[PDF] Commissioning guide: breast reduction surgery

Royal College of Surgeons - RCS
Royal College of Surgeons of England (RCS)
Publication date:
01 May 2014


This guidance relates to patients that present with breast hyperplasia, where breasts are large enough to cause symptoms, infection, pain and adverse effects to quality of life. Breast reduction improves the quality of life of patients by amelioration of associated physical symptoms. The patient is not likely to present with further physical symptoms. There is also an improvement in the patient’s psychological wellbeing, self-esteem, willingness to engage in social activities and employment potential. Breast reduction should be considered for patients who meet the following criteria:

  • Are physically healthy
  • Have a BMI less than 27.5
  • Excised breast weight of 500 grams and upwards
  • Are non-smokers
  • If the patient is taking other medication for other long term conditions, such as diabetes  

Have some or all of the following signs and symptoms:

  • Emotionally and socially bothered by having large breasts
  • Low self-esteem and depression
  • Breast size limits physical activity
  • Back, neck and shoulder pain caused by the weight of breasts
  • Has regular indentations from bra straps that support heavy, pendulous breasts
  • Has skin irritation, intertrigo, beneath the breast crease
  • Breasts hang low and has stretched skin
  • Nipples rest below the breast crease when breasts are unsupported
  • Enlarged areolas caused by stretched skin