Dean Boyce (pictured right) is Clinical Lead for Plastic Surgery at The Welsh Centre for Plastic Surgery & Burns, a Council Member and Chairman of Education and Training for the British Association of Plastic, Reconstructive & Aesthetic Surgeons, and a consultant at Swansea’s Sancta Maria Hospital.
He discusses the issue of patients being denied surgery due to their Body Mass Index (BMI) – and how to best prepare for procedures.
The issue of NHS patients being denied surgery because of their Body Mass Index (BMI) receives much media attention and it is making potential patients anxious.
Weight restrictions have been put in place for elective surgeries including breast reductions and removal of excess skin after weight loss, as well as on non-cosmetic surgeries like knee and hip replacements and varicose vein surgery. For aesthetic procedures, restrictions have been imposed in Wales on people whose BMI is over 25. However, these restrictions may not be applicable for many patients seeking treatment privately at Sancta Maria Hospital.
Of course, lifestyle steps should be taken ahead of a procedure, to aid successful recovery and lower the risk of complications. The fitter the patient, the smoother their recovery process is likely to be.
However, some may struggle to reduce their BMI because of the very condition that needs surgical treatment. Painful varicose veins, or worn knee joints may make it impossible to exercise effectively.
One such complex issue is body contouring, removing excess skin from patients after weight loss. This is a popular procedure at HMT Sancta Maria, which can greatly impact quality of life. Extreme weight gain or weight loss bring complex underlying emotions and the positive impact of removing excess loose skin can be significant.
So, if a patient hasn’t yet got their weight below the 25 BMI threshold, it makes little sense to bar them from surgery, particularly since the weight of the excess skin and subcutaneous tissue itself is often significant.
Clinicians have a responsibility to advise and treat patients in the patient’s best interests, and complex nuances must be considered on a case-by-case basis. If you have concerns about how your BMI might affect your ability to undergo surgery, please speak to your surgeon.