The Body Mass Index (BMI) thresholds for surgery vary depending on healthcare region.
Finland is currently updating its criteria for breast reduction surgery. At the moment, the Body Mass Index (BMI) threshold for surgery varies around the country.
Large breasts are a heavy burden for many women, as carrying excess weight causes pain and discomfort.
Twenty-five year-old Iina Marttila from Helsinki was able to get a breast reduction procedure through Finland's public healthcare system last year. The procedure left her 900 grams lighter.
"My breasts affected both my mobility and sleep. Whenever I wanted to move my arms, they were always in the way. I also had all sorts of shoulder and neck pains," Marttila said.
In Finland, breast reduction surgery among 18-30 year-old woman has nearly doubled in the past eight years. Last year, about 300 young women had the procedure, up from around 150 in 2015.
"More 20 to 30-year-olds are getting referrals for the surgery than before. But the majority are still women between the ages of 40 and 50 who have had children," explained Minna Kelloniemi, a chief plastic surgeon at Tampere University Hospital (TAYS).
In the public sector, reductions are restricted to women whose health is suffering because of big breasts. Problems usually include neck, shoulder and back pain, as well as pressure sores from bras or broken skin under the breasts.
Physicians interviewed by Yle said it was not clear why more young women were now getting the procedure. Kelloniemi suggested that there could be several factors, including the prevalence of obesity, which can also affect breast size.
Terhi Järvinen, a specialist in plastic surgery at Kanta-Häme Central Hospital, said that young people may have become more aware of access to treatment than was previously the case.
She said that while age was not a factor in qualifying for the procedure, young people need to understand the possible effects of the surgery.
"Breastfeeding may not be possible after the surgery. Some individuals may also end up with visible scars," she explained.
New guidelines
The Ministry of Social Affairs and Health is currently drawing up new national guidelines for doctors to use when assessing a patient's need for a reduction mammoplasty. The aim is to harmonise accesss for those seeking the procedure.
Current national guidelines prohibit reductions if a patient's BMI is over 30. However Helsinki University Hospital (HUS) and Päijät-Häme have set a BMI limit of 28.
The upper limit for normal weight is a BMI of 25, and the threshold for obesity is 30.
HUS made the decision to lower the BMI threshold last spring.
"We don't use a scapel to treat obesity," said Tiina Jahkola, a consultant plastic surgeon at HUS.
Jahkola emphasised research findings indicating that being overweight increases the risks associated with surgery. She added that the final result is more aesthetically pleasing if an obese patient loses weight before the operation.
Finland's public healthcare crisis is also a factor when gaining access to the procedure. Surgery waitlists are growing because of healthcare staff shortages.
"If the population's BMI increases, and the criterion for surgery is breast size, then the number of patients keeps growing. Demand surpasses supply," she said.
Iina Marttila said the surgery solved her health problems. Her neck and shoulder pains are gone, and moving has become easier.
But she also told Yle that the procedure had a psychological effect. "It has affected my self-esteem, self-image, and body image. I have gained confidence."
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