Exceptional (Aesthetic) Referrals Protocol

The following is a list of NOT available on NHS in Scotland unless the exceptional criteria are met:

• Body Contouring
  • Abdominoplasty, Apronectomy, Liposuction, Thigh/Arm Lift, Excision of redundant skin/fat, generally after significant weight loss or post-bariatric surgery.
• Benign Skin Lesion
  • Excision of benign skin or subcutaneous lesions, including xanthelasma.
• Blepharoplasty
  • Upper and lower blepharoplasty for excess skin or eye-bags, unless there is a functional visual impairment.
• Breast Surgery
  • Breast augmentation, mastopexy (breast uplift), breast reduction, and related procedures, unless related to cancer or significant congenital deformities.
• Breast Surgery Complications
  • Only if surgery was initially performed by the NHS (e.g., complications or implant removal).
• Gynaecomastia
  • Surgery to alter the shape or volume of the male breast, unless clinically significant breast prominence is present.
• Inverted Nipple Surgery
  • Surgery to reverse nipple inversion unless it is new and linked to an underlying disease.
• Aesthetic Facial Surgery
  • Facelift, brow lift, and neck lift for age-related changes without underlying disease.
• Hair Transplantation
  • Procedures to restore hair growth, unless post-trauma or congenital conditions are present.
• Pinnaplasty
  • Surgery to alter the form of the external ear after the age of 18.
• Rhinoplasty
  • Procedures primarily to alter the appearance of the nose, unless there's trauma or functional issues with nasal airflow.
• Tattoo Removal
  • Not provided unless the tattoo was gained without consent (e.g., trauma or iatrogenic tattooing).
• Thread Veins and Spider Naevi
  • Laser and microsclerotherapy, typically not provided unless there are severe lesions on the face.
• Female Genital Surgery
  • Procedures to alter the appearance of the external genitalia, unless there is significant functional impairment.
• Acne Scarring
  • Only severe facial acne scarring will be considered for treatment.
• Interventional Hair Reduction
  • Provided only for severe facial hair growth in females.
• Axillary Hyperhidrosis
  • Treatment for excessive sweating only provided for those who fail to respond to other treatments.