Am I a Candidate? Or Easy Prey?

I'm 5'9" 275lbs. I wear a 44H bra size and most of my fat is in my mid-section. I'm a mother of 3 (one c-cection). After my cesarean with my last child, I have been unsuccessful in losing the weight or toning my abs. I've had two consultations and both doctors recommended a FTT and breast reduction. I've read that obese women are not ideal candidates but neither doctor hesitated to schedule the surgery or even warned me about potential risks. Am I really a good candidate? Or just easy prey?

Doctor Answers 11

No legitimate plastic surgeon looks at potential patients as "easy prey".

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Whether or not you are good or bad candidate for liposuction depends on many variables. These will be discussed by your plastic surgeon. If you've ended up in an office that looks upon you as a professional fee only you have ended up in the wrong place.

Some additional weight loss would be to your benefit

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At your reported height and weight, your Body Mass Index, or BMI, is around 40.  This puts you in the obese category, if not morbidly obese category for height to weight.  Please do not take offense at these terms as they are meant to classify people by weight and help stratify their risks.  Multiple studies have shown that the incidence of complications increases significantly when people have a BMI over 35; this is where the term "morbid" comes in.  It means that the obesity is at the degree that it leads to illness or risks of illness or medical problems.  To do elective cosmetic surgery on those individuals, in my opinion and according to the literature, increases their risks of complications and unsatisfactory outcome.  Furthermore, in addition to having H-cup breasts, you state that your weight is all in your "mid-section."  That may very well mean that there is a substantial component of "inside fat," or fat in your abdomen around the organs as opposed to fat outside that can be reached with surgery.  This is significant because a) inside fat is the fat that increases our risk of cardiovascular disease the most, and b) we can't reduce inside fat with tummy tuck, and therefore, all we are doing is further tightening an already tight abdominal wall against a large volume of inside fat which can contribute to some medical issues as well as lead to an unsatisfactory aesthetic outcome or failure of the muscle tightening portion of the procedure.  That is just the medical side of things.  I will tell you that it has been my experience that the AESTHETIC outcome of these procedures in people in that weight category has also been less than satisfying as well.  My best advice is for you to make a real honest, concerted effort to lose more weight, and if you can't do it on your own, consider medical guidance through either a medically supervised weight loss program or even bariatric surgery.  Once you have lost some weight and stabilized, the results of your body contouring surgery will be far superior, more satisfying, and definitely safer to achieve.  The one consideration I might make in this whole story is breast reduction.  In some instances, ladies with very large macromastia, or large breasts, may have significant hypertrophy of the glands of the breasts, and this wouldn't be expected to respond to weight loss.  Thus, doing a breast reduction on such patients may alleviate some of the weight burden as well as make subsequent exercise, and thus weight control, easier.  I might consider you for breast reduction first, even before you lost all of the weight you need to lose, but this would have to be based upon a sound evaluation and examination.  I hope that helps, good luck.

Joseph L. Grzeskiewicz, MD
San Diego Plastic Surgeon

Is Tummy Tuck and Breast Reduction Appropriate at 275 lb?

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Without seeing pictures, it is unlikely that a tummy tuck will give a good result. A breast reduction may be helpful but the best option is to start a medically supervised weight loss program with diet and exercise. If you could reach 175 to 200 lbs, the results of surgery would be much better. A weight loss surgery may also be considered.

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 76 reviews

Candidate for tummy tuck or easy prey

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If you are above an ideal body weight you are right to second guess the sincerity of your surgeon. Weight loss will improve your result and should be part of the discussion. The risk of obesity is not great, the reward after surgery will certainly be less unless you make changes.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

The ideal tummy tuck candidate

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Without seeing photos, it's difficult to give you an exact answer.  However, if you're concerned about your results after a tummy tuck look at the work of the doctors that you've seen.  The ideal tummy tuck candidate has loose, excess abdominal skin with looseness of the muscles.  Being at or close to your ideal BMI is also important.  Therefore, if you need to lose a few pounds beforehand it might make your results much better.  Good luck!

Tummy tuck is best delayed until you are close to your ideal body weight

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Thank you for your question. Most plastic surgeons prefer that patients be close to their ideal weight before having tummy tuck.

Be sure to consult a plastic surgeon who is certified by the American Board of Plastic Surgery, very experienced in tummy tuck surgery, and who has an excellent reputation in your community.

If you have doubts and do not feel confident in opinions given to you by a plastic surgeon, by all means seek consultation elsewhere.

Tummy tuck & breast reduction safe for my size?

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It's difficult to say without photos but based on the questions and concerns you have, I would suggest losing weight prior to your surgery so you can get the best results.  You need to set a realistic weight goal for yourself and have realistic expectations.  Try to get to a stable comfortable weight and go from there.  ac

Angela Champion, MD
Newport Beach Plastic Surgeon

Bariatric surgery/tummy tuck

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I think that you should consider bariatric surgery because at 275 lbs your arms and thighs, your back are also in need of help. Once you loose the weight then you can talk about cosmetic surgery.

M. Vincent Makhlouf, MD, FACS
Chicago Plastic Surgeon

Breast Reduction and Tummy Tuck

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Your BMI is 40.6.  Anything over 30 is considered obese and yes has higher risk factors with surgery.  Certainly your best option is to lose weight first, then have plastic surgery on your breasts and abdomen.  I have seen many patients who have tried to lose weight or don't want to consider wight loss surgery.  If you fit in that category and are willing to take the added risks with surgery, then that is an option.  I have had several patients who couldn't or wouldn't lose weight before plastic surgery and went on to lose the weight afterwards.  It kind of jump started them.  Is it ideal? no.  The long term results will be better if you can lose the weight first, then have the plastic surgery, but we don't live in an ideal world.

Randy Proffitt, MD
Mobile Plastic Surgeon

Tummy tuck for obese patients

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Tummy tucks and breast reductions can certainly be performed for patients of your height and weight. It does concern me, however, that the surgeons you met apparently did not even mention the advisability of losing weight first, and the fact that your surgery will be easier with better results if you lose weight. There are certainly risks with these surgeries, and risks do increase with obesity, so you may want to consider having only one of these procedures at a time. I've often performed this combination at one surgical session, but your size may make it difficult to do both procedures in a reasonable and safe period of time. If you truly know that you can not or will not lose any significant amount of weight, the surgery can be done at your higher weight. I've removed large rolls of abdominal tissue from overweight patients who were then able to exercise more effectively and did subsequently lose weight. It would be best if you find a plastic surgeon whom you trust, and who seems to appreciate and understand your particular issues, then heed his or her advice. Without examining you, I can only provide general comments and opinions. Good luck!

Andres Taleisnik, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 42 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.