Breast reduction Referral Access Criteria
Breast reduction Referral Access Criteria
| Referrers should use this page when referring patients to public adult plastics and reconstructive surgery outpatient services for breast reduction. |
| Emergency referral |
 If any of the following are present or suspected, refer the patient to the emergency department or seek emergency medical advice if in a remote region. |
- Post-reconstruction breast abscesses with sepsis or septic shock (based on 2 or more of the following: fever, tachypnoea, tachycardia, hypotension, lactate >2)
- Any suspicion of post-surgical nipple necrosis/ischaemic nipple, expanding haematoma, infection/sepsis, or wound necrosis/breakdown
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| Immediate referral |
 Immediately contact the on-call registrar or service to arrange an immediate plastic and reconstructive surgery assessment (seen within 7 days): |
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| Clinical indications for outpatient referral |
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
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- Breast reduction if required in the following circumstances:
- as part of cancer treatment
- for clinically significant and persistent mobility & functional issues (e.g. impacting ability to complete vocation, shoulder grooving in straps, acquired kyphosis, or chronic pain/depression/significant anxiety related to macromastia)
- for clinically significant and persistent intertrigo (e.g. affecting vocation, requiring multiple antibiotic treatments, intertriginous maceration and/or infection of the inframammary skin)
- significant asymmetry
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| Mandatory information |
Referrals missing 'mandatory information' with no explanation provided may not be accepted by site. If 'mandatory information' is not included, the explanation must be provided in the body of the referral (e.g. patient unable to access test in regional or remote areas or due to financial reasons). This information is required to inform accurate and timely triage.
If unable to attach reports, please include relevant information/findings in the body of the referral and advise where (provider) investigation/imaging was completed.
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| History |
- Relevant history, onset, duration and severity of symptoms
- Degree of functional impairment (e.g. impact on mobility/exercise tolerance/ADLs/ability to work/quality of life)
- Details of current and previous treatment and outcome, including surgery
- For breast cancer patients: history of any oncological treatments
- Details of smoking and/or vaping (containing nicotine) status (not mandatory for malignancies)
- Current medications list
- Any known allergies
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| Examination |
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| Investigations |
- Mammography for women >40years
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| Highly desirable |
| History |
- Advise where or not your patient is taking any anti-platelets or anti-coagulants
- if so, state the indication
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| Examination |
- Breast examination (and any suspicion of malignancy)
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| Investigations |
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| Indicative clinical urgency category |
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Category 1
Appointment within 30 days
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- Breast reduction as part of cancer treatment
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Category 2
Appointment within 90 days
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- No defined category 2 criteria
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Category 3
Appointment within 365 days
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- Macromastia: where breast size causes substantial disability (affecting vocation), and the patient's BMI is <32
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| Exclusions |
- Breast reduction is an excluded condition when BMI ≥32
- except when part of cancer treatment
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| Useful information |
- A patient’s BMI must be under 32 to be considered for breast reduction surgery.
- A breast reduction will usually be considered when the size of the breast is not attributable to excess weight, and when a substantial health benefit can be expected.
- Current smoking is a contraindication to breast reduction surgery
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Last reviewed: 15-08-2025