Female breast reduction, also known as reduction mammoplasty, is an operation to reduce the weight and volume of the breasts.
During the procedure, fat, glandular tissue and skin are removed from the breasts, which are then reshaped and the nipples repositioned.
Breast size is determined by genes, hormones, body frame and weight. For most women, breast size is proportionate to the body, but for some, the breasts are particularly large.
Breasts are sensitive to the hormone oestrogen. They can grow during adolescence or later in life following the menopause or because of the use of hormone replacement therapy (HRT). Some women also develop a noticeable asymmetry (difference in size or shape) between their breasts.
Breast reduction surgery can help women who are unhappy with the shape, weight or droop of their breasts by making them smaller and more lifted. However, breast size alters with body weight, so even after surgery, your breasts may increase in size if you put on weight or become pregnant.
Men can also experience enlarged breasts, known as gynaecomastia. Read more information about male breast reduction.
Availability on the NHS
Because breast reduction is usually done to improve appearance rather than health, it is not normally available on the NHS.
The NHS will not pay for surgery for cosmetic reasons alone. To receive cosmetic surgery from the NHS, you will normally need a referral from your GP. You will have to have a consultation with a plastic surgeon and possibly an assessment by a psychiatrist or psychologist. They will consider whether there is enough social, psychological or physical benefit to justify surgery, for example if your breasts are causing you significant pain or mental health problems.
The final decision is usually made at a meeting by a panel run by your primary care trust (PCT). The panel will take into account the information from your assessments and review your individual case.
Read more information about cosmetic surgery.
When breast reduction may be provided on the NHS
You may be considered for a breast reduction operation on the NHS if you have physical discomfort due to having large breasts. Physical problems may include:
- backache
- neck pain
- skin irritation
- poor posture
- excessive sweating, rashes and skin
- infections under the breasts
- weals or grooves on the shoulders from bra straps
- an inability to exercise or take part in sports
Large breasts can also cause psychological distress. Common complaints from women with large breasts include not being able to wear fashionable clothes and finding it difficult to take part in active sports. Psychological distress may also include:
- unwanted attention or harassment
- self-consciousness
- depression
Before having surgery
It is important to discuss your problems and options with your GP and surgeon before going ahead with a breast reduction. This will help you to get a clear idea of what change you can expect to see and ensure you are aware of any risks involved.
Read more information about things to consider before breast reduction surgery.
Although any surgery carries risks, the potential complications specific to breast surgery include:
- scarring
- unevenly shaped breasts or nipples
- wound healing problems
- loss of nipple sensation
Read more information about the risks of breast reduction surgery.
The operation
Breast reduction surgery takes several hours under general anaesthetic. You will usually need to stay in hospital for a few nights afterwards.
There are several techniques the surgeon might use depending on the size of your breasts and the desired result. Read more information about how breast reduction surgery is performed.
You will need to rest for two to six weeks when recovering from breast reduction surgery, depending on your age and general fitness. It is likely that you will have sore breasts for a few weeks.
