Yoga teacher Echo Elliott’s Instagram profile is exactly what you might expect it to be, at first glance at least. Mostly, it’s photos and videos of the athletic 28-year-old in advanced yoga poses – leg-behind-head while doing a headstand, or an improbable looking backbend while balancing upside-down on her forearms. Sometimes on a sunset dappled beach. That sort of thing.
Perhaps more unusually, in recent months she’s been charting her recovery from major surgery: she underwent a breast reduction in August.
About 10,000 women undergo such an op each year. It’s a serious undertaking, involving removal of tissue and reconstruction of the breast, which leaves considerable scarring. It’s usually carried out to reduce the debilitating back pain caused by disproportionately large breasts, which was at least part of the reason for Echo.
What makes her case remarkable, though, is that it’s not the first time she’s been through the procedure. Just to be clear, it’s her second breast reduction.
Yoga teacher Echo Elliott has twice gone from a 30KK to a D cup
Echo, from Birmingham, underwent her first aged 21. The reason she had to have another is because her breasts ‘grew back’ in the intervening years.
The first reduction took her 30KK bust – extremely heavy for her very slim 5ft 7in frame – down to a D cup. The result was ‘life-changing’, she says, freeing her from both physical discomfort and the gaze of men – and women – whose constant comments on her figure left her feeling excruciatingly self-conscious.
She threw herself into becoming a yoga teacher – yet within a few years she noticed her bust was growing. By the time of her second op, Echo says they were ‘bigger than ever.’ A second round of surgery has, once again, freed her.
Echo has made the decision to share her deeply personal story in order to highlight just how beneficial breast reduction surgery can be – but also to let women know that it might, in rare instances, not be a ‘one-and-done’ op.
‘I want to shed light on the difficulties that women with very big breasts face,’ she explains. ‘I have students who have big boobs and are considering a reduction. I hope they see what a good thing surgery has been for me. To wake up every day and not be in agony, it’s magic. But I’m terrified they might grow back again.’
Her case, also, may be something of a medical anomaly. After our interview I discussed Echo’s case with leading breast surgeons and senior hormone doctors. None had seen a similar patient.
All, however, agreed that there were genetic and hormonal explanations as to why such a thing might happen.
Echo, who grew up in Leicester, says that physically she was ‘a bit behind the other girls at school’ adding: ‘I got bullied for being flat chested.
‘But I developed quickly at the age of 14 or 15 and then ended up getting lots of sexual comments from boys at school. And because I was curvy I looked older than I was, so I had a lot of attention from older men too.
‘I was constantly aware of people looking at me, so I wore a big, black hoodie which I’ve only just thrown away. I lost all my confidence.’
Echo’s unhappiness with her body led her to try to slim down in the hope it would reduce her bust.
‘I just wanted them gone,’ she says. ‘I was running and going to the gym a lot. I thought if I didn’t eat and exercised a lot I could lose weight and it would come off my boobs, but it never did.’
Aged 20 and living in Birmingham, Echo visited her GP to discuss a breast reduction after suffering from back and shoulder pain.
‘It was like a constantly dragging sensation between my shoulder-blades,’ she says. ‘It felt like my head was being pulled down. I would get headaches and pain through my neck. During my period, my breasts would get bigger and the pain would get worse.’
Her feelings of self-consciousness had also intensified. ‘I didn’t like leaving the house, and I didn’t want to draw attention to myself. People just saw my boobs first. But because of the attention I began to feel like they were the only attractive thing about me. It messed with my self-esteem a lot.’
Echo’s GP referred her to an NHS plastic surgeon who agreed to operate. ‘The surgeon was lovely, and agreed that they were too big for my frame,’ she recalls. ‘If I could have, I’d have gone completely flat – I just wanted them gone – but he dissuaded me.’
Breast are made up of fat, glandular tissue – which makes breast milk – veins, arteries and connective tissue which holds everything in place.
Echo, pictured before her second breast reduction surgery, went to Lithuania for the operation
Post-second operation, Echo believes she has returned to a D cup
A breast reduction, also called a reduction mammaplasty, involves removing a section from the underside of the breast. The nipple is also moved to a higher position.
There is, say experts, an art to the operation. Remove too little and the purpose of the operation, to alleviate the discomfort of very large breasts, is defeated. Remove too much, however, and the risk of serious complications – such as compromising the blood supply to the nipple, which can lead to deformity or losing it entirely – increases.
‘In the end he told me he would aim to take me to a C cup, which I was happy with,’ says Echo.
But after waiting a year, just a week before the operation was due it was cancelled.
‘I just cried. I was heartbroken,’ she says. ‘I immediately looked for a private surgeon.’
The operation lasted six hours and recovery was difficult, she says.
‘There was a lot of bandaging and I couldn’t lift my arms for weeks. I was in hospital for a few days and then stayed on the sofa.
‘I was staying with my partner at the time. If we drove anywhere, any bump in the road would be painful.
‘I also suffered problems with one of my nipples, which meant a lot of back and forth to the hospital.
‘When the swelling went down, I was a D cup, not a C, but it felt tiny. It was life-changing.
‘They didn’t make KK cup bras in a width small enough for me, so before the op I had a larger size which didn’t support me properly. Afterwards I could buy a bra without loads of support and it would just fit. I felt free.
‘I’d been doing yoga since my early teens but really began exploring movements that would help recovery and sort out my shoulders. It was amazing being able to move in a different way – there was a new lightness to everything.
‘I didn’t think it was possible for me to do things such as headstands and handstands, but after that first surgery it became an option.’
Four years ago, when Echo was 24, she noticed her breasts were growing again, and the headaches and joint pain returned.
‘My weight hadn’t changed, and my lifestyle was the same,’ she says. ‘But they just began to feel bigger.
‘I also started to get terrible breast pain during my period. I had to cancel work because my boobs were hurting me, but even walking became uncomfortable.’ The ‘looks’ began again, she adds.
I didn’t think it was possible for me to do things such as headstands and handstands, but after that first surgery it became an option, says Echo
By 2021, Echo believes her breasts had returned to their old size. ‘If anything, they felt even bigger and heavier. My back ached and I began hiding in the black hoodie again.’
She booked her second operation last year.
‘A client had come to see me and told me she’d had a reduction,’ she says.
‘She showed me her scars and they were so faint compared to mine. I took her surgeon’s details because I needed to do something – it felt like my breasts were holding me back again.’
This time Echo went to Lithuania for the operation. Her bust has once again been reduced to a D cup, and Echo is, again, delighted. She decided to start posting on Instagram during her recovery, while still in her hotel room in Lithuania.
‘I couldn’t pretend that nothing had happened – I have about 150 students on some days and they’d see I looked different. I also knew some of the women in my class were going through similar things, and I wanted to share information with them.
‘Since the surgery, and talking about how my breasts made me feel, women have apologised to me as they’d judged me because of how I looked.
‘People make assumptions, they sexualise you if you have bigger boobs.’
If she finds this sort of attention unwelcome, why does she post swimsuit pictures on her Instagram page, I ask.
‘No one would bat an eyelid if I had smaller boobs,’ she counters. ‘But if you have bigger breasts, suddenly you’re seeking the wrong kind of attention if you post a picture like that. I was fighting this internal battle, trying to be happy with my body and also feeling like I needed to hide it.
‘Now I just want to normalise the fact that thousands of women have this surgery.
‘One of my big worries was that I wouldn’t be seen as attractive after a reduction, or that men would dislike my scars, but that’s not the case. I’m not ashamed of what I’ve been through and I don’t want it hide it.’
She admits that she’s not sought a medical explanation as to why her breasts regrew. But consultant plastic and reconstructive surgeon Rieka Taghizadeh, based at St Helens and Knowsley Teaching Hospitals NHS Trust, told me: ‘A case like this is as rare as you can get.
‘It is likely the glandular breast tissue that remained after the first operation grew in size, but it’s difficult to speculate about why. Pregnancy, weight gain and menopause also affect hormone levels and, as a result, cause breast growth, but none of these things apply in this case.
‘One reason could be that a woman, for genetic reasons, has very hormone-sensitive breast tissue – I have seen this in younger patients who have had reductions and then experienced some regrowth. Nothing to this degree, but it can happen.’
Considering the possibility her breasts might continue to grow, Echo says: ‘This time, the surgery has been like a rebirth. I’ve started to have therapy – I’m trying to figure out the person I can be, without being «Echo with the big boobs», which was a sort of affectionate nickname.’
I suggest language like this, as light-hearted as it might be, has a corrosive effect. Echo agrees. ‘You wouldn’t talk about any other body part so openly. I have big hair, too, but I wasn’t «Echo with the big hair». You wouldn’t go to someone flat-chested and comment on that.
‘I’d consider surgery if they became too big again. If it happens, there’s no point getting angry. But I’m also hoping, as I get older, I can make friends with my breasts a bit more.’
