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Primary & community care

Procedures not routinely provided by NHSScotland

  • All procedures where the primary aim is to alter the appearance of the nose.
  • Congenital anomalies (e.g. nasal deformity associated with cleft lip) will usually be in a continuing programme of treatment and are not subject to the protocol.

Clinical psychology

  • Referrals only for nasal obstruction do not require specialist Clinical Psychology.
  • Where surgery will cause a change in appearance as a secondary outcome clinical psychology input should be considered prior to the procedure.

BMI

  • There are no specific BMI restrictions.
  • If BMI is significantly raised, consider carefully whether patient is appropriate for this type of surgery.

Considerations for treatment

Indications for referral

  • A deviated nose and functional problem of the nasal airway.
  • Procedures to alter the appearance of the nose after trauma will usually be supported if the patient has sought initial medical attention within one year of injury.

Contraindications for referral

  • Simple cosmetic rhinoplasty will not be supported.

Waiting Times

  • Procedures for nasal obstruction are subject to the 18 Weeks Referral to Treatment Standard.
  • All other indications for rhinoplasty are not subject to the 18 Weeks Referral to Treatment Standard.

Rhinoplasty - evidence summary

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