Page 118 - When surgery alone won’t cut it - Valerie Maureen Monpellier

Chapter 7
INTRODUCTION
ABSTRACT
Reimbursement of body contouring surgery (BCS) is a worldwide problem: there is no objective instrument to decide which post-bariatric patients should qualify for reim- bursement. The British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) has developed a screening tool for this purpose. Goal of this study was to test a modified version of this screening tool in a post-bariatric population.
METHODS
Post-bariatric patients were asked to fill in an online questionnaire based on the BAPRAS screening tool with questions regarding complaints of overhanging skin and medical history. Weight loss data were extracted from a prospective database. The BODY-Q was added to assess patient reported outcome.
RESULTS
A total of 120 patients were included, 96 patients wanted to undergo BCS (80%) and 24 patients did not (20%). In the group who wanted BCS, 25 patients (26%) qualified for reimbursement according to our criteria. Patients who qualified had higher weight loss (33.5% versus 28.1%, p=0.014), lower BMI (29.3 kg/m2 versus 31.4 kg/m2, p=0.062) and more medical (3.4 versus 2.2, p=0.002) and psychological complaints (88% versus 61%, p=0.009). There was a significant, negative correlation between the screening tool scores and almost all BODY-Q scales.
CONCLUSIONS
With the modified BAPRAS screening tool post-bariatric patients with the best weight (loss) and most complaints of excess skin qualified for referral and reimbursement of BCS. The BODY-Q showed the significant impact of excess skin on well-being and should be a standard part of evaluation.
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