We now have official confirmation that cosmetic work should not be undertaken on the NHS, according to Health Secretary Jeremy Hunt. This appears to be based on figures that in the last six years 8000 people had abdominoplasties on the NHS at an estimated cost of £50 million (£6250 per abdominoplasty – a reasonable cost for an abdominoplasty). What are not clear are the reasons for the abdominoplasty – as the NHS protocols clearly state that: “Cosmetic surgery is rarely available through the NHS. There must be overriding physical or psychological reasons for considering it as a treatment option. For example, a clinical commissioning group (CCG) may decide that cosmetic surgery is required for health reasons in rare cases.” So these 8,000 people should have been assessed by a number of professionals who would have deemed the procedure as required and that there was an overriding physical or psychological reason. It is unlikely that the system would have been abused by the vast majority.

Perhaps what is required is a robust independent multidisciplinary pathway for these specific cases to be discussed and treatment options planed. A major problem facing plastic surgery is that the number of cosmetic procedures performed by surgeons in the NHS will fall and the training programmes will therefore depend on trainees gaining experience in a short period of aesthetic fellowship programmes – unfortunately not all trainees will be able to be accommodated in these programs.

The issue then is will the full time consultants in the NHS have the necessary experience and number of cases performed per year to adequately perform these procedures or should the NHS look at funding these on a private basis – and once more spend more than £50 million in the next six years?

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Dalvi Humzah

West Midlands, UK.

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