scholarly journals Is body-contouring surgery a right for massive weight loss patients? A survey through the European Union National Health Systems

2021 ◽  
Author(s):  
Federico Lo Torto ◽  
Jacopo M. Frattaroli ◽  
Juste Kaciulyte ◽  
Ugo Redi ◽  
Marco Marcasciano ◽  
...  
Keyword(s):  
Weight Loss ◽  
National Health ◽  
Body Contouring ◽  
National Health System ◽  
Well Being ◽  
Massive Weight Loss ◽  
The European Union ◽  
Complex Situation ◽  
Level Of Evidence ◽  
Eu Countries

Abstract Background Obesity is pandemic nowadays, and hanging skin with consequent functional and psychological impairments is a common price to pay for massive weight loss. Plastic surgery in postbariatric patients represents a fundamental step to regain possession of a positive self-image. The authors aimed to investigate how EU countries’ National Health System (NHS) behaves regarding reimbursements for body-contouring procedures after massive weight loss. Methods A 1-item survey was sent to contacts found on the NHS official Web sites of 27 EU countries. The question focused on postbariatric surgery practice and investigated the accessibility criteria for NHS coverage concerning body-contouring procedures after massive weight loss. Results Responses were collected between January 2020 and February 2020. Response rate was 65%, and access criteria to NHS coverage for postbariatric surgery presented great variation across EU countries. Only one country presented an NHS with no coverage for postbariatric surgeries. Conclusions Despite the conspicuous variability found among the EU NHS, none of them admit reimbursement in cases of merely aesthetic procedures: postbariatric patients need to display functional or health impairments due to the extensive weight loss. The results of the current study describe a complex situation among EU countries, but a common lead towards postbariatric patients’ care shows off. The ultimate goal of bariatric patient’s healing should be full restoration of physical and psychological well-being. NHS of EU countries are facing this increasing request in various ways, and more studies should be performed in order to understand which is the best approach. Level of evidence: Not ratable.

scholarly journals An Alternative Treatment of Pseudogynecomastia in Male Patients After Massive Weight Loss

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Krista L Hardy ◽  
Ran Stark ◽  
Kevin H Small ◽  
Jeffrey M Kenkel
Keyword(s):  
Weight Loss ◽  
Body Contouring ◽  
Retrospective Chart Review ◽  
Massive Weight Loss ◽  
Average Weight ◽  
Level Of Evidence ◽  
Areola Complex ◽  
Attractive Option ◽  
Chest Deformity ◽  
Male Patients

Abstract Background There has been an increase in body contouring procedures following massive weight loss (MWL), including male breast reduction procedures. Treating male chest deformity after MWL using standard mastopexy techniques often leads to suboptimal results. Objectives The authors describe a technique to treat pseudogynecomastia using a modified elliptical excision and nipple-areola complex (NAC) transposition on a thinned inferior dermal pedicle as an alternative to conventional techniques. Methods A retrospective chart review from January 2011 to January 2019 identified a total of 14 male patients who underwent excision of pseudogynecomastia using the described technique. Results Patients were characterized by age, method of weight loss, pre-weight loss body mass index (BMI), post-weight loss BMI, total weight loss, grade of pseudogynecomastia, and concurrent procedures performed. Patients were followed for a period ranging from 3 months to 1.5 years (average, 8.1 months). Pre-weight loss BMI and post-weight loss BMI averaged 52.0 kg/m2 and 29.6 kg/m2, respectively. The average weight lost was 79.72 kg and the average total amount of tissue removed was 2615 g. All patients had concurrent procedures with an average operative time of 274 minutes. Four out of 14 patients (28.6%) experienced minor complications, which included asymmetry, delayed wound healing, seroma, and hyperpigmentation. There were no wound infections, hematomas, flap necrosis, or dysesthesia. Conclusions Due to several cosmetic advantages and low complication profile, our technique using a modified elliptical excision and NAC transfer on an inferior dermal pedicle is an attractive option for treating male chest deformity after MWL. Level of Evidence: 4

Body Contouring After Massive Weight Loss

2019 ◽  
pp. 563-575
Author(s):  
Natalie S. Barton ◽  
Al S. Aly ◽  
Gregory R. D. Evans
Keyword(s):  
Weight Loss ◽  
Body Contouring ◽  
Massive Weight Loss

scholarly journals Monetary value of disability-adjusted life years lost from all causes in Mauritius in 2019

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 63
Author(s):  
Laurent Musango ◽  
Ajoy Nundoochan ◽  
Philippe Van Wilder ◽  
Joses Muthuri Kirigia
Keyword(s):  
National Health ◽  
National Health System ◽  
Well Being ◽  
Good Health ◽  
Mean Value ◽  
Disability Adjusted Life Years ◽  
Monetary Value ◽  
Disability Adjusted Life ◽  
Life Years ◽  
The Republic

Background: The Republic of Mauritius had a total of 422,567 disability-adjusted life years (DALYs) from all causes in 2019. This study aimed to estimate the monetary value of DALYs lost in 2019 from all causes in Mauritius and those projected to be lost in 2030; and to estimate the monetary value of DALYs savings in 2030 if Mauritius were to attain the national targets related to five targets of the United Nations Sustainable Development Goal 3 on good health and well-being. Methods: The human capital approach was used to monetarily value DALYs lost from 157 causes in 2019. The monetary value of DALYs lost in 2019 from each cause was calculated from the product of net gross domestic product (GDP) per capita in Mauritius and the number of DALYs lost from a specific cause. The percentage reductions implied in the SDG3 targets were used to project the monetary values of DALYs expected in 2030. The potential savings equal the monetary value of DALYs lost in 2019 less the monetary value of DALYs expected in 2030. Results:  The DALYs lost in 2019 had a total monetary value of Int$ 9.46 billion and a mean value of Int$ 22,389 per DALY. Of this amount, 84.2% resulted from non-communicable diseases; 8.7% from communicable, maternal, neonatal, and nutritional diseases; and 7.1% from injuries. Full attainment of national targets related to the five SDG3 targets would avert DALYs losses to the value of Int$ 2.4 billion. Conclusions: Diseases and injuries cause a significant annual DALYs loss with substantive monetary value. Fully achieving the five SDG3 targets could save Mauritius nearly 8% of its total GDP in 2019. To achieve such savings, Mauritius needs to strengthen further the national health system, other systems that tackle the social determinants of health, and the national health research system.

Looking forward to the next 70 years: from a National Ill-Health Service to a National Health System

2018 ◽  
Vol 14 (1) ◽  
pp. 11-14
Author(s):  
David J. Hunter
Keyword(s):  
National Health Service ◽  
Local Government ◽  
Health Service ◽  
Health System ◽  
21St Century ◽  
National Health ◽  
National Health System ◽  
Well Being ◽  
Tipping Point ◽  
Health And Well Being

AbstractAmidst the NHS’s (National Health Service) success lies its major weakness, although one that Klein overlooks in his reflections on the NHS as it approaches 70. The focus on, and investment in, curing ill-health has been at the expense of attending to the public’s overall health and well-being. This preoccupation poses a greater threat to the NHS’s future than privatisation. Despite the weakness having been diagnosed decades ago, redressing the imbalance has proved stubbornly hard to achieve. Rhetoric has not been translated into reality. Yet, we may be on the cusp of a tipping point where in order to ensure a sustainable NHS, and one that is capable of meeting the 21st century challenges facing it, there is a renewed and overdue interest in promoting health and well-being in communities. But for this to succeed, the NHS will need to embrace its bete noire, local government.

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