PBS? No, not the Public Broadcasting System. I’m talking about postbariatric surgery, or, more formally, comprehensive plastic surgery following massive weight loss. If this isn’t the hottest topic in plastic surgery right now, I don’t know what is.

Here’s some anecdotal evidence:

• This issue contains three articles that focus in whole or in part on PBS.

• Statistics from the American Society of Plastic Surgeons (ASPS) and the American Society for Aesthetic Plastic Surgery (ASAPS) that are cited in two of these articles illustrate the dramatic rise in PBS.

• One physician whom I approached for an article on another plastic surgery topic told me he couldn’t do it—his “spare” time was being devoted to writing a book chapter on PBS.

• A large number of scientific papers presented and courses taught during the ASAPS’ recent annual meeting were devoted to PBS and its allied procedures: abdominoplasty and liposuction.

• Body-contouring surgery is all the rage on the medical “reality” TV shows.

PBS has also spawned a surge of new products from traditional industries that serve plastic surgeons.

• It has generated a demand for more and better surgery-recovery garments. Much of the benefit of PBS would be lost if it were not for appropriately constructed compression garments that enable the patient to heal correctly.

• For obvious reasons, larger and sturdier operating tables and hospital beds are required for patients who undergo PBS as well as the bariatric surgery that precedes it. In turn, that means that special linens and other supplies have to be manufactured to fit the supersized equipment.

• Postbariatric patients often aren’t in the best of physical condition. Plastic surgeons have begun to recommend (and often to provide) special dietary supplements to build patients up before surgery and to help their recovery.

PBS also has created possibilities for alliances among physicians. Plastic surgeons seek out bariatric surgeons for referrals, and vice versa. If you want to build your practice in that direction, this is a good place to start.

But you first need to make a decision about taking on PBS. There are risks involved; after all, the prospective patients have recently undergone radical surgery and are in somewhat compromised health. Bariatric surgery and PBS are still fairly new, and all of the contraindications and complications are probably not known.

You also have to assess the present and future economics of your practice. Even though PBS can be quite lucrative, major investments are involved in terms of buying the equipment and learning the procedures. If you have a robust practice now, you may be content to stick with the status quo and leave PBS to others.

Either way, it is safe to say that PBS is now on center stage of plastic surgery and will continue to be for the foreseeable future.

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