Is there a place for cosmetic surgery on the NHS? - Hamilton Fraser


Ranked as the best healthcare system of 11 wealthy countries, many will be celebrating the magnificent National Health Service (NHS) as it reaches its next milestone – its 70th birthday. We, therefore, investigate if there is there a place for cosmetic surgery on the NHS?

This positive press will be a welcome change, after countless negative NHS stories on funding cuts and financial constraints. One of the many topics that regularly receives negative attention, and is never far from the consumer media, is cosmetic surgery.

There is no shortage of undesirable stories about how the NHS has ‘funded a glamour model’s lifestyle’, fixed an abundance of private cosmetic ‘botched jobs’, or a backlash on the NHS providing cosmetic genital surgery to young women.

Cosmetic surgery on the NHS

Health secretary Jeremy Hunt expressed strong opposition to the NHS funding cosmetic surgery back in 2014. Hunt said all decisions must be taken on “clinical need”, and public money must not be used to pay for surgery just to improve someone’s looks.

But is cosmetic surgery just about ‘someone’s looks’? And is there a place for cosmetic surgery on the NHS? We take a look at some examples of where NHS-funded treatments may still be needed.

Breast augmentation

Although it was one of the most damaging stories when it comes to publically-funded cosmetic surgery, the story of wannabe-glamour model Josie Cunningham, who had breast implants worth £5,000 on the NHS, was an example of a congenital medical condition where no breast tissue grows.

Micromastia or breast hyperplasia is the post-pubertal underdevelopment of a woman’s breast tissue. There are two types of micromastia: bilateral and unilateral. Bilateral is when there is no breast tissue on either side of the chest, and unilateral is when there is breast tissue on one side and none, or a significantly smaller amount of tissue, on the other side. This can have a massive effect on a woman’s confidence and self-esteem.

And it’s not just a lack of breast tissue that affects women, but an excess of tissue can be just as emotionally damaging as well as physically intrusive.

On the other side of the coin, many women suffer with oversized breasts; and even men can suffer with unwanted breast tissue, also know as gynaecomastia.

For women, having breasts that are excessively large can emotionally take its toll. It can also lead to severe back, shoulder and neck pain. Due to financial constraints on the NHS, breast reduction is less readily available. Specific criteria must be met for patients to obtain a breast reduction on the NHS. This includes, but is not limited to: expecting more than 500g of weight to be removed from each breast, proof that if the patient is overweight they have brought it down considerably, they must suffer neck/back ache, and have sores under the breasts and grooves on the shoulders from bra straps.


Another procedure hitting the headlines for all the wrong reasons is vaginoplasty. Although there is a concern that this procedure could be wanted by some women due to an abnormal perception of what is ‘normal’, many other women are suffering with serious functional issues, which a vaginoplasty could relieve.

Medical issues such as the labia giving-way during intercourse, not being able to exercise due to enlarged labia, getting sores due to friction from underwear and clothing, and being put off having an intimate relationship due to embarrassment about appearance, are all real issues.

By having the procedure, which has few complications, function, including sexual function, can be significantly enhanced and can be life-changing for those who suffer. In more rare cases, female patients who have previously been victims of female genital mutilation (FGM) may seek correction on the NHS, after suffering on-going issues from the mutilation. Any surgical corrective procedures for them could also be life changing.

Here’s to the next 70 years

Cosmetic surgery is not just about appearance; it is also about correcting functional issues and taking away personal distresses that impact heavily on an individual’s life. It is not limited to these two procedures either – with a sudden increase in reports of acid attacks, which seriously corrode an individual’s skin, cosmetic surgery on the NHS could be the lifeline these people need.

With the NHS now officially 70 years old, we look forward to many more years of its tremendous work in helping those in need, including those needing cosmetic surgery on the NHS.

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