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Cosmetic Treatments
This is a summary of the NHS Devon commissioning policy for cosmetic treatments.
Cosmetic treatment is surgery or non-surgical medical treatment carried out solely to change a person's appearance to achieve what they feel is a more desirable look.
Cosmetic treatment is not routinely commissioned. This policy lists commonly encountered cosmetic procedures which are not commissioned except under the circumstances described, but this policy applies to all treatment which is being carried out for cosmetic reasons.
It excludes surgery to repair and reconstruct missing or damaged tissue that has occurred through accident or illness. It may be difficult to restore normal appearance and this exclusion does not constitute an ongoing agreement to fund surgery until an ideal appearance is achieved. Under normal circumstances the reconstructive surgery is commissioned when it is part of an ongoing package of treatment for the accident or illness, including where the patient has chosen to defer taking a decision on the surgery. Once the patient has been discharged from this treatment plan further procedures are not routinely commissioned.
The revision of treatments originally carried out outside of the NHS is not routinely commissioned.
Breast Procedures
These procedures are not commissioned:
- Breast Asymmetry Correction
- Breast Augmentation (enlargement)
- Breast Lift (Mastopexy)
- Breast Reduction
- Removal of male excess breast tissue
- Inverted Nipple Correction
Body Contouring Procedures
These procedures are not commissioned:
- Abdominoplasty/ Apronectomy
- Brachioplasty (arm reduction and lift)
- Buttock Lift
- Labiaplasty (reduction and/or reshaping of the labia)
- Lipomodelling (surgical fat transfer)
- Liposuction (removal of body fat)
- Testicular Prosthesis
- Thigh Lift (removal of excess skin and fat from the thighs)
Facial Procedures
These procedures are not commissioned:
- Cosmetic dental treatments
- Face Lift
- Laser Surgery for Short Sight
- Pinnaplasty (reshaping and/or pinning of ears)
- Repair of ear lobes
- Shave excision of Rhinophyma
- Sympathectomy for facial flushing
- Treatment to change appearance of face (including botulinum toxin injections /fat transfers/ fillers)
These procedures are not routinely commissioned however there are some criteria under which treatment is funded without NHS Devon panel approval:
- Rhinoplasty/Septorhinoplasty (reshaping of nose)
- Immediate post trauma nasal manipulation which normally occurs two to three weeks after the trauma is funded without NHS Devon panel approval
Skin Procedures
These procedures are not commissioned:
- Chemical peels
- Dermabrasion of skin
- Dermal fillers
- Micropigmentation (permanent make-up)
- Skin lightening
- Tattoo Removal
These procedures are not routinely commissioned however there are some criteria under which treatment is funded without NHS Devon panel approval:
- Hair Removal (Electrolysis or Laser Treatments)
- Treatment for recurrent pilonidal sinus is funded without NHS Devon panel approval
- Treatment following hair bearing flap reconstruction is funded without NHS Devon panel approval
- Scar Revision (reduction in the appearance of scars)
- Is funded without NHS Devon panel approval as a clinically necessary part of a staged procedure to allow for improved functional outcomes
- Wigs, hairpieces and hair transplant/ replacement systems
- Treatment is funded without NHS Devon panel approval when hair loss is the result of previous surgery or trauma, including burns
- Hair pieces and wigs for patients experiencing total or severe hair loss as a result of alopecia totalis, cancer treatment, previous surgery or trauma are available from local NHS Trusts through commissioned pathways
- Wigs are available from the NHS but patients will be charged for them unless they qualify for help with charge
Policies exist for procedures which could be undertaken for medical reasons. There are specific separate policies for these setting out the criteria or circumstances under which they are funded.
Where the circumstances of treatment for an individual patient do not meet the criteria described above exceptional funding can be sought. Individual cases will be reviewed by the appropriate panel of NHS Devon upon receipt of a completed application from the patient's GP, consultant or clinician. Applications cannot be considered from patients personally.
Please see panel policies for guidance on submitting applications for cosmetic treatments.
Date of publication: 22 November 2018
This policy has been adopted from Northern, Eastern and Western Devon CCG
and South Devon and Torbay CCG by NHS Devon CCG from 1 April 2019
