Status: Not funded
Effective date: 1 April 2026
Next review date: 1 April 2031
Essex ICB does not routinely fund cosmetic or aesthetic procedures, whether surgical or non-surgical. This policy ensures NHS resources are used equitably and prioritised for interventions that improve health and quality of life rather than appearance alone.
Cosmetic interventions refer to procedures undertaken primarily to improve appearance without a clinical indication. These include both surgical and non-surgical treatments. Such procedures are not routinely commissioned. The NHS will only fund treatment where there is a demonstrable clinical need, such as reconstruction following trauma or cancer, or management of conditions causing considerable functional impairment.
The following examples reflect common procedures classed as cosmetic in the absence of any functional impairment* and therefore not funded.
Surgical procedures (examples):
- Facelift (rhytidectomy), brow lift, neck lift
- Cosmetic rhinoplasty or septorhinoplasty
- Eyelid lifts for appearance only (blepharoplasty)
- Eye bag removal (lower eyelid surgery)
- Upper eyelid surgery for cosmetic purposes
- Otoplasty or other cosmetic ear reshaping, including split earlobe repair
- Breast augmentation, mastopexy (breast lift)
- Liposuction, abdominoplasty/tummy tuck
- Thigh lift, arm lift (brachioplasty)
- Scar revision for cosmetic reasons
- Tattoo removal
- Other cosmetic head, face or body reshaping procedures
Non-surgical procedures (examples):
- Laser skin resurfacing, chemical peels, dermabrasion
- Injectable fillers for aesthetic purposes
- Botulinum toxin for cosmetic use
- Cosmetic laser treatments (e.g., for pigmentation, thread veins, hair removal)
- Light‑based cosmetic treatments including intense pulsed light (IPL), broadband light (BBL), LED‑based aesthetic therapies, or other non‑laser photorejuvenation/light‑resurfacing treatments
- Other aesthetic skin treatments delivered for appearance rather than clinical indication
This list is not exhaustive. Any procedure undertaken solely to alter appearance will not be funded.
* see relevant SRP if function impairment applicable
Essex ICB does not fund hair-depilation procedures for the management of hirsutism, including laser, IPL, other light-based technologies, electrolysis or medications such as Vaniqa®.
Funding may be considered where a procedure is required to treat or correct clinical impairment, including:
- Reconstructive surgery following trauma, burns, or cancer treatment
- Correction of congenital abnormalities that interfere with normal function
- Breast reduction where physical symptoms (e.g., pain, postural issues) persist despite conservative management
- Eyelid surgery where vision is impaired
- Removal of skin lesions that interfere with movement or cause recurrent infection or bleeding
Refer to the applicable Essex ICB commissioning policy to determine the criteria governing treatment.
Cosmetic procedures, whether surgical or non-surgical, are not appropriate treatments for managing mental health conditions because they do not address the underlying psychological causes of distress. Issues such as anxiety, depression, or body dysmorphic disorder arise from psychological factors, not physical appearance, and altering the body or skin rarely resolves these problems. Evidence shows that patients with untreated mental health conditions often experience poor satisfaction, increased distress, or even worsening symptoms after cosmetic interventions.
Undertaking cosmetic procedures for psychological reasons can also lead to unrealistic expectations, repeated treatments, and heightened emotional vulnerability, increasing the risk of harm rather than improving wellbeing. Mental health needs should be managed through evidence-based interventions such as psychological therapy, counselling, or psychiatric care—not through surgical or aesthetic treatments. This approach ensures care is safe, effective, and clinically appropriate.
Gender identity and cosmetic procedures
NHS England commissions all gender dysphoria surgical services as part of specialised commissioning, including assessment, preparation, gender reassignment surgery and immediate postoperative care. Further information and service specifications are available from the NHS England Gender Dysphoria Clinical Programme.
Following completion of gender reassignment surgery, Essex ICB will not routinely fund additional cosmetic procedures.
Aesthetic (cosmetic) procedures, whether surgical or non-surgical, have been assessed as a Low Clinical Priority by Essex ICB and will not be funded.
Individual Funding Requests (IFRs) are not normally applicable to cosmetic procedures. A desire to alter or improve personal appearance does not constitute clinical exceptionality and does not justify NHS funding. Cosmetic concerns, psychosocial distress, or patient preference alone are not sufficient grounds for IFR approval.
Further information about Service Restriction Policies (SRPs) can be found on the ICB’s website.
For information during approval process only: Formally retire and redirect the redundant pages to the new SRP 046 landing (to avoid dead links and confusion):
- SRP 090 (Body Contouring) → SRP 046
- SRP 084 (Rhinophyma) → SRP 046
- SRP 098 (Tattoo Removal) → SRP 046
- SRP 010 (Acne laser/resurfacing) → SRP 046
- SRP 046 (old facial-only cosmetic) → SRP 046 (new consolidated)