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Breast Implants (non-cancer)

Checked: 04-07-2023 by Rob Adams Next Review: 04-06-2025

Overview

This page deals with requests for breast enhancement and complications from implants in patients who are not suspected to have cancer and are not on a cancer pathway.

For patients with breast lumps/ suspected breast cancer then please go to:

Breast - 2WW (Remedy BNSSG ICB)

For other breast conditions please see the Breast section of Remedy:

Breast (Remedy BNSSG ICB)

Breast implant or enhancement surgery or revision (non-cancer)

Breast implant or enhancement surgery (or revision) for patients who are not on the Breast Reconstruction Post-Cancer pathway is not routinely available on the NHS.

Please see the Breast Surgery page for links to the various funding policies that apply.

Breast lumps in patients who have had implants

If there is an undiagnosed breast or axillary lump then a 2WW Breast referral should be considered if appropriate.

If cancer is excluded and a patient has had privately placed breast implants for cosmetic reasons that have ruptured and developed granulomas (usually axillary), then they may be* entitled to implant removal only. Removal of axillary granulomas is not routinely commissioned.

* final decision needs to be made by the oncoplastic MDT. Small ones may be best ignored.

See the following policy for details: Breast Surgery (for Females) - NHS BNSSG ICB

Breast implant rupture (non-cancer)

Ruptured silicone breast implants can cause breast pain or changes in the contour or shape of the breast. However, ruptured silicone breast implants are not thought to cause breast cancer or other health problems (1).

If a patient has a suspected rupture of an implant that was inserted privately and cancer is not suspected or has been excluded, then the patient should approach their private provider to get advice.

Removal of an implant is not available on the NHS unless there is a granuloma and there would need to be exceptional circumstances for funding to be approved.

PIP Implants

Ruptured PIP implants have no proven long-term health effects. British and European researchers have so far not found any evidence to suggest that the ingredients in the implants can cause cancer or are toxic (2).

For further information on PIP implants please see the link below:

PIP implants

If referral is indicated, then please use the standard Breast Clinic 2WW proforma (embedded in EMIS) to make both suspected cancer and non-2WW referrals via eRS. Please state how clearly how criteria are met.

Referral

Resources

(1) Silicone breast implants: What happens if they rupture? - Mayo Clinic

(2) PIP breast implants - NHS (www.nhs.uk)

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.