Page 109 - When surgery alone won’t cut it - Valerie Maureen Monpellier

Table 3:
Reasons for not undergoing body contouring surgery in desire group (n=368) and number of patients within that group who meet the weight qualification.
Reason
No insurance coverage
Did not ask for referral
I don’t qualify
I cannot afford it
Need/want to lose more weight
Afraid of complications/operation
Medical reasons and pregnancy
Plastic surgeon decided against BCS
Need more information
Still in doubt
General practitioner does not want to refer
* stable weight for ≥12 months and BMI < 35 kg/m2
DISCUSSION
Desire group 105 (28.5%) 101 (27.7%) 43 (11.7%) 36 (9.8%) 35 (9.5%) 32 (8.7%) 20 (5.4%) 11 (3.0%)
9 (2.4%) 8 (2.2%) 2 (0.5%)
Qualification* 40 (39%) 48 (48%) 22 (51%) 22 (61%)
3 (9%) 15 (47%) 9 (45%) 5 (46%) 4 (44%) 3 (38%) 2 (100%)
This study of a post-bariatric population with approximately 2.5 years follow-up shows that there were no differences in the percentage of patients meeting the Dutch criteria for reimbursement, when comparing patients who had a desire for BCS with patients who had BCS. Almost half of the patients who desired BCS met these criteria and, in principle, qualified for reimbursement. However, a significant part of these patients never consulted a plastic surgeon. Part of these patients assume that they will not get reimbursed for BCS and/or are not aware of the current guidelines in the Netherlands. The included population is comparable to populations in previous research. A large part (62.4%) of the post-bariatric patients desired BCS, while only 11% of the popula- tion actually had BCS 4,22. Patients who desired BCS were younger and more often fe- male 23. They reported more body parts affected by excess skin than patients without a desire and graded the amount of excess higher. The abdomen was most commonly affected by excess skin, as were the thighs, arms and breasts/chest 5,22,24-26.
Satisfaction with the whole body was similar when comparing the three groups. How- ever, patients with a desire were less satisfied with several body parts and unsatisfied with the proportions of their body. It might be that patients are overall satisfied with their body, but especially dissatisfied with specific areas (for which they desire BCS). Or that patients are more focused on the proportions of their body, which can be very variable when excess skin is only present in one or two body parts.
Patients who had undergone BCS were more satisfied with their body now than they were before BCS. Although these data might be biased, because of the retrospective ratings, the difference was very large (3.9 versus 7.3 on a scale from 0-10) and this
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