Which Surgery Will I Benefit from Most? Liposuction or Gastric Sleeve (photo)

I am 5'3" 185lbs size 14. I have been doing a lot of research and I am still confused as to which surgery I should do. Initially, I was thinking Liposuction with a tummy tuck and breast implants but I want to get back to fitting into my size 8 jeans. Is this possible with the lipo? Or should I have Gastric Sleeve then do the rest at a later time?

Doctor Answers 4

BMI 32 Bariatric surgery or plastic surgery?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Having a very diverse surgical back ground I can answer this question for you from two very different perspectives that can aid your decision making process.  From a bariatric surgeon's perspective the answer is clear.  You only qualify for gastric banding because your BMI is below 35.  Unfortunately, at that BMI insurance will not cover the expenses associated with your surgery.  Gastric banding performed at a reputable surgical center will cost 12-16K.  That is often equivalent to the cost of a tummy tuck and 2-3 area liposuction. 

When we evaluate a patient that approaches your level of obesity the first question I will need to ask is what is your goal?  Is it primary weight loss or is it achieving a certain shape. You mentioned that you wanted to be a size 8.  At 5'3 you will most likely need to lose around 30-40 lbs and keep it off.  Liposuction will allow you to remove the fat cells from one localized area.  It will not provide you with longterm weight control.  Currently, bariatric surgery is a one of the few proven methods of longterm sustainable weight loss.  Tummy tuck and liposuction are body contouring procedures that although they help with weight loss, they are not sustainable treatment options.

As a cosmetic surgeon I will need to know whether you are concerned about your abdominal wall shape, stretch marks, and skin laxity.  If that is a major concern to you then you have to think about a major dietary and life style change and use the tummy tuck and liposuction as a motivational tool to achieve your goals.  Generally speaking, tummy tuck and liposuction will not result in substantial weight loss.  Based on your pictures you will benefit from Liposuction of at least 3 areas in addition to a tummy tuck.   The total weight loss form that will range between 10-15 lbs.  But combining these cosmetic procedures with a solid life style modification plan can result in achieving your goals of losing up to 30-40 Ibs without change in your internal organs.

As physicians we tend to gravitate towards what we know best and that is often closely aligned with our specialty.  Unfortunately, the disease of obesity does not recognize specialty boundaries and the treatment often requires a multidisciplinary approach.    You need to understand that obesity is a chronic disease that can be controlled by  a longterm plan of lifestyle modification in both eating habits and physical activity.  Most surgical treatments can provide a tool to help you get better control of your lifestyle. 

Liposuction versus weight loss surgery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

First and foremost, liposuction or for that matter, tummy tuck is not a weight loss surgery procedure; rather, they are body contouring procedures and you may loss a small amount of weight. Based on your height and weight, your BMI is about 32. In order to qualify for bariatric surgery, your BMI has to be 35 or higher. FDA approved Lap Band for those with BMI of 30 or higher.

So here are your best options:

1. Loss as much weight as you can by a sensible diet and exercise program. Only then you can proceed with liposuction, tummy tuck or breast augmentation.

2. If unable to loss weight, you can consider a Lap Band procedure to loss about 40-50 lbs prior undergoing any plastic surgery procedure.

Buttom line: excess weight and obesity will reduce your life span and will increase likelihood of having complications down the road 

Monali Misra, MD, FACS
Beverly Hills Bariatric Surgeon

Should I just get liposuction or do bariatric surgery?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
It really depends on if you are comfortable with being the weight you are or if you want to be quite a bit smaller, weight wise. Unfortunately, when you do lose weight with gastric bypass, you tend to have excess skin that you may want removed. With liposuction, excess skin is usually minimal but you cannot remove as much as you would lose with gastric bypass.

Edward J. Domanskis, MD
Newport Beach Plastic Surgeon
4.5 out of 5 stars 28 reviews

Better choose bariatric first

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
is challenging cases like yours where limits was to opt in bariatric surgery and plastic surgery is possible that the desired results have not. as a BMI of you outside the United States and Latin America and my country Dominican Republic gastric sleeve or gastric plication could take place would be wonderful and then after a year or improve your figure shape through plastic surgery, or tummy liposucccion tuck. I think your first step is to lose weight and then plastic surgery.

Pablo Garcia, MD
Dominican Republic Bariatric Surgeon
5.0 out of 5 stars 116 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.