I have lost (and kept off) 100 lbs and am very interested in a tummy tuck. I am, however still overweight at 230lbs where I've hovered for some time. I have a decent amount of muscle, am quite large boned and am decently fit but am so tired of the appearance of my stomach. I realize I am above my ideal weight, but have done quite well keeping the weight off so far and feel I wold benefit from a tt. What are your thoughts at this weight?
I'm Still Overweight After a Substantial Weight Loss, but Am Interested in a Tummy Tuck. What Are Your Thoughts?
Doctor Answers (15)
After this large volume of weight loss you have a considerable amount of hanging skin and fat. The excision will not only take a considerable amount of extra weight off, it will also allow you to look better, and you will be able to exercise with greater facility
Weight Stable and Tummy Tuck
Tummy tuck can be considered in patients who have lost significant weight and have stabilized but who are still overweight. Attendant risks need to be managed on an individual basis, and all of this should be discussed with your board certified plastic surgeon.
Abdominoplasty with Mesh Reinforcement
Your abdominal wall strength is determined by 2 components, fascia and muscle. The muscle can hypertrophy with exercise but fascia cannot. There is a new technique called Abdominoplasty with Mesh Reinforcement. The mesh is used to reinforce the fascia, which has been damaged from your excessive weight and weight loss of 100 lbs. Mesh Reinforcement strengthens your abdominal wall, helps you lose additional weight and maintain the reduced weight.
Gary Horndeski, M.D.
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Second Tummy Tuck
If you have lost over a hundred pounds, you most likely have a significant amount of extra skin in your abdomen and a tummy tuck would likely make a great improvement in the way you look. Since you are still a little heavier than is what is considered ideal, it is important that you understand that if you go on to lose a lot of weight (another 50-100 lbs) after your tummy tuck, you may develop some more loose skin that you would need a second tummy tuck to correct. If you are okay with this, then I think you are safe to proceed. Good luck and congratulations on the weight loss.
Less Than Ideal Patients Can Benefit From Tummy Tucks
Thank you for your question. Congratulations! While tummy tucks work best in patients who are near their ideal body weight, less than ideal BMI patients can benefit from a tummy tuck. There are some considerations that affect the outcome. The amound of residual intra-abdominal fat and flank and back fat can have a negative effect on the outcome. Procedures such as a lipo-abdominoplasty, extended tummy tucks and belt lipectomies can be helpful in these patients. Discuss this matter with a surgeon experience in body contouring after weight loss. Good luck!
Still Overweight After a Substantial Weight Loss-- Tummy Tuck??
The usual guideline for safety and good outcome is that a patient be as close as possible to desirable weight. That may be hard to define. A measurement that is useful is BMI-body mass index, which you can check on-line. Anything over 30 is associated with a higher degree of risk of complications, both minor and major. At 230 pounds you would have to be at least 6'1" to have a BMI of 30.
I use the word guideline, because it is just that. There are exceptions, and if your weight is indeed steady and it is unlikely that you would lose more, that is a consideration when a surgeon measures risks and benefits.
When you ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified, but also is a member in good standing of the major plastic surgery organization in the U. S.
Thank you for your question, best wishes.
Ideal Body Weight And The Timing Of A Tummy Tuck
At what weight to do a tummy tuck is a good question and there is no exactly right answer. While the ideal weight answer is always correct, there are many patients who have lost a lot of weight and simply are never going to get there. Many weight loss patients 'hit the wall' where they reach a certain weight and just can't seem to get past it. Other patients need to have a more realistic weight goal even if it is above their ideal body weight. I think if one is within 10lb to 20lbs of their weight goal and have a significant abdominal overhang then undergoing a tummy tuck at this point is reasonable and can provide a huge psychological uplift to one's body image.
Desparately Seeking Tummy Tuck, but still overweight!
Go for it! I'm sure that with a weight loss of 100 lbs., you have considerable abdominal laxity – and this is your concern. Although you may lose additional weight – and it’s always better to be at or near your ideal weight prior to surgery – I think a tummy tuck at this time would give you a tremendous psychological boost. As long as you realize that you may require a revision to enhance the cosmetic result if you do lose significantly more weight, then you are having surgery with your eyes wide open. I have seen many patients "stuck" at a certain weight, unable to lose more, who had surgery and then were suddenly able to lose weight again. This may be just the right thing for you.
Keep going --- get your BMI under 30. Don't short change yourself on a good result. Keep up the good diet and lose more weight.
Tummy Tuck if not at Ideal Weight?
Thank you for your question. You certainly have done well losing 100 pounds! You will have a substantial amount of skin laxity as well as hanging fat from your lower belly after this weight loss, so you would be a good candidate for a tummy tuck. You will have a great improvement to your belly with this procedure and sometimes this motivates patients to lose even more weight. Even if later you have a revision to the tummy tuck this is not the end of the world.
Pablo Prichard, MD