Am I A Good Candidate For A Breast Reduction?
Do you want smaller breasts? Do you have issues with back pain, difficulty finding clothes and bras that fit? Do you get skin irritation and infections under the breasts? Then a breast reduction might be a good option for you.
So let’s talk about why some people get turned down for a breast reduction. The most common reasons are to do with risk factors - other medical problems that put you at higher risk of complications, and lifestyle issues such as smoking and obesity.
The ideal patient
….doesn’t exist! So don’t worry. Whatever your concerns are we can discuss them but below I am going to outline some of my reasons for choosing not to operate on patients until I am satisfied it will be safe.
A breast reduction is a great operation with high patient satisfaction rates. But it comes with risks and when you come and see me in clinic we will go through these in detail. There are some ‘red flags’ when it comes to doing these sorts of operations and the most common complications include delayed healing, infection, and blood supply problems (necrosis). Now these might happen anyway, but we know there are certain conditions and factors which can significantly increase the risks.
Smoking
This is a no-no for me. I won’t operate on anyone who is smoking or vaping. Did you know lots of ‘0% nicotine’ vapes actually contain nicotine?! (National trading standards 6/3/25). We know from research that smoking and nicotine slows healing, meaning you’re more likely to experience wounds which persist for weeks. In extreme cases I have seen patients who have travelled abroad for surgery (having been refused in this country due to their smoking) suffer complete wound breakdown requiring dressings for months and ultimately deformed breasts as a result. This is not a risk I want to take for you.
I ask patients to have stopped all smoking and vaping for a minimum of 6 weeks prior to surgery (ideally 12 weeks), and to remain off all products until 6 weeks after surgery assuming healing goes well.
BMI
This is a difficult subject to discuss and I know patients can feel judged about their weight. It is often difficult to lose weight ahead of having breast reduction surgery because the size and weight of the breasts make it painful and difficult to exercise. I also recognise BMI is not a great assessment of someone’s fitness and high muscle mass will result in a higher BMI so each case should be judged individually.
But what we do know from studies is when your BMI is over 30 we see more infections, delayed healing, and problems with blood supply to the skin, nipple-areola complex, and fat of the breast. So I ask patients to aim for a BMI of 30 or less but will consider 32 and under in some cases.
Breast-feeding
If you want to try and breastfeed and this is important to you, you should wait until your family is complete. There are techniques which are thought to preserve the ability to breastfeed, and there are reports of patients being able to breastfeed after a breast reduction. But if we are honest we don’t know if we can preserve your ability to breastfeed or not.
Also your weight will change during pregnancy, and your breast size will be affected by the hormones of pregnancy. So it makes sense to wait until your family is complete if breastfeeding matters to you. There is a chance if you decide to have a breast reduction before having any pregnancies that your breast size will increase again during this time. That doesn’t mean you shouldn’t go ahead, but you need to know things might change after surgery.
Other medical conditions
Lots of patients have other medical conditions which are not preventative for having surgery. These might include diabetes, thyroid disease and arthritis. As long as your medical problems are well managed and your GP is on board with the plan to have surgery, it is not usually a problem.
If you have a complex medical history, for instance previous cardiac surgery, taking blood thinners that can’t be stopped, or multiple medical conditions which are difficult to manage, you may not be a good candidate.
Psychology
The other aspect often not discussed but which should be considered is how the surgery might affect your mental health. Some patients come to me with the belief that surgery will solve their problems - help them find a new relationship, help them get a new job, make them happier. And in some ways this can be true - breast reduction surgery makes people feel more confident and self-assured. But it can’t make you happy.
I screen all my patients before surgery, and I listen carefully to what you tell me about your goals from surgery. If there are any areas which I think might be a concern I will discuss them with you upfront so we both know where we stand. Commonly once I have asked more questions and heard more from you I am comfortable to go ahead with operating on you, but I want to do this in a safe way.
Take this quiz to see if you’re a good candidate:
- Are you a smoker? Yes/No
- Is your BMI over 32? (See NHS website for calculator) Yes/No
- Do you have more than 1 medical condition which you are under hospital review for, or have 2 or more conditions for which you take regular medication? Yes/No
- Do you want smaller breasts? Yes/No
- Do you suffer with neck/back ache, painful ridges in your shoulder or skin irritation under the breast? Yes/No
- Do you find it difficult to find clothes that fit and exercise comfortably? Yes/No
If you answered No to the first 3 questions and yes for the last 3 questions you might be a really great candidate for a breast reduction. Even if your answers don’t match exactly the only way to be sure is to come and have a consultation.
Where can I get more information?
You can find more information about these surgeries on the services pages, or on the BAAPS website. But ultimately you will need to seek advice from a professional. Get in touch today to have an open, candid consultation with me about what you're after and how I can help you achieve your desired results.
