Definition of 'cosmetic surgery'
Cosmetic surgery is classed as anything which improves a person's appearance rather than their health. There are some crossovers, for example, breast surgery. A reduction or enhancement may be viewed as cosmetic, but a reduction may be needed as it carries health impacts, or an enhancement due to the psychological trauma the patient is suffering. Therefore, it is possible to have some cosmetic procedures covered by the NHS, although there are stringent guidelines to adhere to. Cosmetic surgery should not be confused with corrective or reconstructive surgery, which is often offered to correct or improve congenital abnormalities or injuries.
What is available on the NHS?
Whilst procedures are rarely available on the NHS, there are some which may be considered. The most common of these are: Breast implants – to correct asymmetry or severe underdevelopment. Also available as reconstruction after a mastectomy Breast reduction – to relieve back pain, problems with posture, general discomfort Nose reshaping – to help relieve breathing problems Abdominal surgery – to remove excess skin after severe weight loss Eyelid reduction – to correct reduced or impaired vision
What to do
If you feel you need cosmetic surgery, even if it is not mentioned above, you should always go to see your GP first. They will be able to discuss your desires and expectations, and advise you of your best course of action. For surgery on the NHS, you must be referred by your GP, and there is no harm asking for a referral if they don't offer one, as sometimes you may feel more comfortable talking to an expert in the field of your particular surgery. Once a referral has been made, you will be contacted by the hospital directly or the NHS appointments office who will advise you of your consultation. This is where you will meet a consultant who will discuss the procedure with you and weigh up whether you meet NHS guidelines. Unfortunately, guidelines change all the time and are becoming increasingly strict, for example to qualify for a breast reduction you must have a BMI of less than 26 and be able to have a minimum of 500g of breast tissue removed. This has only been introduced within the last 12 months. Of course, the final decision lies with your local PCT (Primary Care Trust) and you can appeal a negative decision if you so wish. After your consultation an appointment will be made for your pre-op, which can take up to 2 hours. During this time, nurses will monitor your health (ie take blood and urine tests) and you may be asked to see a medical photographer. This will be the final stage before surgery.
The NHS has notoriously long waiting lists and therefore a majority of patients tend to opt for private practitioners. Not only are they guaranteed a short waiting time, it is also often said that you receive more thorough aftercare as opposed to the NHS. This is understandable, as the resources of the NHS are often stretched whereas you get what you pay for when going private.