BOP Program Statement 6311.04 § 5

consider individually any request from an inmate or a BOP medical

consultant.

a. In circumstances where plastic surgery is a component of

the presently medically necessary standard of treatment, the

Clinical Director shall forward the surgery request to the Office

of Medical Designations and Transportation for approval.]

Examples of when plastic surgery is a component of the

presently medically necessary standard of treatment are: the

emergency repair of lacerations (e.g., facial lacerations,

lacerations secondary to trauma), and when reconstructive surgery

follows standard surgical procedures (e.g., reconstructive

surgery following mastectomies due to cancer, etc.).

[b. If the Clinical Director recommends plastic surgery for

the good order and security of the institution, the request for

plastic surgery authorization will be forwarded to the Warden for

initial approval. The Warden will forward the request through

the Regional Director to the Medical Director. The Medical

Director shall have the final authority to approve or deny this

type of plastic surgery request.]

An example of when plastic surgery would be recommended for the

good order and security of the institution is: plastic surgery

necessary in order to help conceal the identity of WITSEC inmates

(e.g., tattoo removal, etc.).

[c. If the Clinical Director is unable to determine whether

the plastic surgery qualifies as a component of presently

medically necessary standard of treatment, the Clinical Director

may forward the request to the Medical Director for a final

determination in accordance with the provisions of paragraph (b)

of this section.]

d. The inmate's unit team shall be notified before any

arrangements or promises are made for plastic surgery. The

inmate's unit team shall consider the impact of the impending

plastic surgery on unit documentation.

e. The Inmate Systems Manager (ISM) shall be notified prior to

surgery so that photographs can be taken of the involved part

before and after surgery for the purpose of identification. The

Health Services Unit shall notify the inmate's unit team and the

P.S. 6311.04

March 21, 1996

Page 3

ISM when such surgery has been completed. The ISM shall make

appropriate notations in the inmate's record reflecting the fact

that surgery altering the inmate's physical features has been

performed.