Liposuction Surgery On The NHS
Liposuction is considered to be a cosmetic procedure, and so it is not normally available to patients on the NHS.
Even when it is available on the NHS, there is normally a long waiting time to receive an evaluation to determine whether or not you are a suitable candidate, and a longer waiting time still to actually undergo the procedure. Most people interested in liposuction purely for weight loss purposes therefore have the procedure carried out privately, which can cost at least £2,000 depending on the areas treated. The only time liposuction would be available is when it is used for medical purposes. For example, if you are undergoing reconstructive surgery, you may be eligible to have the procedure on the NHS as part of this process.
Liposuction can be used to treat lymphoedema, a condition in which excess fluid develops in numerous places throughout the body, causing unsightly and unpleasant swelling. It can also be used to combat lipodystrophy syndrome, which occurs when fat is gained in one area of the body but lost from another. This is a common side effect of certain HIV treatments. Lipodema is a chronic condition that results in the build-up of fat in the legs, thighs and buttocks, and liposuction is made available on the NHS to successfully treat this condition. Hormonal imbalances in men can cause gynaecomastia, where breasts swell to become larger than normal. Liposuction can be used to treat this, and it can also help surgeons extract fat from other areas of the body and insert into the breast tissue when carrying out a mastectomy, or reconstructive breast surgery following breast cancer.
To get NHS treatment you will first need to ask your doctor for a referral. You will then be given an appointment with at least one specialist consultant to investigate what liposuction could achieve in your case. You may also have to visit a psychologist or psychiatrist for an assessment to help decide if the NHS will fund treatment for cosmetic purposes.
Generally, the NHS only covers procedures that are medically essential, rather than for cosmetic reasons. It is unlikely that liposuction to improve your appearance or where there is no specific underlying medical condition will be provided on the NHS. However, some liposuction treatments where there is a clear medical need may be provided on the NHS.
Prior to having liposuction on the NHS, you will have to undergo a number of evaluations and tests to ensure you are healthy enough to handle the surgery.
Your surgeon may also take pre-operative photos, and you will be asked to sign a consent form prior to the procedure. If you take the contraceptive pill, you’ll be asked to stop this prior to your liposuction. You’ll also be asked to stop smoking, and to refrain from taking any anti-inflammatory drugs or aspirin. If you are anaemic, your surgeon will recommend you take an iron supplement to prepare.
To mark the area that will require treatment, your surgeon will draw on a guide using a pen. They will then administer one of three types of anaesthesia; if you are having liposuction on your lower body, an epidural anaesthetic may be used to numb the lower torso without putting you to sleep. A local anaesthetic can numb certain areas, while a general anaesthetic is used for large procedures. After injecting a solution to reduce the risk of bruising, swelling and blood loss, your surgeon will start by inserting a cannula through small incisions, and breaking up the fat before removing it through a vacuum. Excess fluid is drained and the incisions closed, and the procedure is finished.
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The NHS may fund liposuction when it can be classed as reconstructive surgery. This is where the fat you want to have removed is the result of a particular medical condition. In these circumstances the treatment can be considered a way of overturning a medical effect caused by the condition, rather than merely improving appearance.
One such condition is lymphoedema. This involves damage to the lymphatic system, which is part of the body's circulatory system and is responsible for draining excess fluid from tissues. Lymphoedema can lead to swelling and fluid build-up, which in some cases can be treated by liposuction.
Another relevant condition is lipodystrophy syndrome, which effectively involves an unwanted transfer of fat from one part of the body to another, leading to an excessive build-up in some areas. It is one of the known side effects of some medicines used to treat HIV.
Lipoma, a build-up of fatty cells that forms lumps under the skin, may also be eligible for NHS liposuction treatment. This will depend on where you live: some Clinical Commissioning Groups (the organisations that oversee local NHS provision) rule out paying for removing a lipoma that does not pose a health risk.
If the fat build up you want treated with liposuction is not the result of a qualifying condition, you may in rare cases be able to get NHS funding for treatment on cosmetic grounds. The specific rules in your area are set down by your local Clinical Commissioning Group. A specialist consultant will make the decision on funding in your case based on these rules. Generally these rules say you can only get treatment if the cosmetic surgery is needed because the condition's effect on your appearance is causing you serious psychological damage or serious social problems.
You may feel bruised, swollen and tender following liposuction, which is normal.
You may be prescribed some painkillers, or you can make do with paracetamol or other over-the-counter medicines if needed. Your surgeon may also prescribe you a course of antibiotics to combat infection. If you have only had a local anaesthetic, you should be able to leave to go home straight away, although you will not be able to drive home from your procedure. If you have had more extensive liposuction and have had a higher level or anaesthetic, you may be required to stay in overnight.
Following the procedure, you will be provided with a compression garment. This is to be worn over the treated area to reduce swelling and bruising. How long you will have to wear the garment will depend on your specific treatment, so your surgeon will advise you of this as you recover. Your incisions will not be closed with dissolvable stitches, so you should expect to be asked back for a follow-up appointment about a week after the surgery to have these removed. Your surgeon will give you advice on how to care for your stitches and prevent infection before you are discharged to go home.
If the NHS rejects paying for treatment, you can get liposuction at a private clinic. The cost will usually be in the low thousands of pounds, but can vary significantly depending on where on the body you have the liposuction, how much treatment is needed, and which surgeon you use. Liposuction can be a complex and highly-skilled procedure, particularly in some areas of the body, so opting for the cheapest provider will not always be the best solution for your specific circumstances.