Every three to five years, NHS Lancashire and South Cumbria ICB review its clinical policies to ensure they reflect the latest evidence-based guidance and best practice. We are currently reviewing the following policies and would welcome your views on the proposed changes.
Please share your feedback by completing the short questionnaire.
Abdominoplasty (tummy tuck) is an operation to remove excess skin and fat from the abdomen. An apronectomy is a less extensive procedure that only removes excess skin and fat from the lower abdomen.
The policy, although worded as ‘not routinely commissioned’ has new criteria that should allow more people to have procedure. The policy allows apronectomy alone for patients who are unable to slim down to a BMI of less than 30 kg/m² but have lost 75% of the excess body weight.
The main changes to the current policy are; an increase in the BMI criteria from no more than 27 to less than 30, a lower age limit of 18 years of age, and the addition of specific criteria for apronectomy alone. This is in keeping with guidance from the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS)
The proposed policy is being revised to have the following wording:
Apronectomy or abdominoplasty are not routinely commissioned unless ALL the following criteria are met:-
- Patient is aged 18 years or above
- The current BMI has remained stable for at least 12 months and is <30 kg/m²
- The previous BMI was >40 kg/m² (or >35 kg/m² with comorbidities)
- There is no previous diagnosis of body dysmorphic disorder
- Patient is a non-smoker and there are no ongoing alcohol or drug misuse problems
- There is inflammation and/or infection of the skin folds (intertrigo) with breakdown of the integrity of the skin. This will be demonstrated by evidence of cellulitis, skin ulceration, abscesses, lymphoedema, skin necrosis or equivalent which have been a clinically chronic† problem despite compliance with nonsurgical treatment (e.g. meticulous skin hygiene; dressings; clothing that minimizes skin fold contact; topical antifungal agents, antibiotics or corticosteroids as clinically appropriate).
Apronectomy alone will be commissioned if the patient fulfils ALL of the criteria above but is unable to slim down to a BMI of <30 kg/m² AND
- The current BMI is not >40 kg/m² and has remained stable for at least 12 months
- Either the current BMI is 30.0 – 35.0 kg/m2 OR the current BMI is 35.1 – 40.0 kg/m² and the patient has lost 75% of the excess‡ body weight.
Exclusions
· Patients’ suffering from problems associated with poorly fitting stoma bags are outside of this policy.
· “Chronic” is usually defined as a period of not less than 3 months.
· Excess weight = change of BMI relative to a maximum normal BMI of 25kg/m2 [Calculation is: 100 x (Pre-op BMI – Current BMI) / 25]
Please note this survey closes at midnight on Friday 26 December 2025.