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Being overweight/obese, what should I look for/seek in having an abdominoplasty done for strictly medical reasons?

Prior to our 2nd baby I was an internationally competitive/elite lifter. While pregnant, my abs spread approx. 5" which makes lifting/getting to the gym impossible because of it being symptomatic. Doc assured there isn't a full hernia but at a very high risk of developing one. I'm overweight (~300lbs.), not really interested in the procedure for the "tummy tuck" aspect, but the get my kiester SAFELY back into the gym/get healthy again aspect. Where do I start in finding a PS for the job?

Doctor Answers (4)

At 300 lbs. you do not need abdominoplasty; you should have bariatric surgery.

+1

Congratulations on your goal to lose weight and get back in the gym. Since tummy tuck is an elective cosmetic procedure, you would not receive insurance coverage for this surgery, even if you have your family or other doctor "write a letter." Panniculectomy might be a covered procedure, but would not address your upper abdomen, umbilicus or diastasis (muscle/fascia weakness/stretch). But even more importantly, even if you undergo this "covered" or "free" operation, successfully recover, and go on to lose weight, you will still need a full "real" tummy tuck! So why get the "free" operation that won't really solve your issues, when you could wait and have the operation that will restore your abdominal wall strength and muscular integrity while removing the excess skin?

But only after you lose at least 100+ pounds, one way or another.

I know you think that you can't "get back to the gym" without losing weight via surgery, but tummy tuck will not deal with the significant intra-abdominal fat (omentum and mesentery) that is a significant (majority) amount of your excess weight. Plus, you will have higher risks with this (unsuccessful and not-indicated) operation. You will still be morbidly obese, and will need (another) tummy tuck if/when you do lose 100+ pounds.

If any surgery is indicated at this time, it would be bariatric surgery as my partner and other plastic surgeons have indicated. Bariatric surgery is the only surgical solution to your weight issue--tummy tuck is not (whether covered "for medical reasons" or not). Diet and whatever exercise you are capable of performing CAN work for weight loss, but success is achieved by single-digit percentages of patients, whereas bariatric surgery achieves significant weight loss in a majority of those who choose this life-saving approach to weight loss.

THEN, you can have the skin tightening and muscle-repairing procedures you need and want.

Best wishes on this journey--it is lifesaving, and any of us would be happy to aid you in the secondary part of this process. Dr. Tholen


Minneapolis Plastic Surgeon
5.0 out of 5 stars 126 reviews

When to have tummy tuck?

+1

I think that if you weight 300lbs you need to focus on losing weight with a weight loss specialist or a bariatric surgeon or both first.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

When Should I Have My Tummy Tuck?

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Dear HHF34, My advice to you is to discuss weight loss surgery with a bariatric surgeon in the Twin Cities. Performing an abdominoplasty at your current weight adds significant risk to the procedure and maintaining the rectus repair as well. Also, once you are able to lose the weight, your results will change dramatically and your skin will most likely need to be removed again. Again, please consult with a bariatric surgeon to discuss surgical weight loss options if you are unable to lose the weight on your own. Good luck. Dr. Gervais.

Douglas L. Gervais, MD
Minneapolis Plastic Surgeon
5.0 out of 5 stars 85 reviews

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TT

+1

I truly believe you should be enjoying a much healthier, better quality life acknowledging you are a very young patient. That separation of the muscle is called dyastasis and that is not a life threatening condition but definitely something that has to be fixed because it cause a lot of discomfort and sometimes pain.

You have to know that performing a Tummy Tuck or panniculectomy is very risky on your current weight, and sadly to say, that procedure will not improve much your life.

Your BMI is over 45 and you are in the border of being considered a morbid obese patient.

I will encourage you to really consider to do something permanent as is the Gastric Sleeve or Bypass That procedure will help you and teach you to eat smaller portions of food and it will be your responsibility to eat the best quality of food possible to maintain your weight.

The permanent weight loss surgery will give you the opportunity to enjoy a healthier life now and in the future.

Have a great journey

Dr. Cardenas

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Laura Carmina Cardenas, MD
Mexico Plastic Surgeon
5.0 out of 5 stars 99 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.