INTRODUCTION: Informed consent is a time consuming process, and for massive weight loss patients there is often a long list of potential complications. Patients are often overwhelmed by the amount of information provided, and may be compelled to sign without truly understanding important concepts, such as risk of post-operative complications.1 By determining where discrepancies lie between physician and patient understanding of complications, and by determining patient risk factors which predispose to suboptimal understanding of risk for post-operative complications, we can diminish this gap. METHODS: 40 massive weight loss patients completed a short complication survey pre-operatively and at 1-month and 3-months post-operatively. 22 medical professionals evaluated the complications for comparison. RESULTS: Physicians perceived most complications as significantly less severe compared to patients. At the pre-operative visit, prior to final pre-operative counseling, patients felt that delayed wound healing (p=7E-10), suture extrusion (p=.00001), infection (p=.0001), necrosis (p=.0001), dehiscence (p=.001), and hematoma (p=.007), were more severe compared to how physicians viewed the same complications. Perception of death, DVT/PE, and return to the operating room did not vary significantly. Age did not impact complication perception. Patients seeking body contouring surgery with a primary goal of improved aesthetics compared to improved functionality were likely to view hematoma (p=.08) and dehiscence (p=.06) as more severe, although this did not reach significance. Patients who lost weight through diet and exercise, compared to surgical methods, were significantly more likely to view dehiscence (p=.04), hematoma (p=.01), and infection (p=.04), as more severe. CONCLUSION: A discrepancy exists between what surgeons and patients perceive as significant post-operative complications in body contouring surgery, with the greatest discrepancy being for wound healing complications. Age and motivation for surgery did not reliably predict complication perception, while complication perception could be predicted by method of weight loss. Patients ultimately feared the worst when it came to post-operative complications, thus emphasizing the need for detailed pre-operative counseling and patient education prior to undergoing surgery. Reference Citations: 1. Bester J, Cole CM, Kodish E. The limits of informed consent for an overwhelmed patient: cliniciansa€TM role in protecting patients and preventing overwhelm. AMA J Ethics. 2016;18(9):869–86.