Breast reduction in Thailand

A breast reduction removes breast tissue, fat and skin, moves the nipple up and reshapes what is left, so that heavy breasts become lighter and higher and the neck, shoulder and back pain, the bra-strap grooves and the rashes under the breasts that come with them ease. In Thailand it is sold as a package in Thai baht by the large private hospitals of Bangkok and the plastic surgery hospitals of Phuket and Pattaya, covering the surgeon, the anaesthetist, the theatre, a night or two in hospital and the check-ups until you are cleared to fly.

Two things make a reduction different from the other breast operations people fly for. It is often a medical operation rather than a cosmetic one, which means a funded route may exist at home that you give up by paying in Thailand. And it is a large operation on breasts Thai surgeons see less often than the small ones they augment every day, so the surgeon's experience with big reductions is the first thing to check. This page explains what decides the price, what a package covers, how the techniques differ, how to check a surgeon, what the recovery looks like, and what funding and aftercare in Australia, New Zealand or the United Kingdom mean for the decision.

• Compare what a quote covers

  Every clinic on this page shows its current price with a note of what it includes. A reduction alone and a reduction with liposuction, a longer stay or histology of the removed tissue are not the same quote.

• Ask for large reductions on breasts like yours

  Thai surgeons see many small breasts and few heavy ones. Ask how many reductions the surgeon does a year, how large, and to see healed results at a year on patients of your size.

• Board, licence, accreditation

  Thai Board of Plastic and Reconstructive Surgery for the surgeon, a Ministry of Public Health licence for the facility, and hospital accreditation you can verify.

• A week or more before you fly

  Stay until the surgeon has removed any drains, checked the scars where they meet under the breast and cleared you to fly, usually about a week after surgery and longer for very large reductions.

The price is a package in Thai baht, and it moves with what is actually done. Each clinic on this page shows its current price with a note of what it covers, and that is the figure to compare, because a quote for a moderate reduction with one night and a quote for a very large reduction with two nights, drains and liposuction of the sides are not quotes for the same operation.

• How much is removed. A large reduction takes longer in theatre, sometimes needs the nipple moved as a free graft, and usually means an extra night; the fee follows the time.
• The technique. A vertical-scar reduction is shorter than an anchor reduction, and a liposuction-only reduction, for fatty breasts with good skin, is the shortest of all.
• What is combined with it. Liposuction of the sides of the chest, a tummy tuck or an arm lift each add theatre time, a fee and days to the stay.
• Anaesthetic and nights. General anaesthesia with one or two nights in hospital is the norm for a reduction; a package that promises same-day discharge for a large reduction should be questioned, not welcomed.
• Hospital or clinic, and which city. A large Bangkok hospital with an international department charges more than a clinic; Phuket often sits between the two.
• Primary or revision. Correcting a previous reduction, or reducing breasts that have regrown after weight gain, costs more than a first operation.
• The surgeon. Surgeons who do large reductions regularly charge more, and for this operation that is money well spent.

For a reduction the honest comparison has three columns, not two. The first is the funded route: in Australia a reduction for symptoms can attract a Medicare rebate and private hospital cover when the criteria are met; the New Zealand public system and the NHS fund some reductions, with criteria that vary by region and waiting lists that can be long. The second is a private reduction at home: the surgeon's fee plus the anaesthetist and the hospital, with follow-up in the same rooms for as long as you need it. The third is Thailand: one package in baht that covers the hospital side and ends when you fly.

To compare the third with the second, add to the Thai figure the flights, a week or more of hotel, a companion's costs, travel insurance that will not cover the surgery itself and a reserve for scar care and aftercare at home, then ask what a revision would cost. To compare it with the first, ask whether you qualify before you book anything: a funded operation with a wait may be worth more than a paid one without.

Thailand licenses doctors and facilities separately. The surgeon should hold a licence from the Medical Council of Thailand and the Thai Board of Plastic and Reconstructive Surgery, the specialist qualification issued through the Royal College of Surgeons of Thailand; membership of the Society of Plastic and Reconstructive Surgeons of Thailand or the Society of Aesthetic Plastic Surgeons of Thailand is a further sign of a surgeon trained in the specialty. It is the counterpart of checking a specialist plastic surgeon's registration with AHPRA or the GMC.

The facility should hold a Ministry of Public Health licence for surgery under general anaesthesia. Private hospitals in Bangkok, Phuket and Pattaya commonly carry Hospital Accreditation from Thailand's Healthcare Accreditation Institute, and several also hold Joint Commission International accreditation. A reduction is hours of surgery with real blood loss; it belongs in a hospital with a physician anaesthetist, a recovery unit, a ward and a blood bank, not in a clinic licensed for local anaesthetic procedures.

• Ask for the surgeon's full name and licence number and look them up in the Medical Council of Thailand register before paying anything.
• Ask how many reductions the surgeon does in a year and how large, and how many on Western patients; a surgeon whose portfolio is augmentations is not the one for a large reduction.
• Ask for healed photographs at a year, from the front and both sides, of breasts that started like yours, and look at the scars, the areolas and the symmetry.
• Ask which technique and which pedicle are proposed and why, and whether a free nipple graft is likely for your size.
• Ask about weight and health limits. Reputable hospitals decline or defer patients above a certain body mass index, with uncontrolled diabetes or who smoke; a hospital that declines nothing is telling you something.
• Ask what happens if a wound opens or a revision is needed, who treats it, what it costs and whether the surgeon's fee is waived, and whether the removed tissue goes to a pathologist.

1. 1

   Online consultation with photographs

   Front and both sides, standing, in a plain bra and without, with your height, weight, bra size, symptoms, pregnancies, weight history and whether you plan more children. The surgeon should reply with a technique, a pedicle, an estimate of how much can come out and a reason, not only a price.
2. 2

   Arrival and examination

   A day or two before surgery: examination and measurements, blood tests including a blood count, an ECG, the anaesthetic assessment and, for patients over a certain age, a mammogram or ultrasound if you have not had one. This is where the plan and the price are confirmed and where the surgeon can still say no.
3. 3

   The operation

   Under general anaesthesia, a few hours depending on the size of the reduction. The tissue removed is weighed, and in good hospitals sent to a pathologist. You wake in a surgical bra, often with drains, and stay one or two nights on the ward.
4. 4

   The first days

   Swelling, bruising and a tight, sore chest that settles over the first week; the relief in the neck and shoulders is often noticed at once. Sleep propped up, walk often, do not lift, keep the dressings dry and the arms below the shoulders.
5. 5

   Check-up and clearance to fly

   Around a week after surgery the surgeon removes the drains, checks the incisions, above all where the scars meet under the breast, and clears you to fly. A slow wound means staying longer, which is why the return flight should be changeable.
6. 6

   Home and the long tail

   The breasts sit high and boxy at first and settle over months; the scars are red for months and fade over a year with silicone sheets and no sun. Send photographs at the agreed points and see a doctor at home the same day for a wound that opens, fever, spreading redness or a nipple that changes colour.

The flight itself is rarely the problem once you are cleared; the problems are the ones that declare themselves in the weeks after. The scar junction under the breast can open and need dressings for weeks, a seroma or haematoma can appear, an infection can start after you land, and the scars need a year of care. Medicare, the New Zealand public system and the NHS will treat an emergency, an infection or a bleed like any other patient's. They will not correct a cosmetic result, and private health funds normally exclude complications of elective surgery overseas, even for an operation that would have been funded at home. Ask your fund in writing before you book.

Arrange the doctor who will see you before you leave: a specialist plastic surgeon or breast surgeon for the breasts, your GP for fever or infection, and a practice nurse who can dress a wound if the junction opens. Take the English operative report with you, naming the technique, the pedicle, the weight removed from each side, the sutures used and the pathology result. Some surgeons at home decline to revise another surgeon's reduction, so ask when you book the appointment, not after a problem appears.

1. Ask your GP first whether a funded reduction is possible at home and what the wait would be; decide about Thailand with that answer in hand.
2. Compare the clinics on this page by what the price covers and for what size of reduction, then shortlist two or three.
3. Send the same photographs, measurements and questions to each and judge the answers by whether they name a technique, a pedicle, a surgeon and a written list of inclusions.
4. Look up the surgeon and the hospital in the Medical Council of Thailand register and the accreditation lists before paying a deposit.
5. Ask your health fund in writing about complications, book changeable flights, a companion and a hotel near the hospital, and stop smoking and blood-thinning supplements well in advance as instructed.
6. Take the operative report and the pathology result home, and book your first check-up at home before you fly out.

If you are weighing Thailand against Turkey, the breast reduction in Turkey page describes a market built around European patients with shorter flights from the UK. The breast reduction abroad page compares the destinations, the tummy tuck in Thailand page covers the operation most often combined with a reduction after weight loss, and the plastic surgery in Thailand hub lists the rest.