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Paper short abstract

Why do women choose breast reduction in a culture that celebrates enhancement? Drawing on ethnographic research in Zhejiang, China, this paper explores how health, stigma, gender identity, and medical authority shape women’s decisions to make their breasts smaller as a form of bodily agency.

Paper long abstract

In global aesthetic cultures, breast surgery is often associated with enlargement and enhancement, reflecting dominant ideals of femininity, desirability, and bodily abundance. This paper shifts attention to a less examined practice, breast reduction surgery among women in contemporary China.

Based on ethnographic fieldwork conducted in Zhejiang province, a regional hub for public plastic surgery departments and private cosmetic clinics, this study draws on interviews with women seeking breast reduction and with surgeons practicing in different institutional settings. Rather than pursuing a singular aesthetic ideal, these women articulate diverse and sometimes conflicting motivations for reducing their breasts. Some seek surgical lifting and reduction after breastfeeding, framing the operation as a restoration of bodily order and dignity. Others describe long-term experiences of stigma, sexualization, and verbal harassment associated with large breasts since adolescence. For patients diagnosed with macromastia, breast reduction is understood primarily as a therapeutic intervention addressing pain, mobility, and physical burden. Additionally, lesbian and gender nonconforming women frame breast reduction as a means of aligning their bodies with a more androgynous or neutral gender presentation, resisting heteronormative expectations embedded in mainstream beauty culture.

By foregrounding these narratives, the paper argues that breast reduction constitutes a polarized form of body modification, positioned against dominant logics of enhancement while remaining embedded in medical, aesthetic, and moral regimes. Choosing to make the body smaller becomes a way of reclaiming bodily control, negotiating health and identity, and reworking gendered norms within China’s expanding cosmetic surgery industry.