Role of plastic surgeryBMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b4283 (Published 02 November 2009) Cite this as: BMJ 2009;339:b4283
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Abela et al (1) make the essential point that plastic surgeons play
a crucial role in the management of the post- bariatric patient, although
Plastic Surgeons were omitted from the multidisciplinary team of Leff and
Heath (2). An explanation for the omission might be the existence of a
postcode lottery for plastic surgery in the UK (3).
Only 62% of PCTs allow abdominoplasty without exceptional circumstances,
and these PCTs set a range of inclusion criteria for post bariatric
patients, including BMI decreases from 45 to less than 27 and stability of
weight for up to 24 months. Some PCTs specifically exclude massive weight
loss patients from subsequent body recontouring. One PCT states in it’s
funding guidelines “It is important that patients who are considering
bariatric surgery are given full information about the cosmetic
consequences of the bariatric procedures prior to undergoing surgery, and
that they will not be eligible for abdominoplasty”.
The need for bariatric and subsequent plastic surgery is only going to
increase. Fundholding bodies need to consider the present and future needs
of their populations.
(2) Leff DR, Heath D. Surgery for obesity in adulthood. BMJ
2009;339:b3402. (22 September.)[Free Full Text]
(3) Henderson J. The plastic surgery postcode lottery in England. Int
J Surg. 2009 Sep 30. [Epub ahead of print]
Competing interests: No competing interests