Ask a doctor

4'9", 145lb. Should I Have Surgery Now or Lose More Weight?

I Have Lost 35 (31.4%) Pounds Which I Have Maintained for over 18 Months. I Am 4’9” and Currently weigh 145 after loosing 35 #. My personal goal is to weigh below 130.I am considering a tummy tuck or a panniculectomy. I exercise regularly. Should I have the surgery now or off until I loose more weight? I am fifty years old. I do not desire to look like a model, just simply look pleasant and feel good about myself.

Doctor Answers (11)

Abdominoplasty before or after weight loss is fine- the result should be good either way!

+3

The result of the abdominoplasty is not negatively affected by having extra weight and will only improve with ongoing weight loss.  You do not need to achieve your ideal weight prior to surgery. The surgery itself has a remarkable result and will improve your self esteem, allow you to see the benefits of your exercise and is often helpful for exercise because you are carrying less tissue and exercise is easier.  If you look at our pre and post op photos on our web site you can see the remarkable difference that the surgery will create.  This is truly inspiring for many patients or allows patients to engage more enthusiastically and successfully.  That tissue below the umbilicus/belly button, is the area which tends to accumulate most of the fat.  By tightening the muscles, the front -to back / side view is narrowed.  To lose weight after abdominoplasty will thin the flap that remains and the result will only improve.  


Wellesley Plastic Surgeon
5.0 out of 5 stars 14 reviews

Tummy tuck preparation

+2

Congratulations, I think you're very close to being ready for the procedure from the weight loss point of view.

I do however have a word of advice for you. Patients who are about to undergo tummy tuck surgery spend a lot of time thinking about the physical preparation for the procedure (for example weight loss issues) but do not spend a lot of time thinking about the emotional aspects.

It is not uncommon for patients who undergo the procedure to experience severe “mood swings”. These emotions may range from depression ( “why did I do this to myself”) to elation  (which may lead to over activity). I think it is helpful to be aware that these emotional swings do occur postoperatively. 
Suggestions I have for patients undergoing this procedure: 1. Make sure you have a strong support system in place who have time/patience to take care of you. 2. Be patient with the healing process, understanding that it will take several weeks to months to feel “normal” again. 3. Be prepared to distract your mind with things of interest such as books, magazines, and movies. 4. Expect less of yourself; do not go back to work too early and let others take care of you (for a change). 5. Keep in close communication with your surgeon and do not hesitate to communicate questions/concerns and the emotional swings that you may experience. 6. Keep in mind the end result!

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 722 reviews

Always lose the weight before cosmetic surgery

+2

The only good plan is to lose the weight before the surgery is done to get the best result and the one that will last the longest.  If you lose a lot of weight after body contouring surgery the result may losen up again.

The only exception to this would be if the pannus was so much in the way that it caused too much trouble even now.  But that is rare.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 48 reviews

You might also like...

Weight loss and Timing of Tummy Tuck

+1

Your expectations seem realistic. Ideally, you should be at your long term stable weight before surgery. You can have a good result at your current weight. However, in person exam and consultation will be necessary in order to verify.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 16 reviews

Lose weight first; then have full tummy tuck, NOT panniculectomy!

+1

Getting to your optimal healthy weight so that your results can be the best possible is always good advice, as you see from all the answers here. I would advise, however, NOT going on some fad diet that cannot be maintained long-term, just in order to hit a certain "target" weight! Healing does not occur as well in someone who is catabolic from a severe diet.

Secondly, panniculectomy is a seductive choice because it is "covered" by insurance whereas a tummy tuck is not. However, removal of only the apron of loose skin will do nothing for the loose skin and fat above your belly button, and after the (low) risk and time off work, and recovery, you will still end up needing the operation you should have had in the first place! How about a "free" unnecessary operation?

Do one operation, and make it the right one; likely an extended abdominoplasty with umbilical transposition, rectus muscle sheath plication, and perhaps liposuction of the hip rolls if that is necessary or desirable! Best wishes; keep up your good work and get a great result!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 123 reviews

Pre-Surgery Weight Loss

+1

Reach your optimal weight that you are able to maintain long term, then have your procedure, the extent of which will depend on your anatomical findings and expectations.

Stephan Baker, MD
Miami Plastic Surgeon

Lose your weight before tummy tuck

+1

Just 15 more pounds and you will hit your goal so just go for it. The tummy tuck result can be even better, and a nice reward if you lose the weight first.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 28 reviews

4'9", 145lb. Should I Have Surgery Now or Lose More Weight?

+1

For best results lose the weight. It helps in simplifying the operation, faster recovery, better appearance. From MIAMI 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 62 reviews

Before

+1

Get your weight down at least another 15 lbs before surgery. You will end up with a much better result.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.0 out of 5 stars 9 reviews

WEIGHT LOSS

+1

Currently your body mass index (BMI) is 31.  I would recommend a BMI of 26.  This means you need to lose at least 20 more pounds to help you achieve the best results.  Keep up the good work. You can do it.

Todd B. Koch, MD
Buffalo Plastic Surgeon
4.5 out of 5 stars 8 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.