Breast reduction surgery is a very popular procedure. Celebrities such as Ariel Winter have been open about the results of their surgery. This has increased popularity and attention on the technique. Large breasts cause problems with painful shoulders and back. The weight of the breasts in your bra leads to indentation of the straps and neck pain. Many women find they receive unwanted attention due to the size of their breasts. All of these factors make breast reduction desirable and when performed well it can have a positive effect on self-esteem and well-being.
Where can I get a breast reduction like Ariel Winter?
Most people who have this type of surgery pay for it privately. This normally means having an operation in an independent hospital such as those run by Circle Health (formerly BMI) or Spire. Some women choose to travel abroad as this can seem cheaper but we would always recommend choosing an NHS consultant closer to home in case anything goes wrong. In the past, breast reductions were routinely performed in the NHS. Nowadays, with financial and time pressures to concentrate on urgent care, getting an NHS breast reduction has become very difficult.
How do you get an NHS breast reduction?
In Scotland, there is a clear pathway for patients who wish an NHS breast reduction- the Exceptional Referral Protocol. The government have looked at all of the procedures that patients ask for and decided who they think deserves surgery. This type of surgery does not qualify for the NHS 18 weeks treatment guarantee.
The first step is that you have to prove an “impairment of function”. Next, you have to have a Body Mass Index of less than 27 and over 20 (i.e. you are not over- or under-weight). Finally, you would be seen by an NHS psychologist who would need to be satisfied that you have significant psychological distress.
Impairment of function for a breast reduction means at least one of:
- Having Massively disproportionate breasts (much larger than your frame). The ERP panel will judge this, not you.
- A rash under the breasts not responding to multiple courses of treatment (intertrigo).
- Asymmetry of more than 1 bra cup size. The ERP panel will judge this, not you.
Note that back and neck pain are not acceptable criteria for an NHS operation to reduce the size of the breasts.
What are the reasons I can’t get an NHS breast reduction?
The number of NHS breast reduction performed now each year is tiny. We find that by far the most common reason for patients being rejected for NHS breast reduction is that they are overweight. This is very difficult as one of the many improvements of surgery is allowing you to exercise more. This can help you to lose extra kilos and pounds. You also cannot have surgery within 12 months of a major life event. These include bereavement, giving birth or relationship breakdown such as divorce.
Other reasons you would be denied a breast reduction would be if you have severe depression or a psychiatric illness involving delusion or schizophrenia. Patients who have self-harmed within the past 2 years or have a body dysmorphic disorder are also not eligible. If your doctor feels that you have a view of the problem that is not proportionate to the physical issues then they may not refer.
I’m not eligible, what can I do?
The good news is that private surgery does not have to strictly follow NHS criteria. Experienced consultants such as Ms Lucy Khan and Mr Chris Cartlidge can give you a comprehensive assessment. They will discuss if and how a breast reduction could help you. We are very aware that having the surgery can be a kick-start to a new lifestyle and can actively help women choosing to be healthier.
I think I may be eligible for NHS care, what should I do?
In the first instance, you should see your GP for a non-urgent assessment. If they agree that you are suitable then they may refer you on.