Amazonlar (makale)

SPECIAL TOPIC

The Amazons and an Analysis of Breast

Mutilation from a Plastic Surgeon’s Perspective

Ahmet Karacalar, M.D.

Background: The Amazon philosophy has been increasing in popularity because

of the evolving status of women in society. Many references point to

Themiscrya on the southern coast of the Black Sea in Anatolia as the Amazon

homeland. The primary objective of this article is to discuss the different femininity

of the Amazons and their breast mutilation from the perspective of a

plastic surgeon who has been living in this region that the Amazons inhabited.

Methods: Findings from archaeology, linguistics, anthropology, medicine, history,

psychology, and the fine arts were integrated.

Results: The hypotheses that have been proposed to explain the method of

breast mutilation include amputation, cauterization, breast searing, and breast

pinching. It is generally believed that the primary purpose was to facilitate the

efficient use of a bow. Another explanation would be that breast mutilation was

performed for medical reasons, including the prevention of breast pain, the

development of a tender lump, or cancer. There is another school of thought

on this involving religious and sociological reasons that breast mutilation was a

badge of honor for warrior women and a sign that a woman had become a real

warrior and a sacrifice to Artemis as a sign of service.

Conclusions: Much indirect proof and archaeological evidence point to their

historical existence. The Amazons, who lived in an autonomous and original

social model, changed their image and function to suit the needs of the society

and the times. (Plast. Reconstr. Surg. 119: 810, 2007.)

The Amazons, a race of dominant warrior

women in the bronze age, were mentioned

by many ancient famous, infamous, and

obscure historians. The Amazons first emerge

into literature in two epics about the Trojan War,

The Iliad of Homer1 and a lesser known poem,

The Aethiopis, attributed to Arctinus of Miletus.2

There are differing views as to how many nations

of Amazons there were. Many references,

including Herodotos,3 Diodorus,4 Apollonius,5

Justinus,6 Virgil,7 and Strabo,8 point to Themiscrya

as the Amazon homeland, which is located

in the Black Sea region of the Anatolian peninsula

of modern day Turkey. (The list of ancient

authors is not limited to those we have selected

for quotation; one may also draw from the works

of Pliny, Aeschylus, Stephanos, Hesiod, Lysias,

and Pausanias.) From this center, they made

numerous warlike excursions to various regions

that made the geography of the Amazons rather

complex. Kugler9 reported that the Amazons appeared

on the Ebstorf Map (thirteenth century)

northeast of Troia (Fig. 1).

The Amazons supposedly removed one breast

to use the bow more effectively. Interestingly, no

medical explanation has been hypothesized in

any reports accounting for this tradition. In

1962, Schechter10 from the University of Colorado

School of Medicine reported some known

historical proofs of breast mutilation without

making commentaries on the mutilation procedure.

It is noteworthy that the word Amazon

entered plastic surgery literature in 1977. Mu¨hlbauer

and Wangerin11 proposed the Amazon

syndrome for female patients with Poland’s syndrome

associated with ipsilateral hypoplasia or

aplasia of the breast.

The author of this article, who has been living

in the area formerly inhabited by the Amazons,

attempted to view the Amazons from a plastic

surgeon’s perspective and to highlight some of

the prominent, or simply the known, facts and

thoughts connected with them. In view of their

different femininity and breast mutilation, there

is a link between the Amazons and the broad

From the Department of Plastic and Reconstructive Surgery,

Ondokuz Mayıs University.

Received for publication November 24, 2004; accepted February

16, 2005.

Copyright ©2007 by the American Society of Plastic Surgeons

DOI: 10.1097/01.prs.0000240816.99127.f3

810 www.PRSJournal.com

interdisciplinary nature of our distinguished speciality.

Because of the extreme complexity of the

subject, this article, which includes integrated

findings from archaeology, linguistics, anthropology,

medicine, history, psychology, and fine

arts, was confined chiefly to breast mutilation

with general information on the Amazons.

AMAZONS AND MYTHOLOGY

The corpus of myths may be taken to display

some type of internal logic.12 Therefore, we should

mention several myths related to the Amazons,

because the Amazon reality is situated at the intersection

of history and mythology. The myth of

Theseus of Athens tells of the Amazons invading

Attica to take back their queen. The myth of the

labors of Herakles is the most important and interesting

one relating to the Amazons. Herakles,

the greatest of all the Greek heroes, performed his

famous 12 labors at the command of Eurystheus,

king of Argos or Mycenae. In one of his labors, he

was sent off to the shores of the Black Sea to fetch

the girdle of the queen of the Amazons.13

ETYMOLOGY OF THE WORD AMAZON

AND BREAST MUTILATION

Although the precise meaning of the word

Amazon is not clear, there is a popular belief that

the word is derived from the word amazoi,meaning

without breast. This folk etymology was supported

by the folktale that the Amazons sacrificed their

right breast. The hypotheses that have been proposed

to explain the method of breast mutilation

include amputation, cauterization, breast searing,

and breast pinching.4,6,14–18

Hippocrates15 discussed the mutilation procedure

of the Amazons, writing that mothers cauterized

their daughters’ right breast region before

puberty so that it would not later develop. Plastic

surgeons are quite knowledgeable about how thermal

burns to the breast interfere with normal

breast development by damaging the pliable skin

and breast bud.

According to Hippocrates,15 all the strength

and fullness are transferred to the right shoulder

and arm. His explanation parallels the traditions

of the Yahuna and the Xingfi in northwest Brazil,

who are in the habit of scarifying themselves to

strengthen their muscles.19 Alfred Adler’s idea of

“organ inferiority” further supports Hippocrates’

theory. Simply stated, he postulates that when

there was a biological weakness in an organ, compensation

may take place on the physical level by

striving to attain a homeostatic balance.20

According to Strabo,8 the right breasts of the

Amazons were seared when they were infants so

that they could easily use their right arm for every

needed purpose, and especially that of the javelin;

they also used the bow, sagaris, and light shield.

According to Diodorus,4 the Amazons seared the

right breast of girls so that it might not project and

be in the way when their bodies matured; it is for

this reason that the nation of the Amazons received

the appellation it bears. In Anabasis of Alexander,

Arrian21 reports an unambiguous story of

the hundred female warriors, alleged to be Amazons,

who were introduced to the king in Media by

the satrap Atropates. It is said that their right

breasts were smaller and were uncovered in battle.

This report supports the theory of breast hypoplasia

caused by binding or pinching. Body deformation

by binding has been a bodily mutilation

throughout history.22 Hypothetically, strenuous

activities could have caused small breasts. Jansen

et al.23 evaluated two cases of breast hypoplasia

that developed after traumatic injury to the breast

bud while the body was under increased physical

stress. Theintz et al.24 tested the theory that intense

physical training could inhibit the hypothalamicpituitary-

gonadal axis of female athletes. General

depression of this axis influences early breast development

before menarche.

Some people disagree with the theory of selfmastectomy

and claim that the Amazons would

not have had the medical knowledge to manage

the inevitable massive hemorrhage or infection if

such ablation of the breast actually occurred. Am-

Fig. 1. A feminine Amazon figure appears in the northeast of

Troia (Ebstorf Map, E. Sommerbrodt, 1891).

Volume 119, Number 3 • Amazons and Breast Mutilation

811

putation of the breast followed by cauterization

could have been performed with instruments specifically

designed for this purpose. Throughout

history, mutilating surgery of breast cancer has

been performed without anesthesia.25 It is known

that surgeons of the sixteenth and seventeenth

centuries, including Tabor and Heister, devised

instruments that facilitated rapid amputation of

the breast.26

It is generally believed that the primary purpose

was to facilitate shooting with the bow, during

which the breast might get in the way. Obviously,

a chest somewhat similar to a man’s chest allows

accuracy in releasing the bow, which is the most

critical step in the sequence. We might question

why they did not remove both breasts. The removal

of both breasts would have allowed the

women to be more skilled and precise when working

with a bow. According to Apollorodorus,14 the

Amazons kept their left breasts for nursing.

Some people think that the belief that the

Amazons mutilated one breast makes little sense

in light of today’s two-breasted female archers. In

fact, today’s sportswomen, including female archers,

are usually small-breasted because athletic

activities are hampered by heavy breasts. In archery,

a chest guard is used to prevent or minimize

the risk of injury to the breast.

Based on the clinical facts, we can say that it

may be much more difficult for a woman with

heavy breasts to use a bow despite a chest guard.

Letterman and Schurter27 reported that heavy

breasts change the center of gravity by increasing

cervical lordosis, intensifying tension on the extensor

muscles of the neck and thoracis kyphosis.

Another explanation would be that breast mutilation

was performed for the prevention of breast

pain. There is scientific evidence to support this

speculative theory. Physical exercise causes the

breasts to move up and down and side to side. This

large displacement of the breasts often leads to

breast pain.28 Breast motion is difficult to reduce

because the female breast does not contain strong

intrinsic structural support. Many athletes complain

of breast pain while running or engaging in

other high-impact exercises, especially during premenstrual

days.29 Another common breast complaint

is irritation of the nipples from repetitive

friction against clothing during running.30

The postovulation period can contribute to the

mechanism causing breast pain. Shooting an arrow

would have been very painful if the bow had caught

the tender breast in the postovulation period.

Of interest is Murray’s statement in his book31

that the prolonged repetition of pressure from the

bowstring can lead to the formation of a lump

within the fatty tissue, which is clinically difficult to

distinguish from cancer tissue. Chronic trauma

and irritation would remain applicable as a possible

cause for cancer, although there is no strong

medical evidence to support claims that chronic

trauma to the breast can result in cancer. The

history of breast trauma has been associated with

an increased risk for breast cancer in men.32 Breast

trauma causes benign breast lesions that are associated

with an increased risk of developing breast

cancer.33

All this leads us to question whether the Amazons

performed prophylactic mastectomy to prevent

the development of a tender lump or cancer.

Cancer has been with us since prehistoric times.

The earliest medical record concerned with tumors

of the breast is the ancient Edwin Smith Surgical

Papyrus (3000 to 2500 BC).34

With a longbow draw, the left breast of righthanded

female archers is in the firing line. Therefore,

right-handed female archers today use a

leather restraint to keep their left breast clear of

the bowstring. This fact contradicts the hypothesis

that the mutilation of the right breast was performed

to facilitate shooting with the bow. With a

short, composite reflex bow fired from horseback,

the draw is short and across the body.35 This may

explain why the Amazons sacrificed the right

breast.

Based on the available data, it would not be

unreasonable to think that they were left-handed

archers. Sassanian archers were capable of shooting

to both sides.36 There is a possibility that the

Assyrian archers may have been left-handed.37

However, this theory contradicts the eye-dominance

theory in modern archery that if you are

right-eye-dominant, then you should be a righthanded

archer (a person may be right-handed but

left-eye-dominant, or vice versa).31 The reason behind

this is to align the dominant eye over the

arrow for aiming. Claude Serre,38 a famous French

cartoonist, depicted a female archer, with devastating

humor (Fig. 2). The left breast of the woman,

who is not dressed as an archer, gets in the way of

pulling the bowstring. It seems that the mutilation

of the right breast cannot be explained by simple

practical reasons, suggesting that a more complex

explanation must exist. Because of her role as a

fertility goddess, Artemis was sometimes depicted

as having many breasts, as in marble statues of the

second century AD from Ephesus (Figs. 3 and 4).39

The Ephesus Artemis statue was supposedly

placed by the Queen of the Amazons. Some scholars

have suggested that they sacrificed one breast

Plastic and Reconstructive Surgery • March 2007

812

to Artemis, the Goddess they worshipped. Slater40

conjectured that women who devoted themselves

to goddesses at the time of the Greeks cut off one

or both breasts to present their bodily parts to the

deities as a sign of service. Artemis and Cybele

(Fig. 5) seem to have incorporated the same or a

similar metaphor of a feminized nature.41,42

Taylor35 reported that breast mutilation has a symbolic

meaning that represents women who were

half men.

When we judge this behavior with respect to

today’s modern culture, the Amazons’ denial of

femininity to increase their effectiveness in battle

seems to be a barbaric custom. This is really no

more peculiar, or at least no more wrong, than

foot-binding, teeth sharpening, genital mutilation,

intentional scarring and cranial deformation,

inserting large disks in the lip, or giraffe

women. Removal of both nipples of both breasts

for religious reasons by the Skoptsy has also been

reported.43 From a sociological perspective, in the

Amazons’ purely feminine society, breast mutilation

may have been interpreted as a badge of

honor for warrior women and a sign that a woman

had become a real warrior. The image of the onebreasted

woman might have been a psychological

projection of the fear that a woman with the power

to nurture might arbitrarily withhold such privi-

Fig. 3. Ephesus Artemis. This colossal Artemis statue is covered

with multiple breasts, symbolizing fertility(EphesusMuseum,AD

200).

Fig. 4. Artemis the Fair. This statue is similar to the colossal Artemis.

The upper torso is covered with multiple breasts, symbolizing

fertility (Ephesus Museum, AD 200).

Fig. 2. Note the left breast of the woman in the way of pulling

the bowstring (Claude Serre).

Volume 119, Number 3 • Amazons and Breast Mutilation

813

leges, as reflected in a mutilated one-breasted

biology.44 Revisionist thinking is also evident in

Raber’s article.45 The bared, or in some versions

amputated, breast of the classic Amazon signifies

the rejection of the sexualized femininity expected

of women in favor of masculine, violent

pursuits. In Greco-Roman mythology, the monstrosity

of Medusa and the mutilation of the Amazons

are representations of the threat that a

woman represents for a man in her double condition

of mother/object of desire.46 Some ancient

authors pinpointed Medusa as queen of a tribe of

Amazons called Gorgons (Fig. 6).47

It has been reported that patients with mastectomy

have high scores for mutilation anxiety or

mutilation-related psychiatric symptoms.48 Psychiatrists

sometimes speak of a penis– breast equation.

Mastectomy has the same catastrophic degenderizing

effect for a woman as amputation of

the penis has for a man.49 This brings to mind a

Freudian theory related to the Oedipus complex

and including the benefits of castration fear. According

to this theory, girls can never develop a

strong superego because they do not experience

castration fear. Thus arises the unfortunate fact of

the woman’s weak moral nature.50

What accounts for this complex, maladaptive

behavior is unknown. As stated by Scupin and

DeCorse,51 human behavior is always extremely

complex, and sorting out the causes and effects of

human activity is always difficult. This asymmetric

mutilation reminds me of Dagobert Frey’s words,

which are a replica of the shining original of Plotinus:

“asymmetry signifies motion, loosening, arbitrariness,

accident, life, play, and freedom.”52

AMAZONS IN ART

An indirect proof of the existence of breast

mutilation may be obtained by examining Greek

art, because the Amazonomachy was a very popular

theme among Greek artists. Based on a thor-

Fig. 5. Mother Goddess figurine (6000 to 7000 BC, Anatolian Civilizations Museum, Turkey).

Fig. 6. Apollon Temple head of Medusa, whose snaky locks and

monstrous facewerebelieved to turnmento stone if they looked

at her. She represents the Amazonian male-terrifying power

(Istanbul Archaeological Museum, Turkey).

Plastic and Reconstructive Surgery • March 2007

814

ough analysis of the Attic black figure work, red

figure vase painting, and sculpture, we identified

extremely feminine Amazons, with intact, high

conical, and perfectly symmetrical breasts (Fig. 7);

Amazons with the bare right breast and another

breast visible under their clothing (Fig. 8), Amazons

with their left breasts larger than their right;

Amazons with no apparent breasts; Amazons with

circular marks where the breasts should have appeared;

Amazons with their breasts covered with a

design of little spirals; and single-breasted Amazons

depicted with the right breast bare and another

missing or aplastic breast covered.

Allegedly, Amazons sacrificed their right

breasts. However, there is no representation showing

a mutilated right breast. On the contrary, a

hypoplastic or aplastic left breast can be seen beneath

the Amazons’ clothes in Greek art. Some

modern writers have pointed out these sources as

evidence to maintain that the Amazons were not

mutilated. Obviously, these Amazon images reflect

the fantasies of Greek artists. Therefore, they

may not be accurate depictions of real Amazons

and should be treated separately from the written

sources as a poor guide to scientific insight. Figure

9 is a noteworthy example; a Roman sarcophagus

in the Konya archaeology museum in Turkey. In

this representation, there is some sign of a mutilated

left breast.

AMAZON FEMININITY

Amazon femininity has inspired many writers.

An important focus is placed on Penthesilea’s

beauty. Quintis53 writes that “about her face there

was a beauty at once terrible and splendid.” It is

reported that Achilles killed her with a spear above

her right breast. Quintis notes her exquisite

Fig. 7. Wounded Amazon, 400 BC. Between her two naked

breasts, the belted dress is drawn up over the right shoulder

(Ephesus Museum, Turkey).

Fig. 8. Frieze from the temple of Hadrian. Four blocks form the

frieze. In block B, the Amazons are fleeing from Hercules (AD 300

to 400; Ephesus Museum, Turkey).

Fig. 9. Roman sarcophagus from the museum in Konya, Turkey,

depicting HerculesandanAmazonwarrior, from the second century

AD. There is some sign of breast mutilation. The Amazon

warrior does not wear any metal or leather clothing that flattens

the breast.

Volume 119, Number 3 • Amazons and Breast Mutilation

815

beauty even in death: “Though she had fallen in

dust and blood, her face shone out under her

lovely brows beautiful even in death.”

As reported by Weinbaum,44 although Homeric

Amazons were androgynous, more warrior

than woman (Fig. 10), by the second phase,

beauty, vulnerability, and other male-prescribed

aspects of femininity had become dominant. She

is reduced to a male projection of the conquered

beauty, deprived of her individual existence that

would have included a community of women.54

In the Amazon figures depicted by sculptors

and painters, the faces are usually calm and ideally

beautiful. Their bodies are feminine yet muscular,

supple, and graceful in a short tunic. However, in

fact, the physical environment might have produced

very different phenotypes, such as the

curved leg bones and wide pelvis bone caused by

a life spent on horseback.

The Amazons are also associated with wild

femininity. From this perspective, the female

bodybuilder is a contemporary version of the Amazon

and provides an alternative to the oppressive

body beauty norms.

Women now work in a variety of jobs previously

thought to be only for men, and there are

more women in positions of authority. This type of

femininity contrasts to conventional stereotypes of

women as weak and passive and represents the

reversal of the cultural imperative. The Amazon is

a woman who we believe can successfully challenge,

and thus help transform, domination related

to gender, race, class, age, disability, and

sexual orientation.55

The Amazon philosophy has a growing popularity

and increasing sympathy because of the

evolving status of women in society, and the word

Amazon is often used to refer to strong and athletic

beauty. Amazon feminism is also concerned

with physical equality. As mentioned by Greer,56 it

was enough to look beautiful in the past; now, a

woman has to have a tight and toned body as

reinforced by magazines and the television industry.

Hargreaves57 reported that slender muscularity

is the new female body ideal, at least among the

white middle class. Thinness has been exchanged

for tautness and containment.58 For obvious reasons,

feminists tend to idealize the Amazons.

“Amazonism” is also an emerging form of lesbian

activism. According to Pastre,59 the autonomous

and original social model created by the Amazons

was exclusively homosexual.

ETYMOLOGICAL FINDINGS

To gain insights into the effects of Amazonism

on the local culture, we used unstructured interviews

involving open-ended conversations with informants.

Anecdotal evidence based on our conversations

included tales recalled by the elder

members of the society, myths, narratives, life histories,

and styles suggesting that the Amazons were

cruel, helpless, rich, and antagonistic to cultural

values.

Although today’s society in the Black Sea region

is in general male-dominated and the position

of women is inferior, the women in some rural

areas practice a way of life that seems matrilineal.

Interestingly, the ancestors of Turkish women living

in the geographical region of the Amazons

were well trained to use sword and shield and

could fight competently with men.60

Another tradition that has been passed down

through many generations is a festival on Giresun

Island, formerly called Ares, on the Black Sea.

Every year, women circumnavigate the island, rowing

boats, and make vows for the fulfillment of

their wish to have a baby. It is believed that the

Amazons lived on this island. Supporting this theory

is a ruined temple that is described by Apollonius

of Rhodes61: “. . . they all hastened to the

temple of Ares to sacrifice sheep. Without delay

they took their places around the altar of small

stones which stood outside the roofless temple.

Inside the temple was a sacred black stone to

which all the Amazons once used to pray . . ..”

NEW ARCHAEOLOGICAL FINDINGS

Herodotos reported that in a battle, the

Greeks had defeated the Amazons near Thermodon

and sailed for home with many female prisoners

aboard. However, on the open sea, the Am-

Fig. 10. A Roman sarcophagus in the museum in Ku¨ tahya, Turkey,

AD 200. Homeric Amazons were androgynous and more

warrior than woman.

Plastic and Reconstructive Surgery • March 2007

816

azons rebelled and killed all the Greeks (this

reminds me of a well-known superstition of sailors

that a woman on board a ship at night brings bad

luck). However, the Amazons were poor sailors

and during a storm were cast up on the shore of

the land of the Scythians. The Scythian youths and

the Amazons married and formed a new tribe, the

Sauromatians, who settled in the steppe between

the Don and Volga Rivers. Intensive explorations

of this region have verified the myth of the Amazons

through archaeological proof of rich female

graves containing full sets of weapons and horse

trappings.62,63

CONCLUSIONS

Scientific data about the Amazons are not primary

because there is no information written by

any Amazon. However, it is beyond speculation to

say that the Amazons are a reality, with many indirect

proofs (e.g., written sources, art, legend,

local myths, and traditions) and marked archaeological

evidence. Excavations may help to explain

many intriguing problems that await solution.

Most of the scientific knowledge related to breast

mutilation is tentative and hypothetical. However,

there is a testable scientific proposition that the

Amazons mutilated the right breast to make the

right side of the body stronger. In patients with

simple mastectomy, it would be a worthwhile avenue

of research for scientific knowledge to compare

the strength of the right arm with that of the

left. It seems that the concept of the Amazon is still

active in the cultural process.

Ahmet Karacalar, M.D.

Ondokuz Mayıs U¨ niversitesi

Tıp Faku¨ltesi

Plastik ve Rekonstru¨ktif Cerrahi A.D.

Samsun 55139, Turkey

akaraca@omu.edu.tr

DISCLOSURE

The author does not have a financial interest in any

of the products, devices, or drugs mentioned in this

article.

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Meme başı içe dönüklüğü-çöküklüğü
Meme başının içe dönüklüğü  sadece estetik bir sorun  değildir. İçe dönüklük emzirmeyi engellediği kadar, meme başı altı apselerine de neden olur.  İçe dönük meme başını, içeri doğru çeken bantları gevşetildikten sonra kullanılacak piercing oldukça etkilidir. Altından yapılan bu materyalin doku uyumu yüksek olup aksesuar havasında olduğu için kolayca taşınabilir. Yaklaşık 3 ay yerinde durması önerilir.