Is Breast Reduction Worth It

Breast reduction is extremely beneficial to women who have large, heavy breasts, but the surgery is not always worth it. The benefits of breast reduction include a better quality of life and more confidence. Most women also report that they feel less pain in their neck, shoulders and back after getting a breast reduction.

In this guide, we find out Is Breast Reduction Worth It, breast reduction death rate, benefits of breast reduction, and Does a breast reduction make you look thinner?

Breast Reduction Worth It

Every year, more people undergo breast reductions than you might think. Pamela Anderson, Drew Barrymore and more recently, Doja Cat, are just a few of the celebrities who have opened up about undergoing breast reduction surgery, while the term #breastreduction has over 1 billion views on TikTok.

To add, breast reduction surgery is in the top three cosmetic surgery operations performed in the UK. And, according to the British Association of Aesthetic Plastic Surgeons’ 2020 audit, 4,245 women took on the surgery via private practice in 2019 – making it the second most ‘popular’ treatment recorded after breast augmentation.

While available through the NHS, the number of breast reductions carried out per year on the health service unclear. The figure is understood to be significantly lower than those from private clinics, though, due to the strict criteria NHS candidates have to meet. Something of a postcode lottery is also at play, as some local Clinical Commissioning Groups (CCG) – a team of experts who commission healthcare services in communities – don’t fund the procedure, while others do.

As a result, it can be difficult to get a fully-funded reduction, and the alternative is expensive: around £6,500 – £8,000.

When it comes to NHS procedure: A GP will check whether you meet the criteria of the local CCG, which will often include your BMI (which must be between 20 and 27 – if yours is currently over that, you may be asked to lose weight), the size of your breasts, whether other options have been tried and your age. If these are all in line, then your doctor can refer you to a breast or plastic surgeon for assessment. But that’s not the end of the road. You case will be passed onto a panel of local CCG representatives, who will then make the final decision.

To be considered, you’ll need to evidence experience of serious problems due to the size of your breasts, such as shoulder or neck pain, back aches, irritated skin, an inability to take part in sports or exercise and psychological distress.

The fact that getting one approved is so hard can be frustrating – when it comes to the motivation for a breast reduction, it’s usually very little to do with how you look and is more to do with debilitating and chronic pain. ‘Aesthetics rarely come into it,’ explains Dr Naveen Cavale, Consultant Plastic and Reconstructive Surgeon. ‘Pain is the main reason – shoulders, neck, back, bra straps digging in, sores under the breasts. Some women can find the weight unbearable.’

How painful is breast reduction surgery?

Whether a private or an NHS path is taken, the surgery takes place under general anaesthetic and takes approximately three hours. You’ll be in hospital for one or two days, though this does vary between patients. As you’re is fully unconscious during the procedure there’ll be no pain then, however when coming around there is likely to be discomfort.

Dr Cavale says the pain isn’t as bad as people think. ‘Most is from muscle stiffness, so if you keep your shoulders moving, the pain is less. You are usually able to do most light activities after five days or so,’ but adds that the pain does vary a lot from person to person. The NHS also warns that a significant reduction can alter the shape and look of breasts, of scarring and possibly lost or altered nipple sensation since breast reduction surgery always involves changing the position of the nipples. There’s also a chance future breastfeeding won’t be possible.

Dr Cavale’s patients leave the surgery the same day but overnight stays are also possible depending on the surgery attended and individual factors.

How long does it take to recover from breast reduction surgery?

‘Patients will need someone to help around the house for the first few days,’ Dr Cavale says. ‘I advise 10-14 days off work if you work in an office, longer if you do more manual work and no heavy-duty activity or sports for four weeks or so. You will also need to wear a compression bra for six weeks, 24/7, as it reduces swelling and makes things much more comfortable.’

Overall, full recovery can take around a year depending on the individual, and possibly longer for the scars to fully fade and for the breasts to look and feel ‘natural’ again.

What are the risks of breast reduction surgery?

According to the NHS, you should be aware of the following potential problems.

Are there alternatives to breast reduction surgery?

If the risks sound like too much, there are some possible alternative management techniques, according to the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS). These include the following.

‘Weight loss may reduce breast size and, having reduced weight (a guideline body mass index is 27 or less), some women may find they do not need surgery. Correctly fitting underwear and clothing can improve comfort and appearance. Cognitive behavioural therapy (CBT) can be effective for body image problems.’

5 things to know about breast reduction surgery

There’s no size guarantee

‘There’s no exact science with determining how many cup sizes you can drop, and a good plastic surgeon should inform you of this during the consultation stage,’ says Dr Cavale. ‘There is no guarantee of size, but instead, I perform a breast reduction that leaves the patient with breasts that are proportionate to their frame.’

You need to take time off work

‘We advise patients to take 10 days off work if they’re going into the office, but if they’re working from home, which is a much more feasible option at the moment, then I would suggest they can work from home again from about 4 days in,’ he adds.

You need to wear a sports bra post-surgery

‘A sports bra is worn pretty much 24/7 for 6 weeks. This not only helps keep swelling and bleeding under control, it also reduces pain.’

Smokers are not eligible for the surgery

The risks are too high to perform this surgery on someone who smokes, says Cavale.

Spotting early breast cancer symptoms is still possible after a reduction

‘As there is less breast remaining, theoretically, there is less tissue for cancer to develop in. It’s also often easier for patients to spot the early signs of breast cancer such as lumps, changes in texture as the breasts are smaller,’ says Cavale. ‘It’s worth noting that mammograms can still be carried out as normal post-reduction surgery too.’

What is it like to have breast reduction surgery?

Sophie Horne, 36, qualified for a breast reduction on the NHS when she was 21, as her JJ chest was majorly impacting her life. She had her breasts reduced to a 32DD.

‘At about the age of 17 I went from having small boobs to suddenly having these humongous ones. There were barely any bras that could fit me, I got unwanted attention and just felt like a bit of a freak because I was so massively out of proportion.

‘A chance encounter with a Bravissimo shop assistant, who’d had a reduction herself, set me on course for my own. She spoke to me candidly about the risks, her own experience, and eventually, I went to my GP and was successfully put on the NHS waiting list.

‘In the six month interim between appointment and eventual surgery, I chickened out a couple of times, but eventually took the plunge. Because the reduction to a 32 DD was so dramatic I ended up in surgery for more than six hours and in hospital for three to four days. The most painful aspect was the removal of the tubes that had to be inserted to drain my breasts of excess fluid before I could leave the hospital.

‘Getting the compression wrap off was difficult, too because it looks like you’ve been butchered. To someone thinking of getting a breast reduction, I would say, know that it does take a long time for them to really settle and for you to be completely happy with them.

‘For me, though, the pros have wildly outweighed the cons. I could actually just start wearing the clothes I wanted. It was amazing.’

Holly Hope Harper, 34, had a private breast reduction in February this year, following an initial consultation in November 2019. After after getting really into fitness, her size G/H were restricting the way she wanted to move. She had her breasts reduced to a 36C.

‘I wasn’t scared about the pain and I’m not scared of operations. But I was worried about getting back to work and about not being able to exercise. So I stayed overnight in the hospital for one day. I then went home and rested for one day and went straight back to work.

breast reduction death rate

There is no consensus for when publicly funded breast reduction is indicated and recommendations in guidelines vary greatly, indicating a lack of evidence and unequal access. The primary aim of this review was to examine risks and benefits of breast reduction to treat breast hypertrophy. Secondary aims were to examine how the studies defined breast hypertrophy and indications for a breast reduction.

Methods

A systematic literature search was conducted in PubMed, MEDLINE All, Embase, the Cochrane Library, and PsycInfo. The included articles were critically appraised, and certainty of evidence was assessed using the GRADE approach. Meta-analyses were performed when possible.

Results

Fifteen articles were included; eight reporting findings from four randomised controlled trials, three non-randomised controlled studies, three case series, and one qualitative study. Most studies had serious study limitations and problems with directness. Few of the studies defined breast hypertrophy. The studies showed significantly improved health-related quality of life and sexuality-related outcomes in patients who had undergone breast reduction compared with controls, as well as reduced depressive symptoms, levels of anxiety and pain. Most effect sizes exceeded the reported minimal important difference for the scale. Certainty of evidence for the outcomes above is low (GRADE ⊕ ⊕). Although four studies reported significantly improved physical function, the effect is uncertain (very low certainty of evidence, GRADE ⊕). None of the included studies reported data regarding work ability or sick leave. Three case series reported a 30-day mortality of zero. Reported major complications after breast reduction ranged from 2.4 to 14% and minor complications from 2.4 to 69%.

Conclusion

There is a lack of high-quality studies evaluating the results of breast reduction. A breast reduction may have positive psychological and physical effects for women, but it is unclear which women benefit the most and which women should be offered a breast reduction in the public healthcare system. Several priorities for further research have been identified.

Pre-registration

The study is based on a Health Technology Assessment report, pre-registered and then published on the website of The Regional HTA Centre of Region Västra Götaland, Sweden.

Background

Publicly funded welfare-type healthcare systems with a strong emphasis on equal access to healthcare are increasingly struggling with resource constraints. This requires a standardisation, with continuing re-evaluation, of what should be reimbursed and what should be rationed [1,2,3]. The nature of plastic surgery entails an element of subjectivity and studies have revealed that there is a variation in what is offered which could indicate a lack of evidence and unequal access [1, 4,5,6,7]. One procedure that has been debated, and where guidelines vary, is breast reduction due to breast hypertrophy [3, 5, 8,9,10].

Breast hypertrophy is a condition that may give rise to both physical and psychosocial symptoms, including muscle pain, such as back and shoulder pain, headache, postural changes, bra strap grooves, intertrigo, inability to participate in exercise and sports, sexual problems, bullying, body image problems, and problems with poorly fitting clothes . Most of the symptoms described impair health-related quality of life (HRQoL). A breast reduction (reduction mammaplasty) is considered effective at reducing physical and psychosocial symptoms and improving HRQoL [12, 13]; however, similar effects are also achieved when a breast reduction is performed for cosmetic reasons and therefore it is difficult to distinguish which patients should be operated in the publicly funded healthcare system [14, 15]. Moreover, there is no standardisation regarding the assessment and prioritising of functional problems, such as back pain, compared to non-functional problems, for example suffering due to appearance .

There is no commonly accepted definition of breast hypertrophy and no consensus for when a breast reduction is indicated and should be reimbursed. Some guidelines define breast hypertrophy according to breast volume. For example, the current national Swedish guidelines base the definition on anthropomorphic measurements of mean breast volume (405 ml, median 359 ml) in a population of randomly chosen women . Hypertrophy is defined as at least twice the mean volume observed in the anthropomorphic measurement studies; that is, a volume of > 800 ml per breast. Previous Swedish studies, conducted before the guidelines were established, showed that many women who want a breast reduction have a volume of > 800 ml [19, 20]. Other definitions of breast hypertrophy include the Sacchini criteria and bra size. The Sacchini criteria are based on the mean measurement of the nipple to the inframammary fold distance and the nipple to the lateral border of the sternum distance. A mean distance of less than 9 cm is considered to indicate a small breast, 9–11 cm a normally sized breast and > 11 cm breast hypertrophy. When bra size is used, a cup D or larger is typically considered to indicate breast hypertrophy. In healthcare systems with third party payers, such as the United States system, insurance companies often assess the medical necessity for a breast reduction based on the amount of tissue that can be removed in a normal weight patient , usually according to the The Schnur Sliding Scale [10, 22].

The aim of this review was to examine the risks and benefits of breast reduction to treat breast hypertrophy. Specifically, the primary aims were to investigate whether breast reduction is better than no surgery, in women with symptomatic breast hypertrophy and a BMI of ≤ 35, regarding HRQoL, depressive symptoms, anxiety symptoms, sexuality-related outcomes, work ability, sick leave, physical function, pain, and patient experience, and whether it is safe. Secondary aims were to examine how the studies defined breast hypertrophy and which indications for a breast reduction were used.

benefits of breast reduction

A breast reduction can offer significant benefits to women desiring smaller, more proportional breasts. There are a number of reasons, both medical and cosmetic, for women to undergo this procedure. Whatever the case may be, the goal of plastic surgeons is to provide patients with the best experience and results possible.

By removing excess breast fat, tissue and skin, plastic surgeons can reduce your breast size to be more proportionate with your body. This surgery is very popular among patients since it can alleviate the physical discomfort caused by the size of your breasts.

A breast reduction is more than cosmetic

It’s important to understand that for many women, large breasts are more than just an aesthetic issue – they are also a health concern. Large breasts can cause discomfort and/or pain in the shoulders, neck and back. Large breasts can also cause rashes, interfere with certain activities and even can cause upper extremity numbness, tingling and headaches.

Typically, larger breasts are also usually positioned lower on the chest than ideal and the areola size may be quite enlarged. Shifting the breast tissue upward and reducing the weight in the process combines to help improve a women’s posture and decrease the tension and pressure from her bra straps on her shoulders and neck.

What you need to know about breast reduction

It is important for patients to understand that a breast reduction may cause surgical scars, potential loss of some nipple sensitivity and the ability to breastfeed at a later date. Your board-certified plastic surgeon will discuss all of the relevant issues with you at your consultation and should be able to have you speak to other patients about their experiences.

Open communication with your plastic surgeon is important to get the best possible outcome. Be sure to ask questions and mention any concerns you may have about the breast reduction procedure, and be prepared to discuss your goals for the surgery. Plastic surgeons are trained to modify the procedure for each individual to optimize the outcome of your surgical experience.

Breast reduction surgery is usually performed as an outpatient procedure that, on average, takes about two to three hours. An outpatient procedure means the patient is able to return home the same day of surgery or the next morning if staying overnight in the facility is best to help control discomfort or nausea.

Breast reduction surgery offers life-changing results

Patient satisfaction after breast reduction is remarkably high and the results are long-lasting. Additionally, the majority of women that undergo the procedure later in life report that their major regret is that they did not have the reduction surgery earlier.

If you think a breast reduction might be right for you, be sure to meet with a board-certified plastic surgeon for a consultation. Think about all the activities, as well as clothing styles, that you could be enjoying once your breast size and position match the rest of your body and are in sync with your desires for physical activity!

Does a breast reduction make you look thinner

Breast surgery changes the shape, size, and/or projection of the breasts. However, these alterations can have effects on the other parts of the body. Many patients report that they get comments about their overall physique and many people cannot pick out that they even did something to their breasts. While it is common after breast augmentation for patients to look slimmer, many ask, “Does a breast reduction make you look thinner?”

In some patients, yes, a breast reduction can make them look leaner. Some patients have slim bodies, but larger breasts. This is common with a condition called gigantomastia which occurs for many reasons. If the breasts are reduced to a more proportionate and manageable size, this can mean that the patient can wear well fitted clothing that naturally makes them look thinner.

Additionally, when the breasts come into proportion with the rest of the body’s contours, it can create a more natural looking curve to the body that is often flattering. Therefore, while this is not true in all breast reduction, some patients may look thinner after a breast reduction procedure.

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