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Why Do So Few Post Massive Weight Loss Patients Undergo Plastic Surgery?

By on March 05, 2015

Following a lecture I gave on post bariatric body contouring at a bariatric support group meeting, a particular comment stuck with me. The bariatric surgeon running the group said during my introduction that only about 5-10% of post bariatric patients undergo plastic surgery. That night, I started thinking about that percentage. Why so few?
I will try to answer my own question with three main reasons for not having post massive weight loss plastic surgery. Most of these comments are taken from articles in the respected plastic surgery journal Plastic and Reconstructive Surgery. The rest are anecdotes gathered during my thirteen years of experience as a plastic surgeon.
Reason #1: Finances
It appears that for 30 – 60% of patients, the inability to afford these procedures is the number one reason for not proceeding with body contouring. Interestingly, most patients are shocked to hear that most of the post bariatric body contouring procedures are not covered by insurance. Some insurance companies even have specific clauses not covering these procedures.
What can sometimes reduce cost is a panniculectomy. This is the removal of excess abdominal skin in order to alleviate constant rashes and infections in the creases and surrounding area. Also if the breasts are still excessively heavy, a reduction can be covered by insurance. If you are interested in body contouring post massive weight loss, you should speak with your insurance representative to get a better idea of what you will have to pay out of pocket.
Reason #2:  Lack of awareness
Only 10% of bariatric surgeons routinely refer their patients to a qualified plastic surgeon for body contouring. A little better than that, about 50% of bariatric surgeons will talk to their patients preoperatively about the availability of post bariatric body contouring. Although 90% of bariatric surgeons believe that post weight loss body contouring helps patient both from a cosmetic and functional point of view, they do not think that it is necessary for the ultimate success of bariatric surgery.
Reason #3: Fear
While not something mentioned in medical journals or article, I believe a large number of patients are very scared of undergoing such large procedures. This is partly because they do not understand the procedure and medical processes involved in a surgery that is mostly cosmetic. I try to provide my prospective patients with as much information as possible, both on my website and during in-office consultations. I encourage anyone interested in learning more to contact my office and schedule a consultation today.

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