Big guy tummy tuck, 48M, 5’11”, 250 lbs, down from 310, is it a good idea for me? (Photos)

Question

I'm 48M, 5’11”, 250 lbs., down from 310. It's been a process of weight training, cardio, nutrition (for 2.5 years) and Wegovy (the past year). I've been stable at 240-250 for about eight months, though I'm much stronger through training! Unfortunately, I have an overhang of skin and fat that's been stubborn, or gotten worse as my body has gotten leaner. Would a tummy tuck be a good/bad idea or should I keep trying to lose weight? I don't see weighing much less

Randal Haworth, MD, FACS · Answer

Congratulations on your weight loss journey! It's great to hear that you have made such progress and have been able to maintain a healthier weight for several months. A tummy tuck, also known as an abdominoplasty, is a cosmetic surgical procedure that removes excess skin and fat from the abdominal area and tightens the underlying muscles. It can be a good option for people who have achieved significant weight loss but still have excess skin and tissue that are not responsive to exercise and diet.

However, whether a tummy tuck is a good idea for you depends on various factors, such as your overall health, the amount of excess skin and fat you have, and your personal goals. Generally, a tummy tuck is recommended for people who have lost a substantial amount of weight, have stable weight for at least six months, and are in good health.

That being said, it's important to keep in mind that a tummy tuck is not a weight-loss surgery, and it should not be seen as a substitute for a healthy lifestyle. It is a cosmetic procedure that can improve the appearance of your abdomen, but it does not address issues such as excess fat in other areas of the body or improve overall health.

Before making a decision, it's best to consult with a qualified plastic surgeon who can evaluate your individual situation and discuss the potential risks and benefits of a tummy tuck. They may also be able to suggest other options, such as non-surgical body contouring treatments, that can address excess skin and fat without surgery.

Overall, it's commendable that you have made progress in your weight loss journey, and it's important to continue making healthy lifestyle choices to maintain your weight and improve your overall health.

J. Timothy Katzen, MD, FACS · Answer

Thank you for sharing your weight loss journey and concerns. Firstly, commendations on the remarkable achievement of shedding 60 pounds!
A BMI closer to 30 is preferred for optimal tummy tuck results, which translates to around 220 pounds for your height. Losing an additional 30 pounds would enhance surgical outcomes and lessen potential complications. Achieving this would not only your surgical results but also your overall health.
If further weight reduction proves challenging, considering your weight stability over the past months, you could still be a candidate for a tummy tuck. The procedure would involve an incision spanning hip to hip, plication (tightening) of the rectus abdominis muscles for a flatter profile, and removal of excess skin and fat to address the overhang.
Regardless of your decision, it's crucial to consult a board-certified plastic surgeon to assess your unique situation and guide you to the best decision.
Sincerely,
Dr. Katzen

Jeffrey M. Darrow, MD · Answer

If you have achieved a stable weight and you would not be able to bring your weight down further, proceeding with the resection of the skin would remove your overhang.  However, from your photographs, it appears that you have some residual intra-abdominal fat, which has not disappeared, and therefore your abdomen would not be flat. The intra-abdominal fat could be reduced with further weight loss which would improve your result.

Jose Perez-Gurri, MD, FACS · Answer

Congrats on your weight loss journey. I'm always amazed at weight loss patients and their steadfast goals. IMHO you could benefit from a tummy tuck with repair of the rectus diastasis (abdominal muscle separation). The procedure is done under general anesthesia administered by a physician certified by The American Board of Anesthesiology. Good luck, Doc PG

Moises Salama, MD · Answer

Thanks for your question. For a tummy tuck, at my practice, you need to be under a 33 BMI. Based on you height and weight, your BMI is 34.9 and are not eligible for surgery at this time. I would recommend meeting with your physician to develop a weight loss plan to be eligible for surgery. Hope this helps. Please always consult with a board certified plastic surgeon. Take care, Dr. Moises Salama, board certified plastic surgeon.

Lane Smith, MD · Answer

If you are still taking the wegovy and strength training and your weight isn’t changing, I’d say go for it. If you are still seeing a drop in weight, wait a little longer as you will have more loose skin. I have all of my patients stop taking wegovy the week before their procedures so their blood glucose can regulate and the body can return to its normal state. For your procedure I’d recommend an extended Abdominoplasty with vaser liposuction of the back, flanks, and abdomen. If you would like to be seen for a consultation to go over in more detail, feel free to reach out to my office. Smith Plastic Surgery 702-838-2455

Gary M. Horndeski, MD · Answer

Yes, you are a candidate for a tummy tuck with mesh reinforcement. The mesh will create a flatten abdomen by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Dallas Buchanan, MD · Answer

Thank you for your questions and congrats on your weight loss. In general it is less risk if patients undergoing cosmetic surgery have a BMI of less than 30. At your current weight, your BMI is just short of 35. It would be best if you could get down to a weight of around 215 pounds or less prior to surgery. Not only will this decrease your risk of complications for surgery and recovery, but it will also allow there to be more skin excess created to allow for more skin removal and a flatter abdominal contour after surgery from additional loss of intra-abdominal fat (which can only be treated with weight loss and not surgery). 
Hope this helps!
Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

Michele A. Shermak, MD · Answer

You are a likely candidate for tummy tuck after weight loss - this depends on your medical history and assessment by a plastic surgeon. This procedure would take care of the skin excess on the abdomen. The back , depending on exam, could even be treated with either liposuction or extended skin excision from front. My male patients do amazing with this procedure!
I would recommend you see a board certified plastic surgeon. You can find one at plasticsurgery.org.
Best of luck to you!

Sean T. Lille, MD · Answer

Dear MessofPotamia,  First of all, I'd like to congratulate you on your weight loss success. That is a considerable step towards health. I will not perform tummy tuck or body lift in my practice on patients whose  BMI is above 30. You still carry weight in your abdomen, which would make your tummy tuck result less than optimal at this point. I suggest you drop another 50 lbs. (and work on the visceral fat stores). Optimize your nutritional supplements along with your diet. Best wishes to you!!

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