Claire Thomson Scotland
Melissa AshcroftA woman who has lived with chronic pain for years because of the size of her breasts says a reduction on the NHS feels further away than ever.
Melissa Ashcroft said her size 36M breasts made parts of her life difficult, distressing and painful – leaving her sometimes unable to even lift her newborn daughter out of her cot.
The 30-year-old mother-of-two was told earlier this year that her Body Mass Index (BMI) of about 35 was above the NHS criteria threshold for reduction surgery.
However, Melissa, who lives in Blairgowrie, says the size of her breasts, which add about two-and-a-half stone (16kg), means she struggles to exercise which could help her get her weight down.
Melissa Ashcroft“I find it hard to exercise because I have pain in my shoulders and lower back,” she told Radio Scotland’s Mornings programme.
“Then when I go on a treadmill, for example, I feel really embarrassed and sexualised, like people are watching me, and I don’t want that when I’m just trying to exercise.”
Instead Melissa has turned to swimming to keep fit as she said it can be easier on her joints but she still sometimes feels sexualised when wearing a swimsuit.
“I don’t want the attention,” she said. “I’m not just a walking pair of breasts, I have a personality, and I am a real human.
“It’s not a joke to me, it’s really serious and really upsetting just like any form of chronic pain.”
Melissa first went to her doctor to ask about breast reduction surgery when she 20.
But she says she was told she would potentially struggle to breastfeed her future children if she went through with the procedure.
Melissa now has had two children – a seven-year-old son and nine-month old daughter – and her breasts have grown even more through pregnancy.
She has tried a number of things to reduce the pain, such as physiotherapy, but says she needs the breast reduction to give her a normal life.
Melissa AshcroftWhy are women being denied breast reductions?
The exact criteria for a breast reduction on the NHS depends on where a person lives but many women, such as Melissa, have been refused because their BMI was too high.
Risks for those with higher BMIs are related to anaesthetic effectiveness as well as wound healing, blood clots and infections.
To be eligible for a breast reduction, patients usually have to maintain a BMI of between 20 and 27 for one year.
Melissa says she has been able to reduce her weight since her NHS referral as her hormones have settled after pregnancy and childbirth but she is unsure of how she will ever meet the criteria when her breasts are so heavy.
Over the past decade there has been a debate over whether BMI is the most reliable way to indicate overall health, particularly when bodies, like Melissa’s, are notably disproportionate.
Gill Baird, owner of Cosmedicare and founder of St Ellens’ Hospitals, said even if Melissa was to meet the criteria, she would not be guaranteed to receive the surgery on the NHS.
“There are thousands of people waiting for surgery from before Covid and the NHS are only seeing the most extreme cases just now,” she told Scotland.
“The NHS is not an infinite resource and they have to prioritise what they have.
“BMI is a limiting factor because when you look at the most extreme cases, you’re not going to see women with size G, H or M cups and a BMI of below 30.”
A Scottish government spokesperson said: “We recognise the importance of ensuring clinically appropriate access to procedures such as breast reduction surgery. Access must be fair, transparent and evidence based.
“The National Referral Protocol (NRP), developed and agreed by an expert clinical group, lists the criteria that patients should meet to be able to receive NRP procedures.
“These criteria are informed by clinical evidence and do not aim to restrict access but instead aim to ensure that people who will benefit from those procedures can do so.”



