06/01/2026
This is truly heartbreaking 💔 that public hospitals are now charging for Breast Reduction (BR) surgery instead of offering it free of charge to qualifying women. Unfortunately, it is not surprising, especially within South Africa’s public healthcare system.
In recent months, women have been reporting within our private community, Breast Reduction Support South Africa, that public hospitals are now informing patients upfront that BR surgery is no longer free and that payment will be required. For many women who have waited for years under the understanding that the procedure would be covered if they met the criteria, this news has been devastating.
Over the years, more women have become aware that Breast Reduction surgery is not merely cosmetic, but a medically necessary and life-changing procedure for many. As awareness has grown, so too has the number of women applying for BR surgery at public and government hospitals.
Historically, BR surgery was free at most public hospitals for women who met strict qualifying criteria such as BMI, severity of physical symptoms (chronic back and neck pain, shoulder grooves, skin infections, posture problems) and income status.
From the early 2000s until around 2020, many women successfully accessed free breast reduction surgery through public hospitals, at a time when the system could still accommodate the demand.
However, demand has increased dramatically. Public hospitals are now facing extremely long waiting lists, limited theatre time, staff shortages, and serious budget constraints. This has made it increasingly unsustainable for the public healthcare system to continue offering the procedure entirely free of charge.
At present, this shift is mainly happening in Gauteng public hospitals. Facilities such as Helen Joseph Hospital, Charlotte Maxeke Johannesburg Academic Hospital, Leratong Hospital, Dr George Mukhari Academic Hospital, and Steve Biko Academic Hospital have introduced fees that are still significantly lower than private healthcare costs, generally under R40 000. Unfortunately, Chris Hani Baragwanath Hospital has now also joined this move.
While these costs remain far below private-sector fees, they are understandably devastating for many women who have waited for years under the assumption that the surgery would remain free if they qualified. This change does not mean the surgery is unnecessary. On the contrary, it highlights just how highly demanded and medically important breast reduction surgery truly is.
It is also important to note that while this trend is currently concentrated in Gauteng, more public hospitals across South Africa are likely to follow as pressure on the healthcare system continues to grow.
That said, there is a strong plea for public hospitals and health authorities to ensure that underprivileged, unemployed, and low-income women are not excluded or discouraged from accessing this life-changing surgery. There should be clear exemptions, sliding-scale fees, or social worker-led assessments to protect those who genuinely cannot afford to pay, especially when the procedure is medically necessary.
This situation reflects the broader reality of an overstretched South African public healthcare system, where demand continues to outpace funding and resources. Introducing fees should never come at the cost of denying care to the most vulnerable.
Breast Reduction surgery is a medically necessary treatment for conditions such as macromastia/gigantomastia, which causes chronic pain, mobility issues, skin infections, and postural problems.
Our hearts truly goes out to every woman affected by this 💔. Breast reduction surgery changes lives, and we sincerely hope that more sustainable, fair, and accessible solutions are found across the country going forward.
