March 2009
Breast reduction surgeries on the rise
by Sophie Kerszberg
every augmentation. I think that’s been fair-
breasts were affecting virtually every aspect
“I would never get up in front of a group
ly consistent through my years of practice
of her life. She said she had difficulty
of people if I could help it, because I knew
More and more women suffer from debil-
since 1994.”
breathing due to the weight on her chest,
that everybody would be looking at and
itatingly large breasts, and more of them are
Margaret ,44, (who preferred that her real
and she was unable to lie down on her back
thinking about my chest,” she said. After
finding relief in breast reduction surgery.
name not be used) lives and works as graph-
for more than a few minutes because of the
her breast reduction, though, Margaret said
Nearly 106,000 breast reduction surgeries
ic designer in Centre County. She under-
weight. It was hard to walk, almost impos-
one woman told her, “I’m glad you got that
were performed in the United States in
went breast reduction surgery in 2007 after
sible to exercise and difficult to buy cloth-
done, because the first time I met you, I
2007, up 167 percent from almost 40,000 in
years of suffering and deliberation.
thought, ‘That poor girl.’”
1992, according to data published by the
Margaret said she had been big-chested
“I made my tailor rich,” she said.
“The best outcome of the surgery, even
American Society of Plastic Surgeons. In
since the sixth grade, when the size of her
Meanwhile, her bra straps dug painful
more than alleviating some of my medical
fact, breast reduction has become the fifth
breasts started making her physically and
grooves into her shoulders, and her neck
problems is that I feel way more comfort-
most-performed reconstructive cosmetic
psychologically “uncomfortable, extremely
was under constant strain from holding up
able in front of people,” she said.
uncomfortable.” Her breasts continued to
the weight in her chest. “I was in physical
Dr. Joseph Desantis, a plastic surgeon
grow after she gave birth to and breastfed
therapy for my neck problems,” she said,
Not just a cosmetic fix
who practices in State College and
each of her two children.
“but it didn’t make any sense because my
The physical problems associated with
Danville, said breast surgeries—reductions,
“I wish I had it done a long time ago,” she
neck wasn’t the real problem; my breasts
large breasts are serious, Desantis said.
augmentations, uplifts and reconstructions
said, although she added that she was glad
“There is a fairly consistent constellation
—are what he performs most often.
she waited until after she had children, as
She tried dieting to ease the strain. Even
of symptoms: back, neck and shoulder pain;
Desantis said there’s a high demand for
her breasts may have returned to their for-
after losing 50 pounds, however, Margaret
grooving from the bra straps and irritation
breast reduction surgery in this region of
mer size had she had the surgery prior to
said that her chest size remained the same.
becoming a mother.
In addition to her physical discomfort,
see Surgery , pg. 7
“I probably do three breast reductions for
Before her surgery, Margaret’s overlarge
Margaret felt very self-conscious.
State High project: Back where we started?
ect and tore the community apart.
by Suzan Erem
As board members and the public await
After six months of community meetings
the steering committee’s recommendations
and more than $270,000 spent on a consult-
due in March, Madore wondered aloud
ant to manage them, the State College Area
about where in the long-term plan the high
School Board is expected to face the same
school would land this time. If it comes
or higher price tag for a new high school
after several elementary school projects,
than before voters ousted more than half of
this board could be in the same position the
the board over the issue.
last one was in, except this time - due to
“It’s déjà vu all over again,” veteran
passage of the 2006 state law called Act 1
school board member Gowen Roper said
which requires a referendum for increasing
wryly to one reporter after hearing the
property taxes due to projects this size - it
will likely have to pass a referendum to
The results of those meetings and online
fund the project.
surveys will lead to a steering committee
“Before we put a spade in the earth,
recommendation to the school board this
before we borrow a dollar to start to do it,
month. Whether the high school will be on
that’s when we’ll have to go to the commu-
the current site or a new site, one school or
nity and say here’s a lot more specific detail
two or renovated or built new will be deter-
on what this high school project will look
mined by the school board vote in March,
like,” Madore said. “And given the addition-
explained School Board President Rick
al information then, that’s when we’ll have
the referendum.”
“DeJong has said it will be updatable,”
At the Feb. 23 meeting, board members
Photo by Wilda Stanfield
Madore said of the district wide master plan
were already expressing concerns about
State College Area School District residents record the data from conversations at their tables as oth-
to be adopted. “Maybe we’ll make a few
reaching consensus on the high school por-
ers look on during the February community dialogue. This was the last public input meeting before
relatively minor adjustments.”
tion of the plan. Some commented that it
the steering committee recommends a long-term plan for elementary schools and the high school.
But the devil is in the details, and the last
may require more meetings.
time around, those details plus the four
“To be honest with you, that’s my biggest
have to sell the referendum, and that is a
In the community dialogue held in mid-
years between adopting the plan and imple-
concern, that the community support will be
very difficult task.” Evans said she will not
menting the high school portion of it added
there for one option,” board member Lou
be running for office again in the upcoming
see State High , pg. 9
millions to the cost of the high school proj-
Ann Evans said in an interview. “We will
school board elections.

March 2009
undergo a breast reduction after she loses
“I was afraid when I saw a
from Surgery , pg. 6
some weight, after puberty and perhaps
video of how [the surgery]
after she has had children.
under the breasts either from skin on skin or
was done. That was a mis-
the bra strap rubbing,” he said. “That can
When is the right time?
take, because it kept me
progress to fungal infections and even open
Penn State sophomore and media studies
from having the surgery for
areas. The symptoms are not minor.”
major Niki (who also preferred we not use
Research suggests that large breasts could
her real name) has a different perspective.
contribute to long-term health problems as
Niki, who is now 20 years old, had a breast
well. A
2008 study published in the
reduction at age 16, when she and her moth-
Canadian Medical Association Journal
er agreed that her size “F” breasts were “not
showed that, even when adjusting for over-
worth the trouble,” she said. Like Margaret,
all body fat, larger breasts tend to mean a
“The Health Burden of Breast
her chest began giving her problems in sixth
higher risk of diabetes.
Hypertrophy,” Carolyn Kerrigan and other
grade. “My back hurt all the time, “she said,
And among women who are not over-
doctors described the outcome of a survey
“and I couldn’t just go pick out a bathing
weight or obese, a D bra cup size indicated
that compared the quality of life for women
suit at Target; I had to go to a specialty store
an increased risk of breast cancer when
with overly large breasts with a control
to buy bras and bathing suits.”
compared to similar women who wore an A
group of women with average-sized breasts.
Exacerbating the situation was the fact
cup size, according to the results of a 2005
For Margaret, breast reduction surgery
that she was on her high school’s swim
Harvard study published in the
took five hours.
team and had to spend a lot of time in swim-
International Journal of Cancer . Breast
“It’s not a difficult surgery to go through,”
suits. Unlike Margaret, though, Niki said,
cancer patients with larger breasts are also
she said. Doctors removed 12 pounds of
“It was not a self-image issue. I liked my
Photo by Suzan Erem
more likely to suffer from a more advanced
breast tissue and sewed her incisions with
cleavage and I sometimes liked the atten-
Dr. Joseph Desantis says he performs three
form of the cancer, according to another
about 400 stitches. For nine days she had
tion. But it was just such a burden.”
times as many breast reduction surgeries as
study reported in the journal International
drains in her sides for the wound seepage
breast augmentation surgeries in this region.
More than 6,300 teenage girls (and an
Seminars in Surgical Oncology .
resulting from the surgery. For the 10-week
alarming 16,400 teenage boys) had breast
Women with larger breasts are even at a
recovery period she reports she “couldn’t do
part of the surgery was deciding to go
reduction surgery done in 2007, according
greater risk for wound complications after
much” and had to sleep in a recliner to
through with it.
to the American Society of Plastic
heart surgery, according to a study pub-
avoid pain.
“I was afraid when I saw a video of how
Surgeons, though doctors like Desantis
lished in Archives of Surgery . In an article
Yet Margaret said that by far the hardest
it was done,” she said. “That was a mistake,
encourage teens to wait if possible, for the
because it kept me from having the surgery
same reasons Margaret believes her niece
for years.” The two factors that gave her the
should wait.
courage to have the surgery, she said, were
Niki was glad not to wait, though. With
the supportive online community she found
four pounds of breast tissue removed, Niki
at www.breastreduction4you.com and a sur-
said she now feels more proportional. A few
geon who was willing to talk to her about
of her friends joked that they wished she
the procedure for more than an hour each
could give them her breasts if she didn’t
time she visited his office.
want them, and some boys at her school
“I brought a tablet full of questions with
expressed shock that she would voluntarily
me to the doctor,” she said. “Then I came
reduce her breast size.
back with another tablet full of questions.”
She was also warned by her doctor that
Margaret’s 15-year-old niece is currently
she would have a two-thirds chance of not
going through the same physical and emo-
being able to breastfeed her children in the
tional distress Margaret did as a teenager,
also due to her breast size, Margaret said.
She said she would encourage her niece to
see Surgery , pg. 8
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State College Borough
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March 2009
breast size has been enlarging from genera-
tion to generation in the United Kingdom. A
from Surgery , pg. 7
In addition to obesity and genetics as causes for the increase
decade ago, the average bra size was 34B;
in breast size, xeno-estrogens in such products as plastics
today, the average is a 36C, the report said.
and pesticides are suspect.
“I’m okay with that,” she said. “Boobs
A popular retailer was cited as saying it
are overrated.”
sells twice the number of
Both women’s medical insurance covered
bras than it did even three years ago. In the
the costs of the procedure, which Desantis
Netherlands, a 2006 study found that 32
said costs about $6,000 in this region with-
percent of women wear a “D” cup, up from
valley village had larger developing breasts
of bovine somatotropin or BST, a growth
out insurance.
20 percent just 5 years earlier.
than those from the foothills. The
hormone present in small amounts in milk.
Desantis said he believes several factors
Over the past two decades, obesity rates
researchers took into account the weight,
rBST is injected into cows to increase milk
contribute to the substantial number of
have risen to include about a quarter of
height and genetic background of their sub-
production. Its use has become a con-
breast reduction surgeries.
Americans, according to the Centers for
jects, and diet and lifestyle in the two vil-
tentious practice as consumers worry about
“It probably has more to do with genetics
Disease Control and Prevention. Could
lages are similar. The only variable they
its potential health effects on humans who
than anything else,” he said of the populari-
breasts simply be expanding along with the
could point to was pesticide use.
consume cow milk and meat. If the hor-
ty of the surgery in this region of the coun-
rest of our bodies? Almost every study
Today’s population is exposed to more
mone affects bovine mammary glands, what
“I think breast hypertrophy has a big
examining breast size acknowledges that
xeno-estrogens than ever before, the Daily
might it do to humans? To date, the rBST
genetic component to it, [and] women are
obesity is one factor, but there may be oth-
Telegraph report noted. Xeno-estrogens are
factor doesn’t appear to be that significant.
more aware of the surgery.”
compounds chemically similar to estrogen,
A 2008 National Institutes of Health state-
In the Yaqui Valley of Sonora, Mexico, a
the hormone responsible for stimulating
ment asserts not only that digestion kills
Other possible causes
village literally split itself in two over the
breast growth. Found not only in pesticides
BST, but that human hormone receptors are
Another reason may be an increase in the
issue of pesticide use. The village that
but also in plastics and cosmetics, xeno-
unable to bind to it.
number of women whose breast size gives
stayed in the valley uses modern agricultur-
estrogens mimic the body’s naturally occur-
According to the same NIH report, how-
them medical problems. For that, some
al practices and exposes its residents to pes-
ring estrogen, and some scientists see them
ever, injection of rBST into cows increases
researchers are blaming everything from
ticides, while the farmers that moved into
as one of the culprits behind oversized
the presence of another growth hormone
weight gain to pesticides.
the foothills do not use pesticides. When
known as IGF-I, whose effects are undeter-
Breast size appears to be on the rise in
Elizabeth Guillette of the University of
Some activists point to artificial hor-
mined. NIH scientists called for further
other parts of the globe as well. According
Florida and her colleagues examined the
mones in milk as another suspect. Some
investigation into the long-term effects of
to a
2008 report in London’s Daily
breast development of pubescent girls in
consumer groups and dairy farmers have
BST and into how IGF-I might impact
Telegraph, British researchers found that
each village, they found that the girls from
raised the issue of rBST, a synthetic version
human health and development.
They don't
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March 2009
options by a Citizens Advisory Committee
lap in those figures because steering com-
came from the same computers, DeJong
from State High , pg. 6
appointed by the board and the architectur-
mittee, board members, staff and possibly
said. The results of the final survey were not
al firm hired to assist the district. The firm
some community members attended multi-
available at press time.
February, an estimated 350 people, includ-
included interior designers, mechanical and
ple meetings.
The last run at the high school issue had
ing the 45 members of the steering commit-
electrical engineers and site designers who
Community meetings, committee recom-
been grandfathered in before Act I passed
tee, listened to consultant William DeJong
met with approximately 50 district staff,
mendations, professional consultants, staff
and would not have required a referendum,
spell out seven options for a new high
administrators, maintenance workers,
interviews …If this entire process looks like
but this time, under a complicated formula,
school and various options for elementary
teachers and department heads, according
a do-over, that’s because it is.
board members say it is highly likely a ref-
schools. All but one of the high school
to district records.
“There’s a misconception that the process
erendum will be required.
options were priced over $100 million and
The CAC then held two community dia-
was not the same last time,” said district
Madore wouldn’t commit to when he
as high as
$129 million. DeJong said
logues that drew an estimated 150 people to
spokeswoman Julie Miller. “The processes
expected to have to face a referendum on
recently skyrocketing construction costs as
each. CAC members attended a two-day
were almost identical in terms of the master
the high school. It depends, he said, on the
well as the current recession make accurate
workshop and a series of evening meetings
planning process.” Miller said one differ-
priorities laid out by the steering committee
costs difficult to project.
related to the plans before presenting their
ence is her position, one person dedicated to
recommendation. Still, the possibility of the
The previous final (and only) bid on the
recommendation to the school board. The
public relations, a job that wasn’t filled until
community voting to go into debt for $100
project was $117 million, up from $80 mil-
district did not at the time have the technol-
just before the last school board election.
million-plus seems daunting when the very
lion before a year-long debate between the
ogy to develop Web-based surveys that
Another difference was the feedback. The
people who fought the last high school proj-
old school board and a group called State
DeJong is using this time.
district has spent almost $4,600 to advertise
ect, often citing the
$100 million figure,
High Vision began in 2005, and up from the
That recommendation, coming a number
the meetings.
will now be the very ones recommending it.
original soft estimate of $47 million in the
of years after the long-term plan had been
“As far as people taking the opportunity
Madore said the board will have a lot of
long-term district-wide facilities plan from
established, and costing tens of millions of
to provide input, I would say that is not
work to do with the community before it
2000. That bid was voted down unanimous-
dollars over the original figure, created a
something that happened,” she said.
comes to that point.
stir that turned into an uproar that eventual-
Feedback is also considerably easier now
“I don’t think you should ever ask a girl
But at the meeting Feb. 13, the question
ly unseated five school board members in
because of technology. A Web survey avail-
to marry you unless you already know what
was not, “Can we afford it?” but, “Which do
the last election.
able after the two dialogs netted approxi-
the answer is going to be,” said Madore. “If
you prefer?” Residents, some first-timers
By the time the high school debate was
1,300 responses. DeJong encour-
you do anything other than that, you’re tak-
and some familiar faces, discussed, debated
over and the board reconstituted, the district
aged attendees at the February meeting not
ing a huge chance. Before I put a referen-
and questioned the options in small groups,
had spent $5.1 million on architecture and
to go to the Web the next day to do the sur-
dum out for the public to vote on, I want to
jotting down responses and later recording
engineering, building and site construction
vey. Of the 900-plus Web surveys they had
be as darned sure that that referendum is
those on flipchart paper on the wall.
fees, on a project that was almost ready to
received from the last dialog, only eight
going to be accepted by the public.”
“We’re not supporting any option that
start, according to district spokesperson
doesn’t meet ed specs!” said one woman
Julie Miller.
New school board members and their
“I’m not exactly sure what ed specs are
supporters promised transparency, so while
and how important they are,” one man at
CAC meetings are not required to be open
another table said. That sentiment was
to the public, the new board opened them.
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echoed at a number of tables.
Then it spent $276,000 to hire DeJong, no
Madore admitted later that it became evi-
stranger to the district
(his firm assisted
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State College in its elementary school con-
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vivial while steering committee members
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In 2000, the long-term facilities planning
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March 2009
Couple brings ballroom dancing to neophytes
by Maggie O’Keefe
such a schedule.
In truth, Carter and Ruby look like they
On a chilly Tuesday night in February at
could dance every night of the week. Both
the Panorama Elementary School in State
70-year-olds are fit and graceful, and they
College, the hot sounds of upbeat Latin
dance with a youthful energy.
music echoed in the gymnasium. Cutting
Carter’s passion for dancing started in
through the infectious beats was the voice
1950. When he was 12 years old, he spent a
of Carter Ackerman, giving instructions on
summer at his uncle’s farm in Minnesota. He
how to dance the cha cha.
decided to attend a square dance held each
“Now we will go over the chase,” Carter
week in town but after seeing the dancing, he
said, his voice amplified by a headset
realized he didn’t know the steps. He then
microphone. “The chase is nothing more
read about square dancing in books and went
than a forward and back.” Then Carter and
back the next week, prepared to dance along.
his wife Ruby showed the dancers how to
Carter kept dancing, and when he met
do the step.
Ruby, a high school classmate, in 1958, he
The Ackermans teach an introductory
found his life-long dance partner.
course in ballroom dance, sponsored by
Two years later, the Ackermans moved to
State College Parks and Recreation, to
State College and joined the State College
60 couples a week. The couple
Parks and Recreation ballroom dance class.
Photo by Suzan Erem
teaches such classics as the waltz, the cha
Carter and Ruby Ackerman illustrate the “New Yorker” in the Panorama Elementary School gymnasi-
During their third year of participating in
um where they teach ballroom dance Tuesday nights.
cha, the foxtrot, the rumba, the tango and
the class, the dance caller quit; Carter
swing dancing.
picked up the microphone with the intention
The skill level varies from couple to cou-
your headline,” said a friend at the post-
“It is a nice diversion and really good for
of substituting until they hired another
ple. Some couples follow Carter and Ruby
class dinner, a request that provoked
us because I have a very busy schedule with
step for step, while other couples dance to
applause from the entire table of dancers.
classes and homework,” said Dave Cramer,
He’s been substituting for 46 years.
their own beat, enjoying the music and each
Carter and Ruby Ackerman offer their
25-year-old law student at Penn State
Carter and Ruby have made teaching and
other’s company.
weekly dance classes, which they call “the
taking dance classes a major part of their
“It’s something to do together; make that
perfect exercise,” through June.
“Yeah, it’s a cheap night out!” said his
lives. They take yearly dance classes from
wife, Ashley Cramer, 24.
dancing institutes to keep up with the mod-
The Ackermans dance all week long,
ern styles, and they teach for a simple reason.
teaching square dancing on Mondays and
“We started teaching because people
introductory ballroom dance on Tuesdays,
wanted to learn,” Ruby said.
participating in a square dancing club on
Several couples who take the ballroom
Wednesdays and teaching an advanced
dancing course agreed that it was a “cheap
round dance class on Thursdays; Friday and
date” that brought them to the class each
Saturday nights are spent dancing or enjoy-
week. At $2.50 per person or $5 per couple,
ing community activities.
with no week-to-week commitment to
“We don’t usually go to bed until 2 a.m.
attend, the cost of the course is an entertain-
most nights,” Carter said over the ritual
ment bargain.
after-Tuesday-class dinner at Home
Couples also come for the sheer joy of
Delivery Pizza Pub.
“Can you imagine these two old folks
“It’s the highlight of the week for us,”
dancing seven days a week?” said a friend
said one woman spoke to Ruby during a
and dancing student, laughing at the idea of
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