***This page is under review***
Access to aesthetic surgery is very restricted in the NHS and all referrals must be made via the Exceptional Aesthetic Referral Pathway (EARP) see in Resources and Links. It is accepted that in some cases the patient and their GP will not recognise these conditions as being purely cosmetic as there may be significant associated physical symptoms and psychological upset. Nonetheless the guidelines state that all such patients must be referred via the EARP that includes a panel of surgeons and psychologists. Examples of aesthetic surgery include breast augmentation and reduction, abdominoplasty and body contouring surgery following massive weight loss. The EARP guidelines (see Additional Resource) formalise a list of conditions for which the NHS will not usually offer surgery. However, exclusion criteria have been defined, which if met, may indicate that surgery is appropriate.