Procedures not routinely provided by NHSScotland

Patients who have had implant surgery performed and present with implant related complications should be referred back to the organisation that performed the surgery.
Where this is not possible, investigation and treatment up to the removal of the implant may be performed. Once any emergency interventions are complete any further intervention will only be considered under this pathway.
Replacement of breast implants will only be considered where the original implant surgery was performed by the NHS.
Patients who have had implant surgery performed privately for reconstruction after breast cancer will be treated as if their implants have been provided by the NHS.

Clinical Psychology

Referral to a specialist Clinical Psychologist may be made at the discretion of the surgical team.

BMI

There are no specific BMI restrictions.
If BMI is significantly raised consider carefully whether patient is appropriate for this type of surgery.

Considerations for treatment

Indications for referral

Change in the appearance, size or shape of a breast with a prior history of implant surgery under the NHS.
Pain related to capsular contracture.
Implant rupture or extrusion.

Contraindications for referral

Implants placed privately for cosmetic reasons will not be replaced by NHS Scotland. This would establish an ongoing duty of care for the replacement implants.

Waiting Times

These patients are subject to the 18 Weeks Referral to Treatment Standard.
Patients do not require routine follow-up.

Treatment for these conditions is not routinely offered by NHSScotland and can only be provided on an exceptional case basis in line with the guidelines contained in this protocol.