Policy number: MSEICB 082
Policy name: Breast Asymmetry
Status: Individual Prior Approval
Effective date: 1 April 2023
Next review date: 1 April 2024
Mid and South Essex ICB commissions unilateral breast reduction surgery for breast asymmetry on a restricted basis.
Procedures for cosmetic purposes only will not be funded.
Funding will only be considered if there is gross disparity of breast cup sizes i.e., asymmetry where there is at least 2 cup size difference in breast size on initial consultation with the patient’s GP.
Patients are eligible for surgery to correct breast asymmetry if ALL the following criteria are met and confirmed by a consultant plastic or breast surgeon:
- Clinical evidence rules out any other medical problems to cause this presentation.
- There is no ability to maintain a normal breast shape using non-surgical methods (e.g., padded bra)
- The patient has had no change in cup size for 1 year as documented in patient’s clinical record
- Where relevant, treatment of the underlying cause of the problem has been undertaken
- The patient is a non-smoker at the time of referral (confirmed by CO reading)
Only unilateral breast reduction (not unilateral breast augmentation) will be funded.
Contour irregularities and moderate asymmetry (including dog-ears, nipple direction or position, breast size and shape disparity) are predictable following surgery. Any post-surgical cosmetic irregularities will not be funded by the ICB in revision surgery.
Patients not meeting the above criteria will not be funded unless there are clinically exceptional circumstances.
Individual funding requests should only be made where the patient demonstrates clinical exceptionality.
Further information on applying for funding in exceptional clinical circumstances can be found on the ICS’ website.
A downloadable version of this document is available below:
082 – MSE ICB Breast Asymmetry – Effective from 01.04.23 (docx, 200kb)