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Analysis

Why the NHS should do more bariatric surgery; how much should we do?

BMJ 2016; 353 doi: https://doi.org/10.1136/bmj.i1472 (Published 11 May 2016) Cite this as: BMJ 2016;353:i1472

Rapid Response:

Re: Why the NHS should do more bariatric surgery; how much should we do?

Dear Editor,

We enjoyed 'Why the NHS should do more bariatric surgery; how much should we do?' (BMJ 11 may 2016). We are writing to highlight the need for post- bariatric plastic surgery procedures.

After massive weight loss, patients are left with huge abdominal aprons of skin, ptotic breasts, and redundant skin folds on their limbs. These can severely limit mobility and function, and inevitably develop intractable intertrigo and excoriation. The skin redundancy can be as debilitating and restrictive as the fat itself. In addition, the psychological impact and negative impact on quality of life are well recognised. Plastic surgery procedures such as apronectomy (abdominoplasty), body lifting and other techniques for excising redundant skin are not cosmetic only, but should be regarded as an essential part of the weight loss treatment.

If we are to expand bariatric surgery within the NHS, we must make proper provision to ensure a service can be delivered that saves lives whilst maintaining or improving the quality of those lives.

Yours sincerely,

Oliver Sawyer [oliver.sawyer@nbt.nhs.uk]
STR Plastic Surgery
&
James Henderson
Consultant Plastic Surgeon

Competing interests: No competing interests

19 May 2016
Oliver Sawyer
STR Plastic Surgery
James Henderson
Southmead Hospital, Westbury-On-Trym, Bristol