Heavy Breasts Cause Chronic Pain as NHS Reduction Remains Elusive

A Scottish mother of two has lived with chronic pain for years because of the size of her breasts. She says an NHS breast reduction feels increasingly unlikely due to medical criteria that focus on body weight, not just pain.

Melissa Ashcroft, a 30-year-old from Blairgowrie, notes her breasts weigh about 16 kilograms (roughly 2.5 stones) and are a daily burden—making exercise painful and limiting daily tasks, such as lifting her baby.

Earlier this year, doctors told her that her Body Mass Index (BMI) sits around 35, which falls outside the NHS thresholds for reduction surgery in many areas.

She has found it hard to stay active because of shoulder and back pain, and attempting workouts can feel embarrassing or intrusive, especially on crowded gym equipment. She has turned to swimming to protect her joints but still dreads swimsuit moments.

“I’m more than a body part,” she told INLIBER Scotland. “I want to live normally and be seen for who I am, not just my chest.”

Melissa first sought breast reduction when she was 20. She was warned it could affect future breastfeeding, a concern that lingered as her family grew to two children—her seven-year-old son and a nine-month-old daughter. Pregnancy boosted her breast size further, intensifying pain and physical limits.

She has tried physiotherapy and other pains-relief methods but says only surgery can restore her quality of life.

Why the NHS sometimes denies reductions

Eligibility varies by region, but many applicants are refused because their BMI is above the typical threshold. Medical guidelines warn higher BMI can raise anaesthetic risks, slow healing, and increase clot and infection chances.

Commonly, candidates are advised to achieve a BMI within about 20 to 27 for a year before surgery may be considered. Melissa has managed to shave some weight post-pregnancy, but her breast mass remains a major challenge.

Experts say BMI isn’t a perfect health measure, particularly for people with disproportionately large breasts, but there’s little consensus on how to balance fairness with medical safety.

Gill Baird, who runs a cosmetic clinic network, notes that even if the BMI hurdle is cleared, NHS availability still depends on demand and priorities. “The NHS faces finite resources and must prioritize extreme cases,” she says.

A Scottish government spokesperson emphasised that access to procedures must be fair, transparent, and evidence-based, guided by a National Referral Protocol that outlines the criteria for NRP procedures.

They stressed that the criteria exist to ensure those who will benefit can access care, rather than to cap treatment arbitrarily.

Expert comment

The case highlights ongoing debates about BMI as a health proxy and the real-life impact of policy on people with disproportionate bodies.

Healthcare experts say improvements can come from revising guidelines to better reflect the needs of patients like Melissa while maintaining safety.

Key insight: Access to breast reduction under public healthcare often hinges on BMI thresholds, which may delay relief for those with extreme breast size. Source