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Breast Implants – Replacement

Definition

The presence of breast implants may cause patients a range of symptoms over time. These include a change in appearance of implants or increased associated pain. Common problems include age related sagging; calcification of breast tissue; capsular correction; leak from implant; implant wrinkling or rippling; infection; inflammation or irritation.

Concerns about cosmetic appearance should not be referred to secondary care. These procedures will not be funded.

Red Flag symptoms

In all cases, exclude Red Flag Symptoms and if present, refer 2WW or to symptomatic breast clinic.

Exclusions to policy

This policy does not apply to breast reconstruction as part of the treatment for breast cancer.

Commissioning position

NHS Scarborough & Ryedale and Vale of York CCG’s do not routinely commission the replacement of breast implants.

Where revision surgery is being carried out for implant failure, the CCG will support the removal of failed implants in certain circumstances (see separate policy) but will not approve their replacement, other than where clinical exceptionality may apply and where approval for funding is granted by the IFR panel.

Replacement of implants will only be considered when patients meet the criteria for removal (see separate policy) and both of the following indications are met:

  • The original procedure was provided by the NHS

AND

  • The original implant insertion was following cancer surgery, trauma or developmental asymmetry

The replacement of breast implants for patients whose original surgery was paid for on a privately funded basis is not commissioned unless undertaken following cancer surgery.

OPCS Codes

B30.

References

Poly implant Prothese (PiP) breast implants; Final report of the Expert Group June 2012 Sir Bruce Keogh NHS Medical Director http://www.nhs.uk/conditions/breast-implants/Documents/PIP%20expert%20group%20final%20report.pdf

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