WHEN CUPS RUNNETH OVER: ELIGIBILITY FOR NHS BREAST REDUCTIONS

Surgeons Routinely Misjudge Breast Sizes, Expert Proposes Dignified Assessment

London - 28 November, 2005 - Mark Henley, a leading consultant plastic surgeon based at Nottingham City Hospital , today revealed that many doctors commonly miscalculate patients' eligibility for NHS breast reductions, and recommended that the latest 3D scanning technology, which virtually eliminates human error when determining suitability for the operation, be adopted on a national level. This technology, provided by the team at Body Aspect Ltd., and which has evolved from fashion merchandising use, has been adopted by the 13 PCTs in Nottinghamshire and Southern Derbyshire and has already resulted in an 80% reduction in outpatient appointments and shorter waiting times for patients.

In mid-Trent alone ( Nottingham , Derby and immediate surrounds), over 450 cases a year are considered for a breast reduction, or correction of asymmetry, on the NHS. The national figure is estimated to be around 15,000.

To determine who qualifies, there are common guidelines used as indicators, such as breast volume: 'at least 500g must be removed from each breast'. The decision to focus on breast size is the link between volume and probability of spinal abnormalities, plus back pain and disability. However, this does not always take into account the patient's relative trunk size, Body Mass Index (BMI) and other aspects.

Until now, it has always been the surgeon's personal assessment of the patient which determines suitability for the operation. Yet, at the British Association of Plastic Surgeons Winter Meeting 2004, a survey of 48 trainee and consultant surgeons resulted in 30% (consultants) to 45% (trainees) mean variability when trying to estimate breast volume on a mannequin - widely inconsistent and inaccurate results. When using the scanner, the variability is reduced to less than 5%.

According to Mr. Mark Henley, Council member of both the British Association of Plastic Surgeons (BAPS) and the British Association of Aesthetic Plastic Surgeons (BAAPS), and Trent Regional Advisor in Plastic Surgery to the Royal College of Surgeons ;

"There is an inequality of healthcare provision for patients with large breasts. They are currently assessed 'by eye', by surgeons who may or may not recommend them for the operation based on a flawed assessment. The Body Aspect scanner is a fair and reasonable solution to this issue, by virtue of eliminating human error. Both patients and practitioners can be satisfied with a scientific result."

The technology behind the Body Aspect (www.bodyaspect.co.uk <http://www.bodyaspect.co.uk/> ) medical device has evolved from 3D scanners originally designed to determine body types and sizes for clothing manufacturers, such as Marks & Spencer (where members of the team were involved in resizing bra lines), Debenhams and Next. The medical scanner has been locally implemented in the Midlands to very positive results - over 900 patients have been evaluated using this equipment, with virtually no complaints. The aim of the project, which coincided with a government initiative for modernisation, was to manage demand and capacity whilst prioritising the workload for non-urgent procedures for breast reductions and asymmetry correction surgery.

Prior to the scanning being implemented, all patients referred by a GP received outpatient appointments - a proportion of whom would then be refused surgery, and nearly half of them placed on waiting lists.

According to Richard Richards, Director of Public Health for Newark and Sherwood PCT and a highly respected figure in both the NHS and plastic surgery;

"This programme has resulted in more dignified and acceptable assessments that are easily understood by patients. There are significant cost reductions owing to the elimination of inappropriate referrals and resources can now be targeted to the patients that are most in need. This innovative technology should be present in hospitals nationwide."

According to Graham Hutton, Director of Body Aspect Ltd; "Medical applications of body shape analysis are diverse, ranging from postural analysis to the assessment of breast asymmetry. The 3D Analysis Software can assist in several ways: to help make patient assessments; as a resource for patient consultations and as a tool for deciding on appropriate treatment."

Notes

About Body Aspect

The Body Aspect team (www.bodyaspect.co.uk <http://www.bodyaspect.co.uk/> ) has been providing scanning services to the UK National Health Service since 1999. Plastic surgeons, spinal surgeons and physiotherapists have all used body scanning as a new and valuable augment to patient assessment and treatment. Particular health risks are now being identified as correlated with different body shapes. Originally devised for fashion manufacturers estimating body types and sizes, the 3D Body Analysis can be used to assess and categorise the entire spectrum of body shapes.

(30/11/05)