding their children, if they wish to breastfeed rather than bottle-feed.
"It depends on the techniques that are used. The traditional ways of doing the surgery usually cuts your breastfeeding ability in half," says Dr. Huq.
"I'm not embarrassed to be out in public. I don't feel bad when people look at me. I'm more confident in myself," says Holland about her experiences after the procedure.
Most women are pleased with the results of the procedure and the decrease in discomfort. Dr. Huq says he has a 95- to 97-per-cent satisfaction rate for breast reductions.
"I would recommend the surgery to anybody," says Rusak. "I love it, it is absolutely the best thing that I have ever done."