Should breast reduction surgery be considered cosmetic or functional?

Posted: 12/05/2014

It was recently reported in the news media that Rebecca Campbell, 32, from Australia is planning to undergo breast reduction surgery to reduce her size 34K breasts. Rebecca suffers from chronic neck and back pain caused by her large breasts and is desperate to go ahead with the surgery. However, she has been told that, because the surgery is deemed to be ‘cosmetic’, she will either have to fund it privately – paying up to $14,000 – or face waiting for up to five years on the public waiting list to have the surgery for free.

Her case fuels the debate as to whether breast reduction surgery is actually a ‘cosmetic’ procedure or a necessary surgery to enable women with large breasts to live a normal life. The clinical negligence team at Penningtons Manches LLP has acted for a number of clients for whom the motivation to have the procedure was for functional reasons rather than appearance.

In England, the availability of and criteria for breast reduction surgery on the NHS varies from region to region. The British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS) is unhappy with this postcode lottery and, together with the Department of Health, has drawn up guidelines for commissioning cosmetic procedures on the NHS. However, for the time being, the decision as to whether a patient is entitled to breast reduction surgery remains with the local Primary Care Trust. Due to the limited availability of breast reduction surgery on the NHS, most people who want to undergo the procedure have to pay for it themselves. The cost of this private surgery varies depending on where you have the treatment but you can generally expect to pay up to £5,500 in England.

Elise Bevan, a clinical negligence solicitor at Penningtons Manches who specialises in cosmetic surgery claims, comments: “Breast reduction surgery can deliver excellent functional and cosmetic results. The operation is intended to reduce the size of and lift up the breast. Many of our clients tell us that they had the surgery because of the crippling impact their large breasts had on their ability to carry out normal everyday activities which can be difficult and uncomfortable for women with large breasts. As well as the physical problems such as back pain, skin irritation and poor posture, large breasts can also cause psychological distress. We frequently hear of women not being able to wear fashionable clothes and being unable to take part in active sports.

“Unfortunately, because breast reduction is considered a cosmetic procedure, it is only available on the NHS in very exceptional circumstances. If this is the case, the patient has to consult a plastic surgeon as a private patient and pay for the operation themselves. On a recent broadcast of Channel 4’s Embarrassing Bodies, this was one of the issues raised with a number of people reporting that they were refused surgery because there was not enough funding or that it was not available on the NHS in their area. Unfortunately, most patients cannot afford to pay for private cosmetic surgery from a reputable clinic. What then often happens is that patients seek out back street clinics or travel abroad to have the surgery cheaper running the risks of having an inexperienced and uninsured surgeon, as well as poor clinic facilities and aftercare. We see a number of cases where such surgery has been done in a technically or cosmetically inadequate way, leaving patients with long lasting problems. Maybe it is time that the NHS re-visited its eligibility criteria to try to protect patients who genuinely need surgery to improve day to day life rather than cosmetic appearance.”

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