Not Routinely Funded / Threshold
Norfolk and Waveney CCGs will not routinely fund
Aesthetic / Cosmetic Breast Surgery for the conditions or procedures listed below:
- Surgical treatment of Inverted Nipples (011:v1)
- Hypoplasia or Aplasia of Breast(s) (006:v1)
- Other Breast Asymmetry (009:v1)
- Gynaecomastia (005:v1)
- Breast Reduction (004:v1)
- Ptosis/ Mastopexy (010:v1)
- Breast Augmentation (003:v1)
IFR Form required to be completed.
Norfolk and Waveney CCGs will fund removal/replacement of breast implants on a restricted basis according to the following criteria:
1. Implant removal (007:v1)
- Removal of breast implants will be funded where there is documented evidence of ANY of the following:
- Breast disease (current or prior to previous mammoplasty)
- Implant complicated by recurrent infection
Implant with capsular contracture
- Implant is ruptured
2. Replacement of breast implants (008:v1)
Replacement of breast implants will be funded only for patients fulfilling the criteria for implant removal (criteria 1-4 above) and that the removal and replacement of implant is carried out as part of the same surgical procedure. For implants complicated by recurrent infection, it may not be possible to remove and replace the implant at the same time, and clinically appropriate decisions should be taken for such patients. All other applications for replacement will be considered via the IFR process – IFR Form required to be completed.
Reconstructive surgery following malignancy, trauma or other disease is routinely commissioned across Norfolk and Waveney on a separate care pathway.
||13 October 2016
|24 November 2016
|Next Review date