Cosmetic Policies

The policy is implemented by primary and secondary care healthcare professionals when advising and referring patients, and by providers when considering the treatment options for patients. Those making referrals should not refer to any provider for a treatment or procedure covered by this policy.

Providers should not suggest, recommend or otherwise offer excluded treatments or procedures covered by this policy to any patient, unless it is clear the patient meets the appropriate clinical criteria outlined.

This policy should be read in conjunction with other policies and pathways, e.g.

  • Procedures of Limited Clinical Value (PLCV)
  • Interventional Procedures Guidance (IPG) Policy – Derbyshire wide
  • Musculoskeletal Clinical Assessment and Triage Service (MSK-CATS)

For breast and surgical procedures please see links on the left hand side

British Association Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS)
British Association Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) have developed evidence-based advice to inform commissioning decisions on cosmetics procedures.

Cosmetic surgery and non-surgical cosmetic treatments not routinely commissioned

 The following procedures are not routinely commissioned

Botox (botulinum toxin)
When used to improve cosmetic appearance
Cheek implants
Unless part of the treatment of
- Post trauma cases
- Part of planned reconstruction surgery (e.g. for cancer)
Chin implants (genioplasty, mentoplasty)
Unless part of the treatment of
- Post trauma cases
- Part of planned reconstruction surgery (e.g. for cancer)
Collagen implant
Unless part of the treatment of
- Post trauma cases
- Part of planned reconstruction surgery (e.g. for cancer)
Cranial banding
For positional plagiocephaly
Earlobe repair
Electrolysis
Facelifts (rhytidectomy) Unless part of the treatment of
- facial nerve palsy
- congential facial abnormalities
- cutis laxa
- pseudoxanthoma elasticum
Fat grafts Unless as management of
- post trauma cases
- part of planned reconstruction surgery (e.g. for cancer)
Gender reassignment For procedures not included in the original package of care/ identified as a core procedure
Hair depilation (removal) e.g. for hirsutism
Hair transplantation
Hymen reconstruction
Labiaplasty
Lipectomy/ liposuction Unless as management of
- reconstruction surgery for cancer
- a congenital syndrome
Laser treatment Facial hyperpigmentation
Mastopexy (breast uplift) Unless part of planned breast reconstruction in the management of breast cancer
Nipple inversion

Unless part of planned breast reconstruction in the management of breast cancer

Scar reduction Unless specific criteria met
Skin resurfacing e.g. using laser treatment to manage post-acne scarring
Skin removal e.g. excess skin on thigh, leg, hip, buttock, forearm or other areas (with the exception of apronectomy where criteria are met)
Vaginoplasty

Derby and Derbyshire CCG

Derby and Derbyshire CCG