In the July issue of Plastic and Reconstructive Surgery, Dr. Jeffrey A. Gusenoff et al wrote a study about the myths and misperceptions patients have regarding the issues associated with post-bariatric weight loss surgeries. Just some housekeeping points: post-bariatric surgery means that these are patients who have undergone some form of surgical treatment for managing their obesity. These patients often present to plastic surgeons for help managing the consequences of their subsequent massive weight loss such as loose, sagging tissues most commonly on the abdomen, back, buttocks, thighs, arms, and breasts. As the number of morbidly obese people increase in the United States, the number of patients seeking and receiving some form of surgical procedure to reduce their stomach size and thus their caloric intake is increasing dramatically. Many of these patients will lose hundreds of pounds making some form of post-massive weight loss body contouring necessary.
Dr. Gusenoff and his associates surveyed 174 prospective gastric bypass patients for their perceptions about their future needs for plastic surgery and their estimated costs for these procedures. 65% of the patients surveyed felt that some form of plastic surgery would be required after their massive weight loss and 43% of these patients felt it was important to meet with the plastic surgeon even before their gastric bypass procedure and resulting massive weight loss. Almost all of the patients interviewed underestimated the costs for their potential future plastic surgical procedures with 72% estimating the costs to be equal to or less than a trip to Disneyworld. Similarly most patients underestimated the complexity and time of recovery involved.
What this study clearly demonstrates that both the bariatric and plastic surgeons need to do a better job of cooperating and working together to develop methods to inform potential future bariatric patients of the possible benefits and costs associated with post-massive weight loss body contouring and rejuvenation procedures. Most of the patients surveyed also expressed a desire that their bariatric and plastic surgeons work as a “team” ensuring a continuity of care in managing both their bariatric surgery and their post-massive weight loss issues.
This article touches on issues and concerns that we, the surgeons and staff at St. Louis Cosmetic Surgery, see frequently in our post-massive weight loss patients. I think given the results of this study, we will be working harder to increase our educational efforts for these patients and their bariatric surgeons as to the risks, costs, and benefits of post-massive weight loss plastic surgery. Just a side note-I have never had a post-massive weight loss patient ever tell me they regretted undergoing their contouring and rejuvenation procedures. Most tell me their main regret is that they took so long to perform their surgeries.
Herluf Lund MD