I've had three pregnancies, all c-sections. I've also lost 70 pounds through diet & exercise. However, I still have a BMI of 36 at 5'5" and 220 pounds, which I know makes me obese still. But I'm sick of my stomach overhang--it's gross, lowers my self esteem, and gets in the way while exercising. (My stomach does go flat when lying down.) If I came to you in my present condition, would you do a tummy tuck on me now or do I absolutely have to wait until I get my BMI below 30? Thanks in advance!
Can I Have Tummy Tuck Now or Wait Until I Lower my BMI? (photo)
Doctor Answers (29)
Your Self Esteem IS More Important Than You Weight
Taking off your tummy apron now will actually make it easier to exercise. If the right operation is done you should not need to re-do the tummy tuck later after getting to your ideal weight. The way you feel about yourself and how much easier it will be to buy clothes will help you work harder to get off that last chunk of weight.
Here are some things I think you need to be aware of though:
1 There will be a long scar. As the apron comes of it will involve skin all the way to the side of your hips. This will not be a mini scar
2 It looks like you have stretch marks above your hips and around to your buttocks. These will not go away
3 You will be happier if you let your surgeon do liposuction around the flanks and buttocks to tailor your new waistline. It means you can recover from both procedures in the same amount of time in the same garment!
The "Right" Weight at Which to have Tummy Tuck Surgery
While I understand how many women such as yourself have come to the belief that they need to vigorously exercise and diet in order to have their body contouring surgery (many of it propagated by us surgeons in order to help people understand that this surgery should not be done with weight loss as the goal), I must say that I could not disagree with the concept more...
There is no magic number at which you will instantly become a great candidate for surgery, and above which you are guaranteed to be unhappy and have complications.
Your individual ideal situation for surgery will be different than it would be for other women, and the details of your ideal situation will depend on many things- including your weight and body habitus, but also on your lifestyle, overall state of health, long term nutritional goals, and realistic ideals for appearance and long term exercise regimen.
In other words, I advise my patients to NOT focus on a number they feel they need to see on the scale, but rather to sit down and think about what is healthy and realistic FOR THEM in terms of a long term nutritional and exercise plan... Actually write down how many calories you feel you need to be happy at each meal and snack time, and be realistic- excessively restrictive diets are impossible to stick to. Similarly, write down an exercise plan that you really believe you can stick to OVER THE LONG TERM.
Once you are living the healthy lifestyle you've devised above and truly believe you can maintain over the long term, give it time for your body to adjust and plateau- whatever weight your body settles at for a period of at least 3 months is your individual healthy weight for surgery (assuming you are in good condition for surgery in all other ways).
Provided you are a well adjusted person with reasonable goals and your current lifestyle is one in which you are content and feel you can maintain, there is no reason I am aware of that I would not believe you to be a candidate for surgery now.
Timing for a tummy tuck
The BMI is used as a guideline to help physicians determine the best candidates for abdominoplasty. There are many other factors that go into the dicision making as well. I certainly think that you are a good candidate for the surgery at this time. I believe you will have a very good result and that it will make a big impact on your self esteem. If you continue to loose weight after surgery, you will just look better.
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Tummy tuck and BMI
Congratulations on your weight loss. Not only have you shown great discipline in your weight loss, you are also clearly researching your procedure based on your question regarding your BMI. Our literature shows a clear increase in the complication rate when an individuals BMI is over 35. A number below 30 is ideal but there is a significant drop in complications below a BMI of 35. This is a more reasonable and obtainable goal in the short term than 30 for you.
In review of your photos, you will see a dramatic improvement after a tummy tuck. This will have the advantage of making subsequent exercise and weight loss easier. The potential downside is that further weight loss may lead to some laxity of the skin of the abdomen. This may be minimal and not require interevention.
I would seek out a board certified plastic surgeon withe experience in body contouring after significant weight loss for consultation now.
I hope this was helpful.
Web reference: http://www.drrobkessler.com
Timing of Tummy Tuck
I believe that you are a reasonable candidate to have the procedure at your current weight if that is your choice. It will eliminate the overhanging pannus and improve your appearance and allow you to exercise more once you have healed.
Could have it done now
Congratulations on your weight loss. You have done a great job already. Your photos suggest that you have lost the weight in the right place to consider having a tummy tuck now. There does not appear to be a lot of fat in the upper part of your tummy and it looks like removal of the hanging skin and fat would make a drastic improvement. Certainly, if you have the procedure done and you loose a lot more weight, you could develop further laxity in the skin. However, it may be that at 220 lbs the majority of weight you still have to loose is somewhere else like your buttock and thighs. I think it is time for you to go for an evaluation by a plastic surgeon. This doesn't mean you have to book the operation now, just have the evaluation and get some advice from the doctor in person. I think this will help you better define your further goals. Good luck.
Tummy tuck and BMI
Congratulations for your weight loss. Ideally, you should have a BMI under 30. However, this may not be feasible for you. You should be able to get under and sustain a BMI under 35 prior to surgery.
Tummy tuck now (BMI 36) vs later (BMI 30)
Your weight loss is very impressive - shedding 70 pounds through diet & exercise is no small feat! Yours is a 'it depends' case, so a clearer understanding of where you are - both emotionally and physically - in respects to your weight loss program, is certainly needed.
In general however, my advice in cases such as yours is as follows:
- Wait - if your goal is to loose a little more weight (in your case, roughly 30-40 pounds) then I would wait until you are approximately half way there to undergo surgery.
- Don't wait - If the self esteem and exercising issues you're experiencing as a result of the overhanging abdominal skin are negatively impacting your ability to continue losing weight, then having an extended tummy tuck (with a little bit of liposuction to the hips) now will certainly provide you with a very nice result and if properly performed, will hold up well even if you lose a little more weight after surgery.
I think Dr. Haeck makes a very good point about the importance of maintaining and/or increasing your self esteem during the last and most difficult phase of your weight loss program. A properly performed tummy tuck can certainly function as both a reward for the progress you've made to-date and motivator for further/continued improvement. The other ancillary benefit to removing lax and overhanging skin = more productive workouts.
Once again, congrats on the weight loss and good luck with the rest of your journey!
Might be OK now
Plastic Surgeons like their patients to be at a BMI below 30 because the risk of pot-operative complications - such as wound separation (dehiscence) and fat necrosis - significantly go down. So, if a patient can get there, that is ideal. Some people, however, are simply not genetically programmed to be able to reach that BMI. If you are one of those people - you have stalled out on your weight loss and your weight is stable (not yo-yo-ing), you are in good physical condition, you don't smoke - you may be a candidate for the procedure now. You simply need to accept the fact that you are at slightly higher risk for complications and if you somehow lose a bunch more weight after surgery, your result may be compromised.
Tummy tuck or more weight loss
You can make a dramatic change in the appearance of your abdominal tissue with a tummy tuck. If you are actively losing weight, then I would wait until it stabilizes. If your weight has plateaued somewhat, then I would consider you to be a tummy tuck candidate. Do realize that there are some increase complication risks with higher BMI patients, and also there is a risk that if you continue to lose a lot of weight after a tummy tuck, you may still develop some laxity of the abdominal tissues. Good luck and congrats on the weight loss!
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.
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