The weight of my breasts is causing chronic pain, but I am unable to get a reduction.

A woman suffering from chronic pain due to the size of her breasts says that the possibility of receiving a reduction surgery on the NHS seems more distant than ever. Melissa Ashcroft, who is 30 years old and a mother of two, explained how her 36M cup size has made everyday activities painful and difficult. At times, she struggles to even lift her newborn daughter from her cot.

Earlier this year, Melissa was informed that her Body Mass Index (BMI), which is around 35, exceeds the threshold for NHS-funded breast reduction surgery. Despite the pain, Melissa feels that the size of her breasts, which add approximately 16kg (around 2.5 stone) to her body weight, makes it challenging to exercisea key factor in losing weight. She shared her struggles on BBC Radio Scotland's Mornings programme, saying, "I find it hard to exercise because I have pain in my shoulders and lower back."

She explained that when she tries to use a treadmill, she often feels embarrassed and sexualized, as though people are staring at her, which discourages her from working out. Instead, Melissa has turned to swimming, finding it gentler on her joints, though she still sometimes feels self-conscious in a swimsuit. "I dont want the attention," she said. "Im not just a walking pair of breasts. I have a personality, and Im a real person." She emphasized the seriousness of her condition, stating, "Its really serious and really upsetting, just like any form of chronic pain."

Melissa first sought advice about breast reduction surgery when she was 20, but was told that undergoing the procedure might affect her ability to breastfeed in the future. Now, with two childrena 7-year-old son and a 9-month-old daughterher breasts have grown even larger due to pregnancy. Melissa has tried various treatments to alleviate the pain, such as physiotherapy, but insists that only a breast reduction will allow her to live a normal life.

Why Are Women Being Denied Breast Reductions?

The criteria for breast reduction surgery on the NHS vary depending on the region, but many women, including Melissa, are being turned away because their BMI exceeds the acceptable range. Risks associated with a higher BMI include complications with anesthesia, wound healing, blood clots, and infections. To be eligible for NHS-funded surgery, patients generally need to maintain a BMI between 20 and 27 for at least a year.

Although Melissa has made some progress in reducing her weight since her NHS referral, she is uncertain how she will ever meet the criteria given the ongoing burden of her heavy breasts. Despite her weight loss, her breasts remain a significant challenge.

The issue of BMI as a reliable indicator of overall health has sparked debate, especially in cases like Melissas, where her body is noticeably disproportionate. Gill Baird, founder of Cosmedicare and St. Ellens' Hospitals, pointed out that even if Melissa meets the BMI criteria, theres no guarantee she will be approved for surgery due to the overwhelming demand for NHS services. "Thousands of people are still waiting for surgery from before the pandemic, and currently, the NHS is only seeing the most extreme cases," she said. "The NHS is not an infinite resource, and they have to prioritize," she added.

A Scottish government representative acknowledged the challenge of providing equitable access to procedures like breast reduction. They stated, "Access must be fair, transparent, and evidence-based." They explained that the National Referral Protocol (NRP), developed by clinical experts, sets out the necessary criteria for procedures to ensure that those who would benefit most from surgery receive it.

Despite the frustration and pain Melissa faces, she remains determined to find a way to live without the chronic discomfort that has defined much of her adult life.