BAPRAS responds to decision to restrict access to plastic surgery in Wales

2nd January 2009


The commissioners of Plastic Surgery in Wales (Health Commission Wales) announced this week further restrictions to some plastic surgery procedures which require patients to have a body mass index within the normal range (18-25).

The procedures in question such as breast reduction were already subject to tight restrictions and are not generally available on the NHS and are given a low priority.

There is considerable evidence that breast reduction is a useful intervention for women who, as a result of disproportionately large breasts, are suffering from physical symptoms such as back and neck ache and skin infections (“intertrigo”). There is also evidence that patients who are obese (BMI greater than 30) are at greater risk of complications during surgery. BAPRAS supports the use of such clinical criteria in deciding which women should have the operation.

There is no clinical evidence to support the decision in Wales to restrict the surgery to women who are exactly within their ideal weight range and we are aware that the decision has been reached on financial/resource grounds rather than clinical ones.

Such “low priority” surgery is only a small part of the work of plastic surgeons in the NHS which is mostly devoted to the treatment of cancer, accidents and birth anomalies.

Nonetheless it is of great benefit to patients and we would wish to see it remaining available on the NHS on the basis of clinical need and clinical evidence


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