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Primary & community care

Procedures not routinely provided by NHSScotland

  • Abdominoplasty, Apronectomy, Liposuction, Thigh/Arm Lift, Excision of Redundant Skin/Fat.
  • Generally, any procedures after significant change in body shape - e.g. massive weight loss, post-bariatric surgery.
  • Referral should be for a single procedure. After the conclusion of any treatment episode the patient will require to be referred back through the assessment process including clinical psychology, if consideration of other procedures is requested.

Clinical psychology

  • All approved referrals will be seen by a specialist Clinical Psychologist prior to assessment by a surgeon except HIV lipodystrophy cases.
  • Patients with HIV associated lipodystrophy may be referred for specialist Clinical Psychology assessment if required after surgical assessment.

BMI

  • BMI less than or equal to 27 maintained for one year must be achieved.
  • In a few unique cases with significant functional impairment a higher BMI may be considered if this represents a documented weight loss of 50% starting BMI, again sustained for one year.

Considerations for treatment

Indications for referral

  • Significant physical limitations (e.g. significantly impaired mobility).
  • Significant physical signs despite medical intervention (e.g. severe, intractable intertrigo).
  • HIV associated lipodystrophy.
  • Significant psychological distress combined with one of the above.
  • Contraindications for referral
  • Simple cosmetic requests.
  • Divarication of the rectus muscle is not an indication for referral.
  • Caesarian section sequelae are not an indication for referral.

Waiting Times

  • These procedures are not subject to the 18 Weeks Referral to Treatment Standard.

Treatment for these conditions is not routinely offered by NHSScotland and can only be considered when all criteria are met.