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
Copyright ©2007 by the American Society of Plastic Surgeons
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
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
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
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
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
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
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
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
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
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
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
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
Volume 119, Number 3 • Amazons and Breast Mutilation
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
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.
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
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
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
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
Plastik ve Rekonstru¨ktif Cerrahi A.D.
Samsun 55139, Turkey
The author does not have a financial interest in any
of the products, devices, or drugs mentioned in this
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Plastic and Reconstructive Surgery • March 2007
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.