By Plastic Surgeon Dr Dirk Kremer.

A recent study has shown that a large number of Clinical Commission Groups (CCGs) are not following official guidelines, and are refusing to fund excess skin removal surgeries for patients who have recently undergone massive weight loss (MWL) - cosmetic surgery which could be potentially life-saving.

Following treatments for obesity, such as gastric bands, bypasses and sleeves, and the following weight loss, it is possible for patients to be left with up too much skin, that of 2 people in some serious cases. As a result, this can lead to functional problems which can negatively affect their everyday life through reduced mobility, issues relating to hygiene and a susceptibility to infection.

Why should CCGs fund excess skin removal?

The functional problems mentioned above can have an adverse effect on a patient’s physical and psychological well-being, along with the patient’s ability to work. In several cases, these ‘molten bodies’ can also lead to depression, and in the most extreme circumstances, suicide.

The British Association of Aesthetic Plastic Surgeons (BAAPS) believes that providing funding for excess skin removal surgeries will not only have a positive psychological impact on people who have undergone MWL, but will also be a cost-effective service.

The study has revealed that CCGs are widely ignoring NICE-accredited, national commissioning guidelines, with 92% of CCGs saying they ignore guidelines specific to the removal of excess skin, and 40% report that they do not provide funding for the surgery at all!

One CCG admitted funding only 3 of 66 cases put before them, while two others approved only 7 cases between the two of them. It is clear that CCGs on the whole aren’t considering the full implications of denying a MWL patient funding for excess skin removal surgery.

Half-treated patients

Mark Soldin, a consultant plastic surgeon, has described these patients as only being half-treated. Much of this, he argues, comes down to a misunderstanding of the word ‘cosmetic’ in cosmetic surgery. These procedures aren’t frivolous, rather they can offer patients a new lease of life, and can improve their mental and physical well-being.

However, not only is this refusal to fund procedures affecting innocent patients, it’s also having a direct effect on the economy.

People who aren’t treated for excess overhanging skin often suffer from depression, anxiety, and very often put the weight back on. The cost of treating depression in the UK is over £9 billion per year, while the cost of treating anxiety is over £10 billion a year, that’s to say nothing of treatments for problems associated with obesity (diabetes for example).

BAAPS has concluded that the cost for not providing funding to MWL patients (when considering the cost of treatments for stress, depression, and unemployment etc.) is £53 million per year, meanwhile the net benefit to the economy (that is, savings) could be up to £73 million. Of course, these figures are calculated in the simplest way, which means weighing the one-time cost of excess skin removal versus the yearly, reoccurring costs of not providing treatment. It is clear that there is evidence that CCGs should be taking guidelines about providing funding for those seeking excess skin removal surgery much more seriously.

At Harley Street Aesthetics, the mental and physical well-being of my patients is paramount, if you are considering a plastic surgery procedure to improve your health or boost your self-confidence then please contact us today to book a consultation with Dr Dirk Kremer, one of London’s best plastic surgeons.