Referral

Back
Policies Toggle Pages
Abdominal hernia in adults Adult Snoring Surgery (in the absence of Obstructive Sleep Apnoea) Arthroscopic shoulder decompression for subacromial shoulder pain Arthroscopic surgery for meniscal tears Artificial urinary sphincters for post-prostatectomy incontinence Assisted Conception Benign Skin and Subcutaneous Lesions Commissioning Policy Blepharoplasty (upper and lower lid) including brow lift Botulinum Toxin A for the management of focal hyperhidrosis Breast implants - removal and replacement Breast reduction surgery Carpal tunnel syndrome (surgery) Cataract Surgery Chronic rhinosinusitis with or without polyps Circumcision Cosmetic Treatments Cryopreservation to Preserve Fertility Dilatation and curettage for heavy menstrual bleeding in women Dupuytren's contracture treatment Ear Wax Removal Femoro–Acetabular Impingement, open or arthroscopic surgery Fusion surgery for non-specific, mechanical back pain Haemorrhoids in adults Hallux Valgus (Bunion) - Commissioned pathway Heavy Menstrual Bleeding - Referral for Surgical Management Hip and knee replacement surgery in obese patients (those with a body mass index of 30 or greater) Individual Funding Requests (IFRs) Injections for non-specific low back pain without sciatica Knee arthroscopy for patients with osteoarthritis Lumbar spine procedures – for simple lumber back pain Meibomian cysts (chalazia) Myringotomy/grommets with or without adjuvant adenoidectomy for the management of otitis media in children under 12 years Myringotomy with and without grommets in adults and children aged 12 years+ Open Magnetic Resonance Imaging (MRI) Scanning Radiofrequency Denervation Reversal of male and female sterilisation Spinal injections for sciatica Surgery for ganglion cyst Surgical procedures for the treatment of LUTS caused by BPH Tonsillectomy Trigger finger release in adults Varicose vein referral
Print this page
Contact us about this page

Breast implants - removal and replacement

This is a summary of the NHS Devon policy for Breast implants removal and replacement.

Toggle all

Referral Criteria

Breast implant removal

Patients who have had previous augmentation surgery privately should be directed back to the private provider in the first instance.


Where there is a clinical indication for removal of breast implants this will be commissioned in the following circumstances:

  • After implant leakage or rupture; or 
  • Baker Grade II capsular contracture associated with significant pain; or
  • Baker Grade IV capsular contracture; or 
  • Implants are complicated by recurrent implant infection or seroma; or 
  • The patient develops Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL).

This commissioning decision applies regardless of funding source of the original surgery (i.e. whether funded by the NHS or on a private basis). In the event that only one implant is affected, removal of both implants will be offered to ensure symmetry.

The removal of breast implants due to symptoms termed as Breast Implant Illness (BII) or Autoimmune Syndrome Induced by Adjuvants (ASIA), or due to the risk of developing Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is not routinely commissioned.

Breast implant replacement

Treatment for patients wishing to have their implants replaced will only be commissioned for patients who meet the above criteria for removal AND whose original breast augmentation was performed by the NHS as part of a treatment plan to repair or reconstruct missing or damaged tissue that occurred through accident or illness.

Breast implant replacement or any other cosmetic procedures (e.g., mastopexy), is not routinely commissioned for patients where their original augmentation procedure was privately funded. Patients are not able to self-fund the additional cost of replacement implant(s) (or any other cosmetic procedures) at the same time as surgery to remove implant(s).

This policy does not cover breast reconstruction following surgery for breast cancer.

Patients are not able to self-fund the additional cost of the replacement implant at the same time as surgery to remove the implant as this is inconsistent with DH guidance on 'top up' payment

Guidance notes on exceptionality

Where the circumstances of treatment for an individual patient do not meet the criteria described above exceptional funding can be sought. Individual cases will be
reviewed by the appropriate panel of the ICB upon receipt of a completed application from the patient’s GP, consultant or clinician. 

Applications cannot be considered directly from patients.

Breast implants removal and replacement commissioning policy

Exceptional /Individual Funding Requests (IFR).

Referral Instructions

Applications for consideration for funding approval should be sent to:

Email: d-icb.ifr-newsdt@nhs.net

Patient Information

Individual Funding Request (IFR)

Date of decision: 7 March 2012

This commissioning decision was adopted by Northern, Eastern and Western

Devon CCG and South Devon and Torbay CCG on 1 April 2013, having been

originally agreed by the previous commissioning organisations (NHS Devon,

NHS Plymouth and Torbay Care Trust).

This policy has been adopted from Northern, Eastern and Western Devon CCG

and South Devon and Torbay CCG by NHS Devon from 1 April 2019

This policy has been adopted by NHS Devon ICB on 1st July 22

Updated: 29th February 2024