Breast Asymmetry – IFR Commissioning Statement


Eligibility Criteria

Surgery to correct breast asymmetry will not routinely be commissioned by the NHS for cosmetic reasons.

Surgery may rarely be considered on an exceptional basis, for example where the patient:

  • has a difference of at least 2 cup sizes
  • has a BMI in the range 18.5-27
  • has tried and failed with all other advice and treatment, including a professional bra fitting
  • has completed puberty - surgery is not normally commissioned below the age of 19 years

National supporting evidence

In addition to this criterion and support the IFR, also require:

  • Evidence supplied by a professional bra fitter that there is a difference in breast size of at least 2 cup sizes difference.

Lifestyle Factors - Best Practice


  • Patients with a BMI >30 should be encouraged by their Clinician to lose weight prior to surgery and signposted to appropriate support to address lifestyle factors that would improve their fitness for surgery and recovery afterwards.
  • There is a clinical balance between risk of surgical complications with obesity and the risk to delaying any surgery.
  • See Weight Management Care Pathways


  • In line with 'Healthy Lives, Healthy People; a tobacco control plan for England', local authorities and health professionals are committed to encourage more smokers to quit.
  • Smoking remains the leading cause of preventable morbidity and premature death in England.
  • There is sufficient evidence to suggest that people who smoke have a considerably increased risk of intra- and post-operative complications such as chest infections, lung disorders, wound complications and impaired healing.
  • See Smoking Cessation Care Pathways
Please Note: The life style factors above are not a restriction to the commissioning statements unless otherwise stated

Assurance & Governance

  • This policy was developed on: 05.2017
  • This policy was approved by: Clinical Strategy Group (NK) and Clinical Cabinet (WK)
  • Date approved: 05.2017
  • Publication Date: 05.2017
  • Last Updated: 12.2017
  • Review Date: 04.2018
  • Ref No: IFR4 - 05.2017
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