My Breast Reduction: Why I Had the Operation That Helped Simona Halep Win at Wimbledon | Life and style

TThree days before Christmas 2015, at 19, my chest was reduced. Sitting alone in my apartment after the operation at Ross Hall Hospital in Glasgow, I confronted my scars for the first time and cried.

It was not the first time I cried on my body, but it was not the tears of a miserable and frustrated teenager. I felt like I had gone through a battle and that I had come out victorious. By holding these sewn breasts, a handy 32E of a 34GG, I was finally, gloriously myself.

After Simona Halep was crowned Wimbledon champion in 2019, I wondered if she had felt the same after her surgery 10 years ago. Halep, then a rising 17-year-old, had felt that her chest was affecting her game and had chosen to reduce her breasts from 34D to 34C. "It's the weight that concerns me," she said at the time. "My ability to react quickly – my breasts hurt me uncomfortably when I play."

Although she told Sports Illustrated last year that her breast reduction surgery was her "biggest sacrifice" for the sport, Halep said she had never regretted that decision. "I did not like them [her breasts] in my daily life either. I would have been operated even though I had not been athletic. "

Today, as a 23-year-old journalist, I still feel the magnitude of my decision and its impact not only on my body, but also on my mental health and all other aspects of my life. I no longer need to hide my body under layers of clothing or sleep in a particular position to avoid straining. I can sit upright without attracting attention, nor accusations of attracting attention. The most liberating of all, the operation released me chronic headaches and back and neck pain that had led me to take painkillers every day.

Breast reduction is performed under general anesthesia, most often by cosmetic surgeons in private practice. The operation usually involves removing excess fat, glandular tissue and skin and reshaping the remaining breast tissue. The nipple is displaced, creating a scar that, for most women, extends vertically and through the fold of the breast-shaped anchor.

The operation can remove up to one kilogram of each breast and lasts between 90 minutes and four hours, depending on the extent of the reduction; a hospital stay of two nights is recommended. It is also expensive: around £ 6,500, according to the NHS, excluding consultations and follow-up care.

Nevertheless, the number of people benefiting from the procedure is increasing. In 2018, NHS England funded the reductions of 4,409 women, compared to 4,354 in 2017, 4,188 in 2016 and 3,959 in 2015. The annual audit of the British Association of Aesthetic Plastic Surgeons in May revealed that it was the second most popular procedure for women (after breast augmentation), with 4,014 women in the UK having paid to reduce their breasts during 7% increase between 2017 and 2018.

The fact that so many women are willing to bear the cost themselves is a testament to the potential of this life-changing procedure. A 2010 Georgetown University Hospital study found that many patients with breast reduction reported an improvement in their chronic headaches and migraines as a result of a reduction surgery.

The patient satisfaction rate is high: in 2012, a retrospective analysis of 600 consecutive patients in a single institution in the United States revealed that more than 95% of them would opt for surgery again. He concluded that there was a clear improvement in the patient's quality of life, regardless of her weight and height or the volume of breast tissue removed.

"I do not even consider breast reduction as an aesthetic procedure, it's an extremely beneficial operation," says Chris Hall, consultant plastic surgeon in Belfast and a member of the British Association of Aesthetic, Reconstructive and Aesthetic Surgeons (Bapras). "The physical benefits, the psychological feelings of patients and the improvement of their quality of life are all well documented. Unfortunately, the defined eligibility criteria, which have been tightened more and more over the years, make it almost impossible to put the procedure in place in the NHS. "

NHS criteria are supported by the Academy of Faculties of Medicine, which includes the Royal College of Surgeons and the independent evaluators of the National Institute for Excellence in Health and Care. A patient must have a stable BMI less than 27; their breasts must be "of a massive disproportion compared to the habitus of the body"; they could or should have an "insoluble intertrigo" (inflammation caused by skin-to-skin friction), "asymmetry greater than cup size" and "significant psychological distress".

But many women who have sought surgery have complained of inconsistencies and lack of transparency about how to qualify. Amy Hill, a 23-year-old personal trainer, was initially denied breast reduction despite a 28KK bra. "I hated my breasts – they kept hurting me," she says.

Getting a bra was impossible. When she went to Bravissimo, a specialty store with the slogan "Inspire busty girls to feel unbelievable", they told her they did not do it at her height. "I cried in the locker room."

For almost a year, she was wearing a bikini top. "It was all that suited me. I would always attract unwanted attention: people thought that they were fake. You can always see them. They were huge.

When Hill was informed that she did not meet the reduction criteria – "they told me that they did not mentally affect me enough," she lost consciousness. , she says. "I was so desperate for that. For someone to turn around and say "no", it annihilated me. "

But she kept pushing. "The whole process was so long and exhausting. I would wait for an appointment for three months for them to then tell me something that they could have told me on the phone. I was going to give up, but my mother had had [the operation] when she was my age, she told me that I had to keep trying. She said it was not as difficult for her as it was for me. "

Hill finally had a breast reduction at the NHS in 2016, when she was 21 years old. In the hospital, after her operation, a nurse did not think her breasts had been as big as she had said before. "She got me out of bed to measure them," says Hill. "Everyone in the room pointed out that I could not be the size I said I was; that it was impossible.

"I was so embarrassed that I cried. People were ashamed not to appreciate my breasts and want to rid me of them.

But Hill did not regret the operation for a moment. "Before, when I went to the gym, I had to wear three bras. Now, in the year following the start of my personal trainer training, I open my own fitness center. I was very lucky to have the procedure. "

The eligibility criteria differ in each NHS sector, which means that women who request surgery are almost at the mercy of a lottery with zip code, said Russell Bramhall, consultant at the NHS. Canniesburn Plastic Surgery Unit of the Royal Glasgow Hospital. "I do not remember the last time I did a breast reduction on the NHS. Everything became more and more tight; we work in a poorly funded state system. The referral process and long waiting times can also be a barrier.

In my case, I was right to compare my journey to a battle. I campaigned for my operation to be performed by the NHS for four years. NHS Scotland recognizes breast reductions as part of its exceptional reference protocol for procedures that do not treat an underlying disease process, and therefore provides them only on very rare occasions. Patients should be referred to a clinical psychologist after evaluation and are subject to the decision of a clinical commissioning group.

I was expected to get undressed and get up at every consultation, stung and pushed by male doctors, student doctors and nurses. I felt that I had no choice – it was as if, by opting for surgery, I had waived my right to privacy.

At an appointment, a young GP published the NHS's opinion on breast reduction after consulting Google. In my psychiatric assessment, a clinical psychologist asked me, "When you say that you think people are looking at you in the street, do not you look at them first?"

After an exhausting, humiliating and intrusive struggle with my GP and the NHS Scotland, I ended up paying for the surgery myself. The system effectively pushes women looking for breast reduction in the private sector, say Bramhall and Hall.

Ann (her real name), a 22-year-old student living in Scotland, wants a breast reduction operation of 36 FF, but can not afford to stay private. "I want to love my chest, but I really do not like it, even if all my sexual partners love them. There were times when I felt so frustrated, I imagined the psychological and physical relief of cutting them straight from my body. They do not make me feel more feminine, so I do not think I would feel less like a woman without them. "

Ann finds that clothes are not snug and that bras are much more expensive than standard sizes. But most importantly, she says, "I have back pain, but not enough for the NHS".

Bramhall says that besides the physical problems associated with big breasts – "back pain, shoulder pains, infections, bra cuts, thrush similar to impetigo under the breast" – l 39; impact on mental health and quality of life is often not taken into account. "A common mental symptom in my patients is low self-esteem and poor body image. They lack social trust, and when they are out of their clothes with their partners. I get all the time from women who describe not feeling comfortable in a swimsuit or in summer clothes – the amount of pleasure that they get in summer is reduced. People wear loose clothes all the time to hide their appearance. This is not taken into account at all. "

Those who can not afford private surgery may be tempted by cheaper options that are not always safe or well regulated. Bapras members report seeing patients with post-operative complications after cosmetic procedures outside the UK, where eligibility criteria are often more lax or non-existent. In many cases, the presence of unmanageable large breasts is associated with health problems such as obesity, due to inability to exercise, as well as anxiety and anxiety. depression, due to low self-esteem and poor self-image (which can turn into body dysmorphic disorders).

Hall says that NHS criteria can prevent surgery for those who need it most. "Many criteria are based on inconclusive evidence: for example, it is very difficult to maintain a BMI less than 27 for two years with large breasts. You can not exercise. If you are thin, they look bigger. If you are of size M, your breasts can weigh the equivalent of 2 pounds of sugar on both sides. "

Both consultants acknowledge the pressures on the NHS, leading them to prioritize cases of trauma and cancer. "The NHS does not have a bottomless bottomless pit," says Hall, "but what Bapras would want is transparency and consistency. We would like to see the same eligibility criteria applied across the country so that it is consistent no matter where you live. If the NHS decides that nobody gets a discount, then they should tell us that there is no money and they will not finance it. "

This denotes a more general problem of women's health that is not taken seriously: every year, thousands of women pay for a procedure that undoubtedly improves their health and quality of life. I had a hard time deciding to have my surgery done, asking me if it was anti-feminist to want to change my body – but my reduction has proven to be the most stimulating decision I've ever had. Never took. It was not just about reducing the size of my breasts; it was a path to a life of trust, without pain. I gained autonomy on my body, but I had to fight to get it.