Lethal Pulmonary Embolisms Are Avoidable

Abstract

Sir: We read with great interest the article “Temporal and Demographic Factors Influencing the Desire for Plastic Surgery after Gastric Bypass Surgery” by Dr. Gusenoff and colleagues published in an earlier issue of this Journal.1 The authors conducted a survey-based study of 2501 patients. They found a statistically significant association between young age, divorced status, female gender, history of laparoscopic gastric bypass, and desire to undergo body contouring after massive weight loss. Similarly, we conducted a study of our “bariplastic surgery” patients to further understand their unique needs and characteristics. After obtaining institutional review board approval, a survey was sent to 1991 patients who had undergone bariatric surgery between June of 2001 and June of 2006 at our institution. Two hundred forty-eight surveys (12.5 percent) were returned, 179 of which met inclusion criteria. Study variables included age, preoperative weight, maximum weight loss, nadir attained weight, preoperative body mass index, current body mass index, lowest body mass index, and information regarding insurance coverage and patient satisfaction with plastic surgery procedures. Statistical analysis with paired t testing revealed no statistically significant difference between patients who underwent plastic surgery procedures and those who did not. Contrary to the article referenced above, our study suggests that there are no objective patient- or weight-specific characteristics that make a patient more likely to seek body contouring after massive weight loss. We also found that the bariplastic patient is more likely to pursue face/neck lifting, thigh lifting, and arm shaping operations compared with the general population. Lastly, insurance coverage of plastic surgery was noted to be an important determinant of participation in body contouring procedures.2,3 Marcelo M. Ghersi, M.D. Kimberly A. Swartz Martin I. Newman, M.D. Michel Samson, M.D. Department of Plastic and Reconstructive Surgery Cleveland Clinic Florida Weston, Fla.