My family doctor stated no tummy tucks. My skin is too sensitive and I will get bad keloids. Would lipo or lipo360 help? (Photo)

Question

I went from 262 to 240. My target weight is 200 then lipo. Doing it for back pain not to been seen in a bikini.

Kenneth Hughes, MD · Answer

To reduce the risks of complications during and after surgery and to enhance results, you need to continue your weight loss program to reach your target weight.
For keloid formers, there is not a way to prevent keloids.  In general, the longer the scar or the greater the number of scars, the greater the chance for keloids. 
The only way for sure to avoid keloids is to avoid making an incision. Though the likelihood for developing keloids is low, there is no way to predict their appearance after surgery.

Arian Mowlavi, MD, FACS (license on probation) · Answer

A healthy BMI is between 15 - 24, the maximum recommended being around 30. If you are above 30, then you are encouraged to lose weight before undergoing surgery. The higher the BMI the higher the chance of complications. That being said, the results of just liposuction will be limited and you have to consider the excess skin that will be left when the fat is removed. A Skype or FaceTime consultation with a board certified plastic surgeon will help you get an accurate recommendation for your procedure and for pricing. 
Respectfully, 
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

Mats Hagstrom, MD (license on probation) · Answer

Your family doctor may be correct but perhaps not for the right reason.
You’re not a candidate for any cosmetic surgery at your current weight despite your impressive weight loss.
Your weight needs to get much closer to normal or healthy before considering cosmetic surgery.
In reality that means close to 100 pound total weight loss.
Massive weight loss patients don’t need Liposuction and don’t do well with Liposuction.
Massive weight loss patients typically need skin surgery such as an extended or wraparound tummy tuck a.k.a. body lift.
To assess your potential scar formation we need to look at previous areas of skin injury, skin blemishes, previous scars from surgery or injury.
Keloid scar or hypertrophic scar formation is patient dependent and an atomic location dependent.
Someone may form very bad scars on the front of their chest and shoulders but he’ll reasonably well on other parts of the body.
If someone has had a keloid from a piercing on the back of their ear they may heal well from a tummy tuck.
We avoid blanket statements and instead do a thorough assessment during in person consultations.
For now your job is to stay healthy and continue slow gradual steady weight loss.
Consider finding support groups such as weight watchers or over eaters anonymous.
In reality you may never be a great Liposuction candidate.
High-volume Liposuction removes 5 L of aspirate which in reality it’s only about six or 8 pounds of fat.
In Florida this is restricted to 4 L.
Even if removed from the most problematic areas it’s still will leave you weigh 232 pounds at best.
It simply isn’t going to make enough difference at your current weight to justify having the procedure.
To get impressive results you would probably need three full sessions of Liposuction costing close to $20,000+.
If you don’t have control of your eating habits you will most likely regain weight after liposuction. many people do.
It’s simply not appropriate to do liposuction at your current weight.
A weight of 180 pounds may be approaching some thing where you can be assessed.
At that point you may realize that you have skin laxity and skin surgery is by far the better option.
You’ll get different opinions from different providers. Unless you are medically not fit to have a tummy tuck it’s not your primary care physicians decision if you have cosmetic surgery or not.
Do you recognize that your physician is looking out for your overall best interest in that plastic surgeons will be somewhat biased  because this is how we make our living.
Keep up the good work. Focus on continued weight loss for now.
Unfortunately there are no easy shortcuts.
If you absolutely hit the wall and cannot lose further away than weight loss surgery is probably more realistic than cosmetic surgery.
Having support and help of others who have gone through and are going through what you’re going through can really help.
Checkered support groups.
You don’t have to do this alone.
Best, 
Mats Hagstrom MD

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