The best results from any body contouring procedure are achieved when a patient is at or near their ideal body weight. That being said, it is very common for patients who are overweight to seek tummy tuck surgery. I recommend that if you are able to lose weight, it is best to do so before surgery. If you have your surgery now, an improvement may be made in the shape of your tummy, but the results would be much better with weight loss first. Additionally, if you lose a significant amount of weight after your tummy tuck, you may find that your skin is loose again, though probably not to the same degree as it is now. If you are able to lose weight prior to surgery, you may find that you don't need the liposuction you anticipate for your back. Even if you're not able to reach your "ideal" weight, I recommend trying to get as close to that weight as possible prior to surgery and when your weight loss plateaus, then make plans to move forward.
With regard to when you should have a consultation with a plastic surgeon, you may do that at any time to discuss your areas of concern, their preliminary recommendations, their suggestions regarding weight loss, and the anticipated cost and recovery time for your procedures. That way you have a definitive goal and plan to think about during your efforts to lose weight. Best wishes!
At 5' 4", you need to lose to at least 145 lb before considering a Tummy Tuck. This corresponds to a BMI of 25 which is at the upper limit of ideal weight. At very minimum, you need to lose the intraabdominal fat so that, when the muscles are tightened. undue pressure is not placed on the veins from the legs of the other intraabdominal organs. This reduces the possibilities of postoperative problems.
First of all, you don't look like you weigh 214. The real criterion for the surgeon is the ability to bring the muscle edges together in the abdomen. It would be a shame to perform a tummy tuck and not fully align the abdominal muscles. For most women who are 5'4" this means they should be no more than about 200 pounds. So you don't have far to go. I've attached a link to my website. You can view other patients of similar weight. You will likely be more motivated to stay in shape after surgery. There tends to be a big psychological boost.
Ideally, your weight would be about 170 pounds before having a tummy tuck. However, many people have found it difficult to lose the weight. After aggressive liposuction and tummy tuck, most patients can go on to lose weight more easily because (1) they are psychologically very encouraged by their new shape, (2) exercise is easier, and (3) their is less of a fat burden post-op (i.e. fewer fat cells to burn up during exercise). I have performed lipo/tummy tuck on many patients prior to their reaching their ideal weight as long as they were realistic about the end results. You could get a consult now just so you can start formulating a game plan. Also, envisioning the end result is often a great motivator for patients. I hope it goes well.
The closer you are to your ideal body weight, the better the Cosmetic result and the safer and easier the operation will be for you. So wait till you have your best effort in controlling the weight and your result will be very pleasing.
Thank you for your question and photograph. I understand how hard this to lose weight but at your current weight you simply will not be happy with a tummy tuck result that you get now. Part of what makes the tummy protrude his fat inside the belly wrapped around the intestines. Only weight loss will help remove fat from the inside of your tummy as well as the outside.
As far as it is try to lose weight at least until the bulge of your stomach and your waist size decreases and the skin is hanging loosely.
You may go for consultation at any time to learn more about how abdominoplasty and liposuction will help you but you must understand that the results of your abdominoplasty are proportional to how much you weigh at the time of your surgery. Based on your height your ideal body weight is approximately 140-145. The more weight you lose the more skin can be removed and the easier it will be to tighten your abdominal muscles.