Non-cosmetic body contouring surgery is an operation to remove loose and saggy skin folds after weight loss from certain areas of the body which are causing medical problems. This type of operation helps patients to prevent further or future illnesses.
There are a number of surgical interventions which can be described as body contouring procedures:
Also known as a ‘tummy tuck’, a full abdominoplasty involves making openings from hip to hip and around the belly button to remove extra skin and fat. Some tissues and muscles are also tightened before the skin is repositioned and sewn up. This procedure will leave a circular scar around the belly button and a long scar along the bikini line.
A mini tummy tuck involves making a horizontal cut along the bikini line to remove a block of skin and fat from the lower tummy. Sometimes the muscles will also be tightened. This procedure will leave a smaller scar along the bikini line.
An extended abdominoplasty involves a full ‘tummy tuck’, with the additional removal of extra skin and fat from the thighs and back at the same time.
Endoscopic abdominoplasty is a procedure carried out if only the muscles of the abdominal wall need to be tightened. A small cut near the bikini line, or around the belly button is made to insert special surgical tools to tighten the muscles. As skin is not removed during this procedure, liposuction can also be carried out at the same time.
An Apronectomy removes the large excess of skin and fat hanging down over the pubic area which looks like an ‘apron of skin’. This extra skin can affect normal activities such as walking and may lead to serious medical problems such as skin inflammation or infection under the flap.
Brachioplasty, also known as an arm lift, removes and tightens loose skin and excess fat in the upper arm. A long cut is made between the elbow and armpit to remove sections of the skin and fat. The remaining skin and tissue are lifted and sewn up.
Thighplasty, also known as a bum and/or thigh lift, involves removing the ‘extra’ loose and saggy skin around the bottom and thighs. Liposuction may also be performed during this procedure to tighten the bottom and thighs.
Liposuction is an operation using a suction technique to remove fat from certain areas of the body which haven’t responded to exercise and diet.
The clinical evidence reviewed showed the benefit to patients in certain clinical circumstances where excess skin is causing problems with daily life activities or ongoing skin infections which have not improved after six months of treatment.
Non-cosmetic body contouring is a restricted procedure and the removal of excess skin will only be funded if the patient:
- Is 18 years old or over at the time of application and has lost at least 50% of their original excess weight and maintained their weight for at least two years
- The patient has skin folds which are affecting their ability to carry out activities of everyday life such as sleeping, eating, walking
- The patient has recurrent skin infections in the skin folds which have not improved after six months of treatment.
This means the patient’s NHS commissioning organisation (CCG), who is responsible for buying healthcare services on behalf of patients, will only fund the treatment if the patient meets the eligibility criteria above, or if an Individual Funding Request (IFR) application has shown exceptional clinical need and the CCG supports this.
Advice and further guidance:
- Read the evidence review
- For more information and advice visit www.nhs.uk
- Choosing Wisely UK is part of a global initiative aimed at improving conversations between patients and their doctors and nurses.
Treatment policy for patients covered by NHS Birmingham and Solihull CCG