I decided to write this blog after giving a lecture on post bariatric body contouring last night. I was presenting at a bariatric support group meeting and what got me thinking was a comment the bariatric surgeon running the group said during my introduction. He stated that only about 5-10% of post bariatric patients undergo plastic surgery. That night, I started thinking about that percentage. Why so few?

I will try to answer my own question with three main reasons for not having post massive weight loss plastic surgery. Most of these comments are taken from articles in the respected plastic surgery journal Plastic and Reconstructive Surgery. The rest are anecdotes gathered during my thirteen years of experience as a plastic surgeon.

Reason #1: Finances
It appears that for 30 – 60% of patients, the inability to afford these procedures is the number one reason for not proceeding with body contouring. Interestingly, most patients are shocked to hear that most of the post bariatric body contouring procedures are not covered by insurance. Some insurance companies even have specific clauses not covering these procedures.

What sometimes is, and can reduce their cost, is a panniculectomy. This is the removal of excess abdominal skin in order to alleviate constant rashes and infections in the creases and surrounding area. Also if the breasts are still excessively heavy, a reduction can be covered by insurance. If you are interested in body contouring post massive weight loss, you should speak with your insurance representative to get a better idea of what you will have to pay out of pocket.

Reason #2:  Lack of awareness
Only 10% of bariatric surgeons routinely refer their patients to a qualified plastic surgeon for body contouring. A little better than that, about 50% of bariatric surgeons will talk to their patients preoperatively about the availability of post bariatric body contouring. Although 90% of bariatric surgeons believe that post weight loss body contouring helps patient both from a cosmetic and functional point of view, they do not think that it is necessary for the ultimate success of bariatric surgery.

Reason #3: Fear
I have not seen this in any of the articles but I believe a large number of patients are very scared of undergoing such large procedures. This is partly because they do not understand the procedure and medical processes involved in a surgery that is mostly cosmetic.

This article has been written by Dr. Peter Fisher, a board certified Plastic Surgeon in private practice since 1990. He has specialized in post bariatric body contouring since 2000, with some unique innovations of his own. He currently resides in San Antonio, Texas.

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San Antonio Plastic Surgeon