A number of things can be caught up in the breast reduction figures. Photo / File
Most people wouldn't consider a jog around the block to be a luxury, but for 21-year-old Jess, it was the first time she'd been able to run since she was just 10.
That's because Jess had already developed double D breasts in primary school.
Years of discomfort, back pain, and snide whispers from her classmates later, Jess finally had breast reduction surgery last year, and the results have been life-changing.
She was one of the lucky ones chosen for publicly-funded operation. Many women around New Zealand shell out thousands of dollars, or put up with the pain.
"For people who have neck and upper back pain, or people who have deep shoulder grooving, or who have problems with hygiene with rashes underneath the breasts, breast reduction can often be a transformational operation for people," said the vice-president of the New Zealand Association of Plastic Surgeons, Brandon Adams.
"It gives people huge relief. It's probably one of the best operations that we have in terms of reliably improving people's lives."
Despite figures from the Ministry of Health showing the number of mammoplasty procedures have quadrupled in the last three decades, Adams said the talk in hospital units was that access to funding for traditional breast reduction surgeries was decreasing.
Adams believed breast reductions were just as important as other life-improving procedures, such as those for hips and knees, but people were less inclined to talk about it because breasts were considered a more "private" matter.
"Not many people are willing to stand up and say 'my nana and I were talking about how heavy and painful her breasts are.'
"People may not be willing to march on Parliament for a painful neck because they've got large breasts."
Adams said a number of things could account for the figures of hospital discharges for publicly funded reduction mammoplasty procedures.
The numbers jump from 56 discharges in 1988 to 291 last year. Women having breast reconstruction surgery after breast cancer might go through a reduction to even out their breasts, or a piece of breast tissue being removed to protect against breast cancer could be included in the umbrella of reduction mammoplasty procedures.
Other things that could be included might be a reduction of excess skin after massive weight loss, or the removal of breast tissue in young males.
But as for traditional female breast reductions, Adams' impression was that it was becoming more difficult for women with painfully large breasts to access public funding for reduction surgeries.
By the time Jess got her surgery in October 2018, she was wearing a size 12 GG bra, and suffering "really bad" pain, as well as tearing of her skin underneath her breasts.
At the all-girls school she attended, classmates would spread rumours she was stuffing her bra. Her family thought she was just overweight.
She hadn't realised how unusual her large breasts were until she was about 18, and started feeling "sexualised" when she went out.
Other girls would come up to her in the bathrooms at nightclubs and touch her chest without asking.
She is glad she waited until 21 to get the surgery, saying she knew herself better by then.
"I don't miss them at all."
"I was known for my breasts and I hated it"
Selena Going is still struggling with her H-cup breasts after being told she couldn't have a publicly funded reduction surgery.
She was assessed more than 10 years ago and told she met the criteria, but received a letter saying she would not be put on the public waiting list.
The 38-year-old has a rare condition called gigantomastia, which involves excessive breast growth during puberty or pregnancy. She was hit twice, with her breasts only growing to the size they are now when she had children.
But Going first began developing breasts at the age of 9. She had double C cups by the time she was 12, and was nicknamed "big tits" in school.
One day she wore a T-shirt with the word Pepsi on it, and from then on she was called "Pepsi tits".
"It was always about my breasts with the kids."
Even at family gatherings Going was subjected to comments from relatives.
"I was never anything but my breasts. I was known for my breasts and I hated it."
Going won't go swimming in a pool because she's worried about other people looking at her.
On top of the embarrassment, her neck and back are "constantly sore", and she has big dents in her shoulder skin where the weight of her bra straps press down heavily. She has semi-permanent bruises from the underwire.
Hayley's reasons for the surgery were aesthetic. She wasn't experiencing pain, but didn't like the way her E cup breasts looked and felt.
The 39-year-old researched the cost of getting the surgery in New Zealand, but said it would have cost her about $26,000.
The cost for getting the surgery in Thailand - including flights and 10 nights of accommodation - came out to only about $10,000.
While the hospital and staff were fantastic, Hayley was unprepared for the emotional effect of going through the surgery entirely alone in another country.
"I felt vulnerable and just a bit scared, really," she said.
Hayley was 9 years old when she first started wearing a bra. Before the surgery, she was only able to wear "nana bras with the three clasps at the back".
She remained unsure about whether not liking the look of her breasts was enough of a reason to go through a major surgery.
She has had trouble with her wounds healing since the procedure. Seven weeks on she was still visiting the doctor every few days.
"Everybody says it will be worth it in the end. I'm not quite there yet."
A Ministry of Health spokesman said data on how many women are denied funding for breast reduction surgeries is not currently collected.
"It is important to direct limited resources to those with the greatest need. Treatment decisions must be based on two things - the impact of a patient's medical issue on their life (need) and the likelihood that these impacts can be reversed or improved (benefit).
"District health boards use clinical prioritisation tools to support them to make fair and equitable decisions about access to services.
"People referred for breast reduction surgery will be prioritised against others referred to the service, including those requiring mastectomy and reconstructions."