Hello I have a question for you, why does the information given online not make it clear that if you’re over 30 BMI you don’t qualify for breast reconstruction after a mastectomy on the NHS? I’ve been sent down a rabbit hole told have ur breasts off, then found out I had to loose weight to qualify for reconstruction which has been adding to my horrid situation, as my hormones are the cause of all this so of course I had a few pounds extra, then given meds that cause weight gain and left with no help or advice. I’ve managed to starve myself to loose some weight which is not ideal through this situation but I’m still slightly over 30 so I’m living in fear not knowing if when the day comes I’ll be turned way it’s not healthy to live like this so last night I thought I’ll look online see what others have done in this situation shockingly it’s not at all clear why its not possible on the NHS if your slightly over 30 BMI it does not say you will not be entitled just says you may be asked to loose weight. If it is because it’s a higher risk an explanation as to why I’m fit enough to go through having a full mastectomy and the skin expanders fitted which is the most risky surgery yet if I’m over 30 BMI when my appointment finally comes along I could be turned away for removing them and fitting implants in just a day surgery home the same day? Why on earth is this not on the news and people being made aware of how the NHS are treating cancer patients in this situation? It’s sick to do this to someone in my situation, screws with ur mental health. 

  • Dear Honest, 

    Thanks for getting in touch. 

    My name is Carole and I’m one of the Cancer Information Nurse Specialists on the Macmillan Support Line. 

    Waiting on surgery can be an anxious time and having enough information can help to make you feel more in control. 

    I will feedback your experience of information online with our cancer information development team. They are responsible for the content on our website and within our booklets.  

    I can’t say for certain, but BMI guidelines vary between hospitals, so that could explain why some information might say you could be asked to lose weight. 

    For any type of surgery, the guidelines around weight can be different when an operation is considered urgent, for example when its being done to get rid of cancer.  

    Although it’s not likely to take as long as your previous surgery, the surgeon and anaesthetist may ask you to make some lifestyle changes to reduce the risk of surgery. The Royal College of Anaesthetists have these tips for people preparing for surgery.  

    Your hospital team should be able to explain their reasoning for not offering immediate reconstruction, including any risks possibly associated with having a BMI greater than 30. We’d recommend speaking to them again. 

    We know how difficult it can be to lose weight gained through cancer treatments. Our booklet about managing weight gain gives suggestions and tips to help reach a healthy body weight. It may be helpful to have a look at it. 

    And I’m not sure if you have heard of the charity, Penny Brohn? They have lots of good resources and have developed this treatment support programme. It includes support from a specialist dietician.  

    You’ve mentioned the effect your situation is having on your mental health. It may be helpful to speak to your GP, or if you’d like to be referred for counselling, please don’t hesitate to give us a call. If you prefer, you can book a wellbeing assessment with Bupa, here. 

    I hope this is helpful. If you have further questions, please don’t hesitate to get back in touch. 

    Sending best wishes, 


    You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email 

    Our ref: JL