HNY Policy and Pathway Repository - North Yorkshire

Lipoedema, Lymphoedema or Body contouring 

Lipoedema 

This intervention is not commissioned for treatment of lipoedema and therefore should not be routinely offered to patients. Application for funding approval can be made, using the IFR process, by the clinician recommending the intervention, if their assessment is that there are exceptional reasons why their patient could benefit from it. 

Lymphoedema 

This intervention is commissioned for treatment of chronic lymphoedema if: 

• there is evidence of significant functional impairment AND  
• routine conservative and medical management for a minimum of 6 months has not been adequately effective AND 
• the decision to offer this intervention is the recommendation of a multi-disciplinary team with expertise in managing lymphoedema 

Body contouring 

This intervention is commissioned as an adjunct (at the surgeon’s clinical discretion) to some other surgical procedures (e.g. Male Gynaecomastia Reduction Surgery, Abdominoplasty), if the criteria in the relevant policy are met. It is not commissioned solely to correct the distribution of fat tissue. 

Lipoedema

Evidence on the safety and efficacy of liposuction for lipoedema is inadequate, so this intervention should only be used for that indication in the context of research.

Lymphoedema

Evidence on the efficacy and safety of liposuction for chronic lymphoedema is adequate.

Body contouring

Liposuction may be useful for contouring areas of localised fat atrophy or pathological hypertrophy and as an adjunct to other surgical procedures

IPG721 Liposuction for chronic lipoedema (NICE)

IPG723 Liposuction for chronic lymphoedema (NICE)

Information for commissioners of plastic surgery services (BAPRAS)