AIBU to think the NHS should cover this?

[Icannotcope]

I know I'll probably get slated for this but I just don't understand it.
I've always had large breasts and a small frame. I'm 5'1, 50kg, size 6-8. My breasts are a 32H. During pregnancy they got absolutely massive, I have no idea what size - but huge! Now they've settled back but they're still massive.
I have severe back pain and neck pain. I have injured traps from trying to support them and this has caused nerve damage so I get shooting pains down both my arms and have a loss of sensation in my left hand. I also get twitches in my hands. The pain on my neck/shoulders means I can't do things that involve having my arms forwards for more than a few minutes at a time (like typing, cooking, writing, driving etc). I've been to physio multiple times and done so many exercises but nothing helps. They've all suggested ensuring my bras are properly fitted but that hasn't helped either. They've ended up all saying that the only option is to have my breasts reduced.
Because they got so big during my pregnancy and have now deflated a bit, I have a tonne of excess skin. So, they hang down almost to my belly button. The excess skin gets irritated and infected because there's so much of it. I have to wash it multiple times a day, use aloe vera to try to keep it cool and talcum powder to try and keep it try. I take baby wipes, aloe vera and talcum powder everywhere I go because it gets so hot and sore.
On top of all that, it's affecting my career. I work in a professional field but there are no outfits that I can wear that don't look unprofessional because of the size of my breasts. Anything that's button up either bursts over them or is so large on the rest of me that it looks sloppy. Anything too high neck makes them look even larger and draws more attention to them. Anything low neck is obviously a problem too.
I simply cannot afford to have them reduced - it costs so much money and I just do not have it. Every time I've spoken to my GP, they've just said "it's a cosmetic procedure - you can't get this on the NHS". Surely it's not fair that I'm in agony all day every day. It I were experiencing this pain and these symptoms because of any other body part then the NHS would help but there seems to be some kind of decision that breasts are exempt from help.
AIBU to think someone should be helping me!?

[Sexnotgender]

@HaudMaDug

I see where others are coming from about your bra/back size but I'm 5'2" and a little under your weight and size 6-8 but I'm a 32A, there is no way I could fasten let alone be able to breath in a 30" or a 28".
Having had a friend who went through a similar experience to yours, however she was also obese and had 5 stone to lose before they would operate. She lost the weight but her cleavage stayed the same. Her op went well and she's now so happy she can go to bed without having to wear her bra. She is also an inch taller now that she can stand up straight.
Keep pressing your GP or ask to see another as this must be agony for your little frame. This is definately not a cosmetic issue.

You could fasten a 28/30 back though with the correct cup size.

[Icannotcope]

Hi everyone,
Thank you all for your advice - I'll definitely be looking into all of your suggestions.
I'm definitely wearing the right size bras but sometimes they vary as different stores just make them differently. Sometimes I'm as low as a 28 and sometimes my cup size goes up to a K - I just put 32H as it was easier to say one size and didn't want to sound like I was exaggerating.
I've found my CCG requirements. It says I need "ulceration that does not respond to treatment" - does anyone know what they mean by this?

[PixelatedLunchbox]

Another vote for new GP - this sounds horrendous. It needs to be covered.

[IwishIhadaMargarita]

You need to measure correctly. At a size 16 and 5’9” I wear a 36 so bc a 32 sounds too big and all the support is in the band. Try using the boob or bust measurements.

[QualityFeet]

Pressure your gp, complain and escalate. How dare they dismiss this as cosmetic. God if all else fails could you get a loan- this matters.

[Juno231]

@sexnotgender not if it doesn't reach around torso underneath your breasts? Per all these posts I should be wearing a 30 but I would look like a badly stuffed sausage in a 32 nevermind a 30.

Let's not forget that bra sizes are not uniform and change depending on brand. My friend did her MBA thesis on this and it showed sizes can vary a lot.

[thenightsky]

It says I need "ulceration that does not respond to treatment" - does anyone know what they mean by this?

I'd take that to mean open sores that won't heal, probably because the pressure that caused them is still there.

[HaudMaDug]

I was told I was a 30DD at a sizing appointment once but when fastened on the widest clasp I was being cut in half with empty creased up cups that started in my armpits. Remeasured since and advised to stick to a 32A as anything else was giving me heartburn

[Alsohuman]

ulceration that does not respond to treatment

It means open raw patches that won’t heal. Your GP would have to go through every possible prescription with no effect. If you don’t meet your CCG criteria, it would be a complete waste of time and money to refer you to a surgeon who, however sympathetic, can’t operate.

[supercalifragilistic123]

ulceration that does not respond to treatment
This means open sores that will not heal.

Unfortunately in my experience it is nearly impossible to get a reduction on the NHS. Many places won't even do a reconstruction after mastectomy anymore. Breast surgery is chronically underfunded.

Is there no way you could go private? Is finance an option?

[ChequerBoard]

Find out the name of your local CCG and then google CCG (name) breast reduction. They should have a breast reduction policy that clearly sets out the criteria under which the NHS will fund this type of surgery.

For example I've just done this for my local CCG and their breast reduction policy document states:

The NHS will only provide breast reduction for women if all the following criteria are met:
^

• The woman has received a full package of supportive care from their GP such as advice on weight loss and managing pain
  
• In cases of thoracic/ shoulder girdle discomfort, a physiotherapy assessment has been provided
  
• Breast size results in functional symptoms that require other treatments/interventions (e.g. intractable candidal intertrigo; thoracic backache/kyphosis where a professionally fitted bra has not helped with backache, soft tissue indentations at site of bra straps).
  
• Breast reduction planned to be 500gms or more per breast or at least 4 cup sizes*
  
• Body mass index (BMI) is

[evilharpy]

I have no advice but am furious to read this. There is no way that if men suffered from this they would be expected to put up with it and refused help. You poor thing, OP, it sounds very difficult to live with. I really hope you're able to fight your case and get help.

[Coffeecak3]

If you can afford just the private consultation with a good surgeon you may find he’ll put you on his NHS list when he sees how you’re struggling.
Just ask your gp for a private referral to the best breast surgeon.
Probably cost you £250/300.

[NoMoreDickheads]

YANBU- People have boob jobs on the NHS as they claim it effects them psychologically. You could try that angle- say it's making you feel bad due to its effects on your work etc? Basically lay it on thick in every way. I'm not suggesting you lie, but just list all the mental and physical effects.

If you don't get anywhere I would try GP surgeries and have another go.

As to things not fitting, it doesn't cost all that much to get a seamstress to take them in. You could buy them in an ok size over the boob, then they can take in the rest for you.
-
A lot of private surgeons have monthly payment plans for stuff I think, so if you change GP surgeries and still don't have any luck you could look into that.

[Icannotcope]

My CCG requirements are:
 The individual patient’s breast development is considered to be complete AND
 Bra cup size of greater than GG AND
 Where the BMI is stable below 26kg/m2 for at least 24 months prior to funding request AND
 Medically documented evidence of a clinically significant history of intertrigo or ulceration which has not responded to treatment AND
 Symptoms are not relieved by wearing a brassiere fitted by a trained bra fitter AND
 Where medically documented evidence of a clinically significant history of back, neck and shoulder pain, which has not resolved despite documented conservative management tried and complied with for a minimum of 24 months.

The only one that I'm concerned I might not meet is the fourth one. I get really sore rashes that often ooze and bleed but they do tend to heal eventually. I have grazes over my shoulders and against my rib cage were the bras rub too - but they aren't open, more like blisters or callouses.
I didn't say earlier that I used to play sport at a very high level but now I cannot run anywhere at all because sports bras just do nothing. I get shooting pains in my breasts as well, I think from the ligaments tearing under their own weight.

[CatRamsey]

This should definitely be covered on the NHS. Of course some people have breast reductions for cosmetic purposes but yours simply isn't that. Definitely see if you can get a second opinion.

[Alsohuman]

My CCG’s criteria:

Female Breast Reduction (Reduction Mammoplasty): Not routinely funded.
Note: Funding may be considered when a detailed application is made for patients who present with significant musculoskeletal pain considered to be due to breast size. Patients experiencing severe daily pain maybe be considered exceptional where:
 pain is not controlled by regular analgesia; AND
 they have used professionally fitted brassieres; AND
 they have undergone at least 3 months of physiotherapy; AND
 a breast surgeon considers that at least 500g of breast tissue would be removed from each breast in a breast
reduction.
Only patients aged over 21 years, with BMI6 months) are likely to be considered. Breast reduction for asymmetry (unless total absence of breast tissue), even with psychological impact, is not routinely funded.

[Icannotcope]

@Alsohuman Which CCG is this? I'd genuinely consider moving to be able to get this surgery. It's crazy because I've had surgery performed by the NHS before on my ankle because of pain and scar tissue build up - I only needed 12 weeks of physio before they said I could have it and I was in far less pain than I am now. It seems that the NHS is not providing basic medical care because breasts are just deemed to be a sexual object rather than a body part.

[DomDoesWotHeWants]

One of my school mum friends had exactly the same. When the GP was sure she didn't want more children he referred her to have it done on the NHS.

[SoupDragon]

Whereabouts on the CCG page are the criteria? I'm looking at mine out of curiosity but can't work out where to look

[Tigersneeze]

@winningeveryday Refusing to leave till you get what you want is awful advice. It usually just results in security or the Police being called and a possible ban from the surgery.

first of all, I did this and it saved my life. had life-saving emergency surgery 5 days after seeing the specialist, the specialist the GP tried to refuse me to see. I refused to leave and got my referral. and I'm here today.

secondly, well imagine the horror of a woman causing a fuss, dearie me, security might be involved!!! oh... lets better not...much better to suffer in silence till the nerves in OP hand are damaged beyond repair. we wouldn't want to make a fuss would we??

this attitude makes my blood boil.
if there is money for viagra, then there is money for female healthcare!

[monkeyonthetable]

Your GP is just wrong. It's not a cosmetic procedure. You need this done to reduce pain and infection not to improve your outer appearance. Really emphasise this and repeat it several times. Get a second or third opinion until you find a GP who listens to you. Insist on a consultation. Really overplay the pain, the problems, the hygiene issues.

[Alsohuman]

My CCG is Cambridgeshire and Peterborough @Icannotcope. It’s notoriously tight here because it’s so underfunded. Surely it would cost as much to move as to pay for the surgery? You’re looking at around £6.5k. I’m surprised it’s so little, my cataract surgery cost me £5k.

[HopelesslydevotedtoGu]

Now that you have your CCG criteria list, I would evidence how you meet those criteria. For example you could take photographs when you get a rash or sore and write down how long it lasts for, what treatments you needed. Return to your GP with a written list of how you meet all the criteria.

If you don't meet all your CCG criteria, write a document about the criteria you do meet and anything you think may justify your case being exceptional, and discuss with your GP. If your GP thinks your case is exceptional, they may be able to apply for special funding via an Individual Funding Request Panel. In my area the Panel will only approve cases that are truly exceptional - not just where the treatment would help or 'should' be done.

If you aren't able to get surgery from NHS, the options could be researching private surgery, appealing for a change of rules within your CCG, or researching if other CCGs nearby have less strict criteria and considering moving house, drastic I know. Hopefully you can get treatment in your current area.

[Nacreous]

Icannotcope

I would start having a good around your area. Lots of CCGs in an area will be under one management team: that means that they are likely to have the same criteria, but probably only if that team has been in place for a couple of years. If local CCGs have been under the same management for some time have a look at the next patch out from you.

Your CCG is determined by the GP practice you are registered with, not where you live so you may get away with just changing GP surgery if you live close to the edge of a catchment area.

My local one has it has a partially excluded procedure, so has to be assessed at a panel but the actual requirements are fairly fair:

www.westsuffolkccg.nhs.uk/clinical-area/clinical-thresholds-lpps/

That's the whole list, breast reduction is towards the bottom.