Breast reduction

Breast size is determined by genes, hormones, body frame and weight.

For the majority of women, their breast size is proportionate to their body frame. However, some women have particularly large breasts, and this can cause psychological distress and physical discomfort.

A female breast reduction, also called a reduction mammoplasty, is a surgical procedure in which the excess fat, glandular tissue and skin is removed to reduce the weight and volume of the breasts.

The problem of overly large breasts can develop during adolescence because the breasts are over-sensitive to the female hormone oestrogen. Alternatively, large breasts may develop in later life following the menopause or because of the use of hormone replacement therapy (HRT). Some women may have a noticeable asymmetry (difference in size or shape) between the breasts. In extreme cases, surgery may be undertaken to reduce the larger breast.

As breast reduction is not vital to your health, it is known as cosmetic surgery. To qualify for cosmetic surgery you must meet specific criteria as set out by your Primary Care Trust (PCT). To receive cosmetic surgery from the NHS, you will normally need a referral from your GP, a consultation with a plastic surgeon, and an assessment by a psychiatrist or psychologist. It will then be decided if there is enough social, psychological or physical benefit to justify surgery.

There is some evidence that a breast reduction may decrease the chances of developing breast cancer. Research into breast reduction and breast cancer is still ongoing.

Male breast reduction

Breast reduction surgery is not only an option for women. Some men who have large breasts may need to have a breast reduction, which is a procedure called a gynaecomastia. Unlike the female breast reduction – which is carried out to both reduce and reshape the breasts – male breast reductions are usually required to flatten the breast area.

Large breasts in men are often believed to be a result of obesity, but this is not the only cause. Men, like women, can have an abnormal growth of glandular breast tissue, usually due to a hormonal imbalance. Some studies have shown that male breast growth could be as a result of high levels of the female hormone oestrogen being present in their bodies. Other causes of male breast enlargement include:

• Excessive alcohol intake.
• Use of certain drugs, particularly anabolic steroids (often used by bodybuilders).
• Dramatic weight loss, causing skin to sag.

The surgical procedure for male breast reduction is exactly the same as the procedure carried out for women (see how it is performed section). However, the male operation usually only takes an hour. The recovery time is also the same (see recovery section), with men needing to wear an elastic garment (sometimes referred to as a pressure garment) for up to four weeks after the operation. The elastic garment helps to encourage smooth results.