BACKGROUND: Body contouring surgery (BCS) improves quality of life, weight loss and body image after bariatric surgery. It is unclear why only a minority of the post-bariatric population undergoes BCS. In this study, we assess overhanging skin, body satisfaction and qualification for reimbursement of BCS in a Dutch post-bariatric population and study the differences between patients who have undergone BCS, patients who desire BCS and patients who do not. METHODS: Post-bariatric patients at Clinic X". were selected from a prospective database. Electronic questionnaires evaluated demographics, desire for BCS, excess skin and satisfaction with their body. RESULTS: A total of 590 patients were included: 368 patients (62.4%) desired BCS, 157 (26.6%) did not desire BCS and 65 (11.0%) had undergone BCS. There were no significant differences between the groups regarding the percentage of patients who met the qualifications for reimbursement. Patients who desired BCS had more body parts affected by overhanging skin and more often rated the overhanging skin with a Pittsburg Rating Scale grade 3 compared to patients without a desire. The plastic surgeon was never consulted by 39.1% of the "desire" population; 44.1% of these patients met the weight criteria. CONCLUSIONS: Post-bariatric patients who desired BCS had more excess skin than patients without a desire and were less satisfied with their body. Almost half of these patients never consulted a plastic surgeon, partly because of incorrect assumptions regarding reimbursement. Plastic surgeons (together with bariatric teams) should better inform post-bariatric patients about BCS possibilities.