Sociodemographic characteristics of patients and their use of post-bariatric contouring surgery in the US

Abstract

Background Expansion of healthcare insurance coverage to bariatric surgeries has led to an increased demand from patients for post-bariatric contouring surgeries. This study examined the relationship between the use of contouring procedures on post-bariatric surgery patients, clinical need and sociodemographic factors. Methods Data were extracted from the Healthcare Cost and Utilization Project (HCUP) Nationwide Ambulatory Surgery Sample (NASS) regarding hospital-owned ambulatory surgical centres in the US. Episodes without missing values relating to patients, 18 years old or above were the primary unit of analysis. Episodes were excluded if the field regarding expected payer was reported as “no charge.” The primary outcome was the likelihood of panniculectomy, abdominoplasty, and mastopexy among post-bariatric surgery patients; and the degree to which uptake of these types of contouring surgery were associated with age, gender, median households’ income, expected payer, patient’s location, and comorbidity. Results A total of 66,368 weighted episodes of care received by patients who had had bariatric surgery were extracted (54,684 female [82.4%]; mean age, 51.3 [SD, 12.1]; 6219 episodes had contouring surgeries [9.37%]). Panniculectomy was the most common post-bariatric contouring procedure (3.68%). Uptake of post-bariatric contouring procedures was associated with age, sex, payment type, area-based measures of median household income, and patient location. Compared to Medicare insured patients, the odds of receiving contouring surgery among self-payers were 1.82 (95% CI, 1.47 to 2.26) for panniculectomy, 14.79 (95% CI, 12.19 to 17.93) for abdominoplasty and 47.97 (95% CI, 32.76 to 70.24) for mastopexy. Rank order of comorbidity profiles also differed between insured and self-paying recipients of contouring surgery. Conclusions Insurance status of bariatric surgery patients and their sex were strongly associated with receipt of a range of contouring procedures. Self-payments were associated with a doubling of the odds of having panniculectomy and an increase in the odds to approximately 14 times for abdominoplasty and 48 times for mastopexy. Thus, access to contouring surgery by post-bariatric patients may be disproportionately dependent on personal preference supported by ability to pay rather than clinical need. Further research is needed to examine the impact of contouring or delayed/denied contouring on health status.

Factors and barriers influencing the decision to undergo body contouring surgery after bariatric surgery

“…According to a recent British study, patients who underwent body-contouring surgery after bariatric surgery were more likely to be female, older, have higher education, and higher income compared to those who did not undergo such procedures. 7 These findings align with the patterns observed in our study, suggesting some consistency across different populations regarding the demographic characteristics associated with the decision to undergo body-contouring surgery after bariatric procedures.…”

“…The most commonly carried out body-contouring procedure among post-bariatric patients in our study was the excision of excess skin and tissue in the abdominal area, which is consistent with findings from other studies. 7 These findings have practical implications for healthcare providers and practitioners involved in the care of post-bariatric patients who are considering body-contouring surgery. It highlights the importance of providing proper counseling and education tailored to the needs of this specific patient subgroup.…”

“…The questionnaire was developed based on previously published studies that covered similar topics. 7,9,15 The questionnaire was divided into 3 parts. The first part gathered socio-demographic information, including age, gender, nationality, relationship status, and education level.…”

“…4 Consequently, an increasing number of individuals who have undergone bariatric surgery are seeking aesthetic or body-contouring surgeries. 7 This survey-based study aims to identify the factors and predictors associated with undergoing aesthetic surgery among patients who have previously undergone bariatric surgery. The findings of this study have the potential to provide valuable insights to healthcare providers and policymakers, helping them understand the demand for cosmetic services following bariatric surgery and ultimately improving patient outcomes and satisfaction.…”

“…Consistent with previous research highlighting, gender as a significant predictor of surgical procedures, it is not surprising that females were more likely to undergo body-contouring surgeries. 7,9 In fact, data from the American Society for Aesthetic Plastic Surgery indicates that over 90% of aesthetic surgery consumers are female. 5 Achieving the ideal weight within 2 or more years following the bariatric procedure was identified as a major significant predictor, along with a lower median change in BMI.…”