Purpose: Plastic surgeons caring for patients after gastric bypass procedures have noted a significant gap between patient perceptions regarding post-bariatric reconstruction and attainability, cost, insurance coverage, and value. The purpose of this study is to investigate the perceptions of prospective bariatric surgical patients and identify misconceptions and strategies to potentially aid in the attainability of post-bariatric reconstructive surgery. Methods: 176 prospective gastric bypass patients were surveyed. We evaluated their perspectives on plastic surgery, a new “Club” concept integrating plastic surgical/bariatric teams, in addition to identifying payment strategies for these patients. Cost comparisons were set up to compare to major consumer purchases. Outcome measures were assessed by univariate analysis. Results: 174 patients (139 F, 35 M, mean age 42.3 yrs, mean BMI 49.3 kg/m2) completed the survey. 65.9% expressed an interest in plastic surgery; women were more interested than men (p<0.05). 47% desired a consult with a plastic surgeon at the time of their initial gastric bypass consultation. 73.1% wanted their plastic surgeon affiliated with the bariatric surgeon/team. 14.4% of patients equated the cost of a total body lift to the cost of a new car, versus 3.8% for a new home, 31.9% for a trip for two to Disneyworld, 23.8% for a flat screen TV, and 16.3% for a radio. Participants were willing to pay 2x as much for a new car as for a total body lift. Patient estimates for costs of plastic surgical procedures were underestimated by 60%. 42% of patients needed a payment plan, whereas another 41% needed to save or borrow money. 73.8% were interested in a “Club” environment, with most desiring an exercise component. 73% would pay a “Club” fee, although this monthly fee was estimated at 14x less than people would pay for a monthly car payment. 60% were interested in a monthly payment plan that paid into a “Club” account that could be used for plastic surgery in the future. 35% were willing to pay a monthly fee for certain procedures they desired in the future. 22% were interested in a flat fee for unlimited plastic surgery in the future with an average up-front payment of $9,722. None of the independent variables predicted which payment plan would be the most practical. Conclusion: Future gastric bypass patients, particularly women, are a unique population with a concentrated desire for plastic surgery. Common misconceptions exist with regards to post-bariatric reconstructive surgery. Early patient education, financial awareness, in combination with pre-existing or newly created bariatric centers, may improve attainability and overall well-being for this population.
View Synopsis (.doc format, 36.0 kb)