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.
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Breast symmetrisation surgery is a procedure designed to improve balance and symmetry between the breasts, often performed after breast cancer treatment or for congenital or developmental breast asymmetry.
Reflecting guidance from the Modernisation Agency, British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) the policy is an increase in provision with a shift from a ‘not routinely commissioned’ position to criteria-based commissioning. The proposed policy supports symmetrisation surgery for congenital breast asymmetry. Patients who meet defined clinical thresholds will now be eligible for treatment.
The proposed policy wording is as follows:
1. Breast symmetrisation surgery is not routinely commissioned for cosmetic purposes alone.
2. Breast symmetrisation surgery will be commissioned in women if all of the following criteria are met:
a. the woman is aged at least 18 years
AND
b. BMI does not exceed 30kg/m2 and has been stable for at least 12 months
AND
c. breast asymmetry (with an estimated difference of 3 cup sizes or more, (approximately 300g in weight) has been confirmed by a breast specialist
AND
d. the asymmetry is thought to have resulted from:- macromastia, Poland Syndrome, tuberous breast, unilateral or asymmetric hypoplasia, unilateral amazia, congenital symmastia.
3. If there is less than 3 cups sizes the difference between the breasts, symmetrisation breast surgery will only be offered if there is a clear tubular deformity of one breast. In these cases, the breast base diameter of the tubular breast must measure less than 50% of the contralateral breast.
N.B For bilaterial congenital condition such as amazia please refer to the LSC Breast Augmentation Commissioning Statement
Additional requirement for all patients
NHS specialist breast surgeons in Lancashire and South Cumbria are reluctant to offer aesthetic breast surgery in smokers due to the associated increased risk of complications such as poor wound healing rates. Referring clinicians are requested to ensure the patient is a non-smoker or has stopped smoking for at least one month before referral (this includes all nicotine-based products e.g. cigarettes, vapes, e-cigarette, nicotine replacement).
Exclusions
· Any procedures which are being performed as part of oncoplastic reconstruction are outside the scope of this commissioning statement and are routinely commissioned.
Survey closes at midnight on Friday 26 December 2025.