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I'm not losing any more weight & my stomach area is very bothersome. Is a Tummy Tuck or Panniculectomy best best option? (photo)

I'm a 35 year old female and I had a weight loss of 50lbs, my beginning weight was 300lbs and I have stayed at 250 since. I exercise regularly, I'm not losing any more, and my stomach area is very bothersome...I know I am still obese and I would be interested in finding a surgeon willing to operate on me, hopefully in the Pacific NW. I have had two c-sections and a lap band, for previous surgeries, no issues with anesthesia...My blood pressure is normal and no diabetes or other health issues.

Doctor Answers (10)

Panniculectomy or tummy tuck

+3
Thank you for your question and congratulations on your weight loss.  A panniculectomy is a less invasive procedure and a full tummy tuck.  As others have stated a BMI of 30 is best if a full tummy tuck is contemplated.  Considering the fact he simply want the comfort removal of the excess abdominal skin a panniculectomy may be your best choice.  Please consult a board certified plastic surgeon.


Boston Plastic Surgeon
4.5 out of 5 stars 29 reviews

Body contouring surgery

+2
The best candidates for aeshtetic body contouring surgery are those with a BMI of less than 30.  Patients whose BMI os over 30 have increased surgical risks - delayed wound healing, venous thrombosis and pulmnary embolism, anesthesia complications, etc.  Patients who have a BMI of greater than 30 are sometimes a good candidate for surgery; however, both patient and surgeon should be clear about the increased risks.  As to the specific recommendations, no one can make an insightful recomendation without a through review of your medical history, a physical examination and a discussion with you about your expectations from surgery.

Michael B. Tantillo, MD
Boston Plastic Surgeon
4.5 out of 5 stars 13 reviews

I'm not losing any more weight & my stomach area is very bothersome. Is a Tummy Tuck or Panniculectomy best best option? (photo)

+2
Thank you for your question.

With pictures provided you will need an extended tummy tuck with liposuction.

Many surgeons, including myself, offer online virtual consultations where you send us your photos and we can estimate the cost. I, like many surgeons, also offer free consultations so that you can be examined and given the most accurate quote. Choose a board certified plastic surgeon who has done a ton of Brazilian Butt Lifts and has privileges to do this surgery at a local university hospital. This says his credentials have been checked out by fellow Drs. All surgeries carry risk, talk to your plastic surgeon and choose one wisely.

Mel T. Ortega, MD
Miami Plastic Surgeon
4.5 out of 5 stars 158 reviews

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Best option for body contouring?

+2
Hello and thanks for your post. For significant weight loss and excess skin there are several options. You have already mentioned panniculectomy, but you should also consider lower body lift and extended tummy tuck. These 3 techniques I have used in similar situations with good success. The decision for the best technique in your case can only be derived after a full consultation with a board certified plastic surgeon with broad experience in all 3 techniques. Best wishes, Dr. Aldo.

Aldo Guerra, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 127 reviews

Is a tummy tuck or panniculectomy the best option?

+1
Hello! Thank you for your question and photos! I hope that these answers help! A panniculectomy is an excellent method for removing the excess skin and soft tissue of the lower abdomen (abdominal panniculus), often caused by weight loss. It is mainly performed to ameliorate symptoms caused by the abdominal apron such as hygiene issues, excoriations, rashes/infections, back pain, etc. A panniculectomy gives almost immediate relief from these issues as well as has been shown to stimulate additional weight loss as your activity level is increased after removal of the panniculus. An abdominoplasty is more of an aesthetic procedure in that as opposed to simply excising this excess tissue in a wedge to relieve complaints, an abdominoplasty focuses more on abdominal contouring, abdominal wall tightening, re-insetting the belly button, as well as often times the addition of liposuction.

I would highly recommend continued diet and exercise prior to any consideration for a panniculectomy or body contouring as getting down to your ideal weight prior to the procedure will certainly give you the best results as well as be the safest for you. Neither one is a weight loss procedure. Also, a continued healthy and active lifestyle will be needed in order to maintain the benefits that the procedure has given to you. You should consult with a plastic surgeon at anytime to go over options and in order to assist you in deciding which procedure(s) would be right one for you. Depending on your examination, photo documentation, and discussion of your symptoms, insurance coverage may be possible. Best wishes for a wonderful result!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

Tummy tuck for overweight patients

+1
Hi there.  And congratulations on your weight loss.  

It's super important to distinguish between healthy overweight and unhealthy overweight patients.  From your photo and your history, I would put you in the former category - healthy overweight.  It looks like most of your excess fat is on the outside of your belly as opposed to the inside, you are not hypertensive and you are not diabetic.  To me that says your excess weight is more of a cosmetic issue than a medical issue.  

You would likely need an extended tummy tuck and maybe some liposuction.  For overweight patients like you, I recommend a pain pump to help you mobilize early and also Lovenox to help prevent blood clots.  

Some of my most grateful patients are ladies just like you who have worked so hard to slim down but have just "hit the wall" with weight loss.

Good luck!

Lisa L. Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 41 reviews

Higher BMI Increases Surgical Risks From Tummy Tuck

+1
Because you mentioned that you "still obese" body contouring surgery may not be safe for you because of the increased risks. 

Patients with a BMI of less than 25 in the normal range are considered to be ideal candidates. However, if you are a body builder, very muscular, or have lost more than 100lbs, a BMI of less than 30 may also be acceptable.

If you could achieve a lower BMI, a full tummy tuck would probably achieve your desired results.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 57 reviews

I'm not losing any more weight & my stomach area is very bothersome. Is a Tummy Tuck or Panniculectomy best best option?

+1
   A panniculectomy may be reasonable at your current weight if further weight loss cannot be obtained.

Kenneth Hughes, MD

Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 203 reviews

Congratulations

+1
Congrates.
You have already done the hard part. One of the best advantages of the lap band is that it can be adjusted in situations like this by adding a little more fluid through the skin. This will help tremendously and the port is usually left in during the tummy tuck in case you choose to adjust it further.
Port adjustment is the IDEAL procedure for you now! This will significantly help achieve the long term result that you are searching for.

Larry C. Leverett, MD, FACS
Phoenix Plastic Surgeon
5.0 out of 5 stars 4 reviews

Wait for the Tummy Tuck

+1
Thank you for your pictures.  Congratulations on losing weight.  Certainly someone can perform a panniculectomy at this stage but I would not recommend that.  You should continue on with your weight loss. Maybe revisiting with your gastric bypass surgeon to see if your lap band can be tightened.  Once you reach your goal weight then a tummy tuck would be the best option.

Earl Stephenson, Jr, MD,DDS, FACS

Earl Stephenson, Jr., MD, DDS
Atlanta Plastic Surgeon
5.0 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.