Surgery following massive weight loss
Excluded
- BMI greater than 28
- Weight loss not sustained for more than six months
- Surgery for inner thighs and upper inner arms
Abdominoplasty (tummy tuck)
Excluded
- Patients with a BMI greater than 28
- BMI and recent weight change should be included in the referral letter
- Surgery for post partum related abdominal wall laxity, striae gravidarum, skin excess or other change of appearance
- Patients desiring correction of obesity
Allowable
- Where previous surgical scarring (usually midline vertical, or multiple) leads to very poor appearance and results in disabling psychological distress
- Transverse suprapubic scars (Pfannensteil) usually follwing obstetric or gynaecological surgery only rarely cause such problems
- Intractable intertrigo within a fold of overhanging abdominal skin
- As part of incisional hernia correction
- Correction of problems associated with poorly fitting stoma bags
Liposuction
Excluded
- Reduction and correction of symmetrically distributed fatty deposits for enhancement of appearance (liposculpture)
Allowable
- Isolated, usually unilateral, deformities (such as lipomata)
- Lipodystrophies (Post traumatic and diabetic)
- As part of a breast reconstruction revision
- Thinning of bulky reconstructive surgical flaps
Limb contouring
Excluded
- Age, sun and cigarette-related laxity of skin giving rise to poor appearance. It would be unusual for any of the below to be requested on the basis of functional disturbance.
- Upper arm reductions
- Thigh reductions
- Buttock lift / reduction
Allowable
- Ehlers Danlos and related collagen disorders of skin leading to premature laxity