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Body Contouring Surgery after Massive Weight Loss

Excess Skin, Body Satisfaction, and Qualification for Reimbursement in a Dutch Post–Bariatric Surgery Population

Monpellier, Valerie M., M.D.; Antoniou, Evangelia E., M.Sc., Ph.D.; Mulkens, Sandra, M.Sc., Ph.D.; Janssen, Ignace M. C., M.D.; Jansen, Anita T. M., M.Sc., Ph.D.; Mink van der Molen, Aebele B., M.D., Ph.D.

Plastic and Reconstructive Surgery: May 2019 - Volume 143 - Issue 5 - p 1353–1360
doi: 10.1097/PRS.0000000000005525
Cosmetic: Original Articles

Background: Body contouring surgery improves quality of life, weight loss, and body image after bariatric surgery. It is unclear why only a minority of the post–bariatric surgery population undergoes body contouring surgery. This study assesses overhanging skin, body satisfaction, and qualification for reimbursement of body contouring surgery in a Dutch post–bariatric surgery population.

Methods: Post–bariatric patients were selected from a prospective database. Electronic questionnaires evaluated demographics, desire for body contouring surgery, excess skin, and satisfaction with their body.

Results: A total of 590 patients were included: 368 patients (62.4 percent) desired body contouring surgery, 157 (26.6 percent) did not and 65 (11.0 percent) had undergone body contouring surgery. There were no significant differences between the groups regarding the percentage of patients who met the qualifications for reimbursement. Patients who desired body contouring surgery had more body parts affected by overhanging skin and more often rated the overhanging skin with a Pittsburgh Rating Scale grade 3 compared with patients without a desire to undergo body contouring surgery. The plastic surgeon was never consulted by 39.1 percent of the “desire” population; 44.1 percent of these patients met the weight criteria.

Conclusions: Post–bariatric patients who desired body contouring surgery had more excess skin than patients without a desire and were less satisfied with their body. Almost half of these patients never consulted a plastic surgeon, partly because of incorrect assumptions regarding reimbursement. Plastic surgeons (together with bariatric teams) should better inform these patients about body contouring surgery possibilities.

Huis ter Heide, Maastricht, Utrecht, Den Haag, and Nieuwegein, The Netherlands

From the Nederlandse Obesitas Kliniek; the Faculty of Psychology and Neuroscience, the Department of Epidemiology, Care and Public Health Research Institute, Maastricht University; the Julius Center for Health Sciences and Primary Care and the Department of Plastic, Reconstructive Surgery and Hand Surgery, University Medical Center, Utrecht; Nederlandse Obesitas Kliniek West, Haaglanden Medical Centre; and the Department of Plastic, Reconstructive Surgery and Hand Surgery, Sint Antonius Hospital.

Received for publication January 21, 2016; accepted April 29, 2016.

Presented at the 2016 European Obesity Summit, in Gothenburg, Sweden, June 1 through 4, 2016.

Disclosure:V. M. Monpellier works as an M.D. and researcher at the Nederlandse Obesitas Kliniek and I. M. C. Janssen is the medical director of the Nederlandse Obesitas Kliniek. The authors have no financial interest to declare in relation to the content of this article.

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Valerie M. Monpellier, M.D., Nederlandse Obesitas Kliniek, Postbus 601, 3700 AP Zeist, The Netherlands,

©2019American Society of Plastic Surgeons