Summary
Background
Following massive weight loss, patients are left with folds of redundant skin that
may cause physical and psychological problems. These problems can be addressed through
body contouring procedures such as abdominoplasty and the thigh lift. Despite an exponential
rise in the number of bariatric surgery procedures performed in the United Kingdom,
there are no national guidelines on the provision of body contouring procedures after
massive weight loss. We conducted a survey of UK Bariatric Surgeons to determine the
pre-operative counselling that patients receive on this issue, their opinions towards
post-bariatric surgery body contouring and current referral patterns to Plastic Surgery.
By exploring the relationship between Bariatric and Plastic Surgery, we aimed to identify
how the comprehensive treatment of patients undergoing bariatric surgery could be
improved.
Method
A questionnaire was sent to 86 surgeon members of the British Obesity and Metabolic
Surgery Society. Questionnaires were analysed from the 61/86 respondents (71% response
rate).
Results
92% of the responding surgeons feel that patients face functional problems relating
to skin redundancy after massive weight loss, and a high percentage of patients complain
about this problem. However, only 66% of surgeons routinely counsel patients about
these problems before they undergo bariatric surgery. 96% of respondents feel that
body contouring for these patients should be funded on the NHS in selected cases.
However, it is difficult for patients to access consultation with a Plastic Surgeon
and there are no explicit guidelines on the criteria that patients must fulfil to
undergo body contouring surgery on the NHS. At present, these criteria are locally
determined and represent a postcode lottery.
Conclusion
The NICE guidelines on obesity recommend that patients undergoing bariatric surgery
should have information on, or access to plastic surgery where appropriate, but this
standard is not being achieved. National guidelines on post-bariatric body contouring
surgery are needed to improve the comprehensive treatment of these patients. The clinical
and cost effectiveness of bariatric surgery has been well established. Further studies
focussing on the outcome of body contouring after massive weight loss could support
this becoming and integral part of the bariatric surgery pathway.
Keywords
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Article info
Publication history
Published online: October 24, 2011
Accepted:
September 30,
2011
Received:
July 3,
2011
Identification
Copyright
© 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
