Page 108 - When surgery alone won’t cut it - Valerie Maureen Monpellier

Chapter 6
(4.2±2.0 versus 5.8±1.7; p<0.001), waist (4.0±2.0 versus 5.5±1.6, p<0.001), buttocks (4.4±2.0 versus 5.9±1.7, p<0.001) and thighs (3.7±2.1 versus 5.7±1.7, p<0.001). The abdomen was the body part that was most often rated as very important, by 36.3% of the patients. The breasts/chest was rated as very important in 29.2% of the patients and the waist in 24.2% of the patients. In the desire-group 35.6% (n=115) was very unsatisfied with the proportions of their body, in the BCS-group this was 10.9% (n=6) and in the no desire-group this was 5.5% (n=7).
Correlations
The PRS abdomen correlated negatively with rating of the abdomen (r=-0.486, p<0.001), thus higher PRS grading was related to lower satisfaction with the abdo- men. The PRS flank also correlated negatively with rating of hips (r=-0.406, p<0.001) and waist (r=-0.435, p<0.001). Correlation for PRS breasts with breasts/chest rating was r= -0.035 (p=0.476); and for the PRS arms where the rating of the arms was r=- 0.087 (p=0.057).
Reasons for not having BCS
In the desire-group, the most commonly stated reason for not undergoing BCS was non-reimbursement by the insurance company; these patients stated that they had consulted a plastic surgeon and the insurance company did not reimburse BCS (n=105, 28.5%) (Table 3). In the group of patients who stated this, 39% (n=40) met the weight qualifications. The second most common reason was that patients did not ask for a referral (n=101, 27.7%); 48% (n=48) of these patients met the weight qualifica- tions. The third most common reason was that patients thought they did not qualify, but never checked with a physician (n=43, 11.7%). A total of 22 of these patients (51%) met the weight criteria. There was also a group that assumed they could not afford a procedure (n=36, 9.8%), 61% of these patients met the qualifications.
In the desire-group, 144 patients (39.1%) had never consulted a plastic surgeon. Of these patients 84.7% (n=122) had a BMI < 35kg/m2 and 61.1% (n=88) had a stable weight. A total of 49.3% (71 patients) met the weight criteria.
In the no desire-group the most common reason for not undergoing BCS was ‘no complaints’ and/or minimal skin surplus (n=72, 45.9%). In addition, 51 patients (32.5%) stated they had no skin surplus at all. Nineteen patients (13.2%) did not want to undergo BCS because of medical issues.
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