Should and CAN I Have a Tummy Tuck or Lipo or Both? (photo)

I'm 28. I have had two c-sections and my tubes cartarized so no more kids for me. I'm 5'7 and 270lbs. My primary doctor and I have tried diets, pills, exercise at the hospital rehabilitation with doctors on site. Nothing has worked. I am maintaining between 257-266 lbs. She suggested going to a surgeon to remove the fat and then continue on the exercise routine we are doing along with the dieting and pills to get to my healthy weight.

Doctor Answers 9

In abdominoplasty is necessary to correct the consequences of pregnancy when they include excess skin and abdominal wall laxity.

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The picture demonstrates a sizable amount of redundant skin, a large amount of subcutaneous fat, and probably some abdominal wall laxity after pregnancy. Liposuction will flatten the abdomen somewhat which made the all the patient wants. If the desire is to return to a pre-pregnancy state a full abdominoplasty will be necessary.

Making the right choice when overweight

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The right choice for you is not any kind of plastic surgery but rather a surgical weight loss procedure like a lap band or gastric bypass.  Go to the best bariatric surgeon and be evaluated.  After losing all the excess weight, plastic surgery can then be done to remove the loose skin.

Should and CAN I Have a Tummy Tuck or Lipo or Both?

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Neither is a particularly good idea at this time. Patients with a BMI over 30 (yours is about 42) have much higher complication risks, and lesser amounts of improvement. You would have to lose down to 190 to reach the threshold of 30. 

There is a surgical alternative, and that is  one of the operations for weight loss. They are effective, and work directly on the problem. 

A tummy tuck would get rid of some excess skin and fat, but would not make a dent in the overall weight. Liposuction to the safety maximum would remove 5 liters of fluid--11 pounds, of which 8 or 9 will be fat, and if no change is diet and exercise, you might well equilibrate back to your starting weight. Ask your doc for a referral. All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Excess Fatty Tissue treated by Tummy Tuck

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Thank you for sharing your photos and your concerns.  I am sorry that your weight has not responded to medical management.    I do have concern about the recommendation of your primary care physician.

Tummy Tuck and liposuction are not weight reduction procedures, they simple contour the area.    Liposuction cannot safely remove all your abdominal fat, as much of the fat is within the abdominal wall and not superficial.

In patients who have not responded to medical weight loss, I recommend that they undergo evaluation by a surgical weight loss specialist, bariatric surgeon, prior to any plastic surgery.     If a procedure can be performed to reach an ideal weight, then the plastic surgery procedures will be much more effective and dramatic.  In addition, the procedure will be much safer for you with a much lower chance of complications.

I wish you a safe and healthy recovery.

Paul S. Gill, MD
Houston Plastic Surgeon
4.8 out of 5 stars 95 reviews

Should and CAN I Have a Tummy Tuck or Lipo or Both?

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Only could recommend IN HOSPITAL lipo to monitor you because you are over weight. Best to have intensive weight loss and exercise to lose 40 to 80 pounds before cosmetic surgery. In hospital surgery gets expensive. 

Should and CAN I Have a Tummy Tuck or Lipo or Both?

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    If weight loss with diet and exercise has not been effective, bariatric surgery may be the next alternative.  I am sure that you have had all endocrine function examined by now and that has been ruled out.  The problem with doing a tummy tuck now is that it will not achieve the contour that you want.  And, if you were to lose your weight in the future, the tummy tuck would have to be done again.  Kenneth Hughes, MD Los Angeles, CA

Tummy Tuck Candidate?

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I am sorry to hear about the “struggles” you have had with your weight. However, I do agree with the other respondents that no plastic surgical procedure is indicated at this time. Given your efforts already, bariatric surgery may be your best option. Certainly worth learning more about.

 Best wishes.

Weight loss first priority

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While you may be a candidate for abdominoplasty combined with liposuction in the future, for now it is most important to achieve a healthier weight.  If you have been unsuccessful despite a doctor supervised program, you may consider consultation with a bariatric surgeon specializing in weight loss surgery.  Once you have lost 50-80+ pounds you will be a much better candidate for cosmetic enhancement of your abdominal contour.

David J. Levens, MD
Coral Springs Plastic Surgeon
5.0 out of 5 stars 79 reviews

BMI over 40

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No cosmetic surgery is for you. You need to loose weight, either diet and exercise or with a gastric bypass. You are only fooling yourself if you think you can maintain that weight with eating no food.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 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.