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When Is A Breast Reduction Medically Necessary?

When is a breast reduction medically necessary, what are the implications for your health, and how do you make the right decision for you?

Tagged: Body & Breast

Date: 31st January 2023

Medically Reviewed by:  Mr. Bryan Mayou (GMC: 1414396)

Last reviewed: 1st February 2024

Large or oversized breasts can be very difficult to live with. Not only can they cause pain and physical discomfort, but the presence of large breasts can also have a negative impact on a woman’s mental health and wellbeing. As a result, you may be considering a medically necessary breast reduction in a bid to alleviate discomfort and help to restore some self-confidence. 

But when is a breast reduction medically necessary? In short, a breast reduction may be medically necessary if you feel that your quality of life is being negatively impacted by your breasts. This can include physical discomfort and pain, psychological implications like low self esteem, and limiting your lifestyle choices. 

What causes breasts to grow too big?

Women develop breasts during puberty due to the rising level of the female sex hormone oestrogen. Some women are naturally predisposed to growing large breasts because of genes inherited from their mother and/or from their father’s side of the family. If a close female relative has large breasts, this may mean you’re more likely to develop them too.  

Breasts may change size numerous times during the course of a woman’s life, which is completely natural. This is often due to hormonal changes during pregnancy and breastfeeding, which can lead to breasts becoming bigger.  

After pregnancy and breastfeeding, some breasts may return to their previous size, but it’s also just as common that they remain a different size, shape, and fullness. Again, this is completely natural though not always desirable for some women. 

Weight gain can also cause breasts to grow larger, as the fatty tissue accumulated can change their size, shape, and weight. Losing weight through exercise and diet may help address this, though sometimes this doesn’t yield the results we’d like. 

Oversized breasts can also be caused by a rare medical condition known as gigantomastia, which results in excessive breast growth in women. However only a couple of hundred cases of gigantomastia have ever been reported. 

It’s important to note that this isn’t just limited to women, as many men can also be in possession of breast tissue commonly referred to as ‘man boobs’. This is called gynaecomastia, and therefore male breast reduction is available for this too. 

What are the physical indications that make a breast reduction medically necessary?

There are a number of physical indicators which suggest that a medically necessary breast reduction might be a good option for you. 

If you were to have breast reduction on the NHS, you would need to meet a list of strict criteria to qualify for surgery. As a private clinic, at the Cadogan Clinic you don’t need to ‘qualify’ for a breast reduction if you and your surgeon agree it is a viable and beneficial choice for you. 

You may choose to have breast reduction surgery if you are experiencing one, some or all of the following. 

Back, neck, and shoulder pain

  • Many women with disproportionately large breasts find that they suffer from back, neck and shoulder pain. This can range from mild discomfort to long-term chronic pain. This is because this excess weight carried at the front of the chest causes a strain on the surrounding muscles and ligaments. It can be difficult to maintain good posture if you have overly large breasts and this may lead on to further problems, such as a curvature of the spine. 
  • Many women complain of their bra straps leaving red marks and indentations on their shoulders because of the weight of their breasts, which is another cause for discomfort and further indication a breast reduction may be a good idea. 

Skin irritation and rashes under your breasts

  • Another common medical reason for breast reduction is the appearance of uncomfortable, embarrassing and persistent rashes underneath the breasts.
  • These often develop as a result of friction on the skin, compounded by the build-up of sweat and skin cells in the area. This can result in conditions such as dermatitis or a yeast infection.  
  • As well as being itchy and uncomfortable, the appearance of irritated skin may cause a woman to feel self-conscious about her body and she may even avoid intimacy as a result. This may also limit clothing choices and certain clothes may irritate the skin further, causing even greater discomfort and distress.  
  • Sometimes certain rashes or skin infections can be difficult to treat or may recur frequently. Preventing this skin irritation from happening in the first place is one of the many health benefits of breast reduction surgery. 

Your breasts making you seem 'bigger' than you are

  • If you have disproportionately large breasts, then this can have an impact on the overall appearance of your body and can make you feel ‘top heavy’ or out of proportion. For example, enlarged breasts may push down on your stomach and make it appear bigger than it actually is.  
  • Women with large breasts often need to wear larger dress sizes in order to accommodate their breasts. However if the rest of your body is a smaller dress size, this can further accentuate your unbalanced proportions. It’s no wonder that many women opt for a breast reduction because they feel self-conscious day to day in their own clothes, and why the surgery can be incredibly freeing should you be viable. 

Words from our clients:


What are the mental and emotional indications for a breast reduction?

Whilst there are plenty of medical reasons for a breast reduction, the mental and emotional indications are just as important. Feeling comfortable and confident in yourself should never be downplayed. 

If oversized breasts are having a negative impact on your mental health, preventing you from taking part in certain activities, or impacting on your day-to-day life, then these are also valid reasons for breast reduction. 

Poor self-esteem and self-image

  • Large or disproportionally large breasts can contribute to poor self-esteem and self-image, which is possibly one of the biggest cases for breast reduction surgery.
  • Oversized breasts may draw unwelcome attention, in some cases causing you to feel over-sexualised or simply like you’re being looked at. Because larger breasts can affect the appearance of the rest of your body and the clothes you wear, many patients also feel that they themselves look ‘bigger’.  
  • These feelings of low self-esteem and self-image may be so intense that they may interfere with life and relationship choices and in some cases may even develop further into conditions such as body dysmorphia, depression or anxiety.  
  • Seeking to rebalance your mental relationship with your body is definitely one of the main health benefits of breast reduction surgery, as the difference in before and after breast reduction surgery can affect more than just the breasts’ appearance. 

Being unable to partake in activities like sports and exercise

  • Large breasts may already be a source of pain or discomfort, but this can be made worse when playing sport or exercising. Not only can the movement and weight cause pain or discomfort but a lack of sportswear and sports bras that fit and provide adequate support can make exercise or sport almost impossible.  
  • The movement of unsupported breasts may also make you self-conscious as well as causing physical discomfort, which again turns something that is supposed to be enjoyable or productive into a distressing experience. 

Limiting lifestyle and social choices because of your breasts

  • You may find that having large breasts has put limitations on your lifestyle choices. For example, you may avoid swimming or going to the beach because you don’t want to be seen in swimwear, you may avoid social gatherings because of limited clothing options, or you may be uncomfortable in intimate relationships.
  • Feeling like you’re missing out on a portion of the fun, however big or small you feel that portion to be, or like you have to think of your breasts or body first before anything else, can feel very isolating. It’s perfectly understandable, too. 

Large breasts are perfectly natural, but if you’re uncomfortable with the appearance, weight, or feel of your own then you may be a good candidate for a medically necessary breast reduction. 

If your breasts are impacting your quality of life, you don’t have to just ‘put up with it’. We can help advise on your suitability for a breast reduction or, potentially, advise on a different solution for you. For example, a breast reduction can and is often paired with a surgical breast lift, too. 

Book a consultation with one of our expert surgeons here at the Cadogan Clinic in London to find out more about the patient-centred options available to you. 

How to qualify for a breast reduction on the NHS?

Patients often ask us ‘what size breasts qualify for a breast reduction on the NHS?’, although in reality it is not simply a question of size. 

In the UK, patients qualify for breast reduction surgery on the NHS based on whether they meet specific criteria to establish medical necessity for the surgery.  

This varies by region, but eligibility is made on a case by case basis and generally a function of a mix of both physical symptoms (such as back pain, neck pain, shoulder pain etc.), psychological symptoms (such as emotional distress and negative sense of wellbeing), and whether they have tried other alternative non surgical treatments (e.g. counselling, lifestyle changes such as weight loss). 

It is important to note the process is often long, and requires first seeing a GP before seeing a specialist. Waiting times vary but may be several years 

A word from Mr Bryan Mayou our world renown plastic surgeon founder and breast reduction surgeon 

"The reality is that the number of patients who qualify for breast reduction surgery on the NHS is very small. You may need to balance considerations of how urgently you feel you need the surgery, with expected local waiting times. These have only increased with Covid and you may well be waiting some time. Ultimately it’s a personal decision, and needs to be considered on a case by case basis"


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