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Employees may need to take time off from work for a variety of reasons but cosmetic or elective surgeries present unique challenges. This article explores how that leave should be handled, considering not just your legal obligations but employee well-being and fairness too.

Is there a right to take the time off for cosmetic or elective surgeries as sick leave?

Strictly speaking, there is no statutory right to take sick leave for any reason. However, in practical terms, this right will generally be written into an employee’s contract or an attendance/absence management policy such that employees will have a right to time off if they are not well enough to work.

However, those terms may not go far enough to cover how time off for elective or cosmetic surgery will be handled.

You may want to take a different approach when it comes to time off for cosmetic or elective surgery than time off for other kinds of sickness absence. This becomes a matter of discretion and will depend on whether the surgery is genuinely purely cosmetic or elective.

What enquiries should we make about the surgery?

It is paramount to understand whether or not the surgery itself is purely cosmetic or elective. Open communication and transparency will help when discussing leave for such surgeries with your employee. There will also be a careful balance to be struck between respecting your employees’ privacy and what might be a sensitive situation for them whilst also having enough information to ensure that fair, consistent and non-discriminatory decisions are being made.

If the surgery is medical advised, then subject to the contractual terms or any internal policy, sickness absence should be granted. The question as to whether not the surgery is medically required is a matter of fact and context and may require further investigation. Remember that you will need your employee’s consent to obtain any information from their doctor.

Cosmetic surgery is not always carried out for aesthetic reasons and may be recommended under medical advice because of psychological or physical conditions, for example, a breast reduction due to back problems or a breast enhancement which relates to reconstructive surgery after cancer treatment. Further, surgery related to gender reassignment will entitle the employee to sick leave under specific provisions of the Equality Act 2010. Any failure to permit sick leave in that scenario would therefore potentially leave you open to the risk of a discrimination claim.

To help establish the reasons for the surgery, you may need to request medical information. Usually, if a procedure is medically recommended, an employee will provide confirmation from their doctor of matters such as the reason for the recommended operation, any consequences of it not being carried out, the operation date and the recovery period. If that can be provided, and employers are satisfied that the surgery has been medically recommended, it would be advisable to treat any such procedure as sick leave in the normal way.

If the surgery is purely cosmetic or elective, and unless an employee’s contract contains any right to the contrary, there would be no right for an employee to take sick leave to cover the time off.

What should we do if it isn’t sick leave?

This will be at your discretion.

Employees should have a free choice about when they can take holiday, however, one option in this scenario would be for an employee to use holiday to cover the time off for the surgery and for the recovery period. Alternatively, you may be willing to permit a period of unpaid time off.

Are employees entitled to be paid for time off for cosmetic or elective surgeries?

Even if the surgery in question falls to be regarded as sick leave, that may not automatically bring a right to be paid.

An employee may not be eligible for statutory sick pay (SSP) if undergoing cosmetic or elective surgery. While there is no statutory definition of “sickness” in relation to eligibility for SSP, one factor is whether the employee is incapable of working. Someone may have had an operation but, depending on the nature of that operation and their role, nevertheless be capable of working. On the other hand, an individual may be deemed incapable of working and therefore be entitled to SSP, if they are under medical care for a “disease or disablement” and a medical professional has advised them to refrain from work “for precautionary or convalescent reasons”. It is therefore feasible for an employee to be legitimately off sick for the purposes of SSP where cosmetic or elective surgery is undertaken.

In practice, of course, if an employee takes annual leave either because their absence doesn’t fall to be dealt with as sick leave under your policy or simply because they have otherwise chosen to cover the absence in that way, then they would be better off financially than being paid SSP.

As a contractual sick pay policy can be worded as you wish, you could choose to word the policy so that an employee who takes time off for purely cosmetic or elective surgery will not be eligible for contractual (enhanced) sick pay over and above any SSP entitlement. However, bear in mind that if your contractual sick pay scheme is based around eligibility for SSP, then the previous points mentioned above as regards deemed incapacity will need to be considered. Do note that if, having made enquiries about the surgery, you discover an underlying reason for it, not paying contractual sick pay could potentially be discriminatory so it is important here again to have the reasons for the surgery in mind.

If the surgery is medically recommended, we recommend allowing the employee to take sick leave and be paid for such time off in the usual way.

Should we document our approach?

Yes, we would recommend that, once you have determined how time off for elective and cosmetic surgery will be handled and whether it will be paid, you document that so that your employees have certainty around how such matters will be dealt with. This is, in part, about educating and informing your employees. If you can provide specific examples of what may/may not be included and any medical evidence that may be required to entitle someone to sick leave and/or pay, that will further foster understanding and prevent confusion or dissatisfaction. Once finalised, this can be included as a policy in your staff handbook.

Managing time off for cosmetic/elective surgery requires a delicate balance between legal regulations, employee needs and employer discretion. By ensuring ethical considerations, transparency and fairness all have a place in your decision-making, you can create a workplace that supports diverse individual circumstances while maintaining operational efficiency.


If you need support with managing employee cosmetic or elective surgeries, please contact the Employment Team on 01392 210700 or email