January 2017 – NICE is updating this guidance (see the guidance in development page for information). The NHS should continue to follow the recommendations in this guidance until the update is complete.
The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on liposuction for chronic lymphoedema.
Chronic lymphoedema is swelling of the limb caused by a defect in the lymphatic system. This may be a defect that the patient is born with or can result from surgical removal of the lymph glands, such as in surgery for breast cancer. The swelling results from accumulation of lymph fluid and it can cause cosmetic problems, discomfort, pain and limited movement. Liposuction for chronic lymphoedema involves the removal of subcutaneous adipose tissue and accumulated lymph fluid via several small incisions in the limb. After the procedure, the patient wears a compression garment permanently, which can be removed intermittently for short periods.
This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account. However, the 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.
Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.