Was anyone told they were too fat for a Tummy Tuck?

First of all, congratulations on your 15 pound weight loss.  When it comes to the timing of a body contouring procedure, the best results are likely to be achieved when a patient is at or near their ideal body weight.  That being said, many patients find it difficult to achieve that weight yet can still obtain a significant improvement in their shape with surgery.  Weight changes after surgery (gain or loss) can result in changes in the overall result.  For example, if you have surgery at your current weight then lose 30 pounds thereafter, you may develop some looseness of the skin or contour irregularities.  Weight gain after surgery can obviously detract from the result as well.  I personally don't recommend fad dieting or other unsustainable measures to lose weight prior to surgery.If you are making progress with your weight loss, I'd recommend continuing to try to lose weight before having surgery.  If you're at a plateau despite your best effort to lose more weight, it is reasonable to proceed with body contouring at your current BMI as long as you have reasonable expectations regarding your result (better but not as good as it could be) and your risk of complications will be higher. My bottom line is that you should lose the weight you can lose with healthy eating and exercise, have your tummy tuck, and have a plan to maintain that weight after surgery.

I appreciate
your question.Congratulations on your weight loss!Best to be at a BMI less than 30 or within 10 pounds of your goal weight and stable at that weight for 6 months prior to surgery for optimal results.

The best way
to assess and give true advice would be an in-person exam.

Please see a
board-certified plastic surgeon that specializes in aesthetic and restorative
plastic surgery.

Best of luck!

Dr. Schwartz

Board
Certified Plastic Surgeon

Director-Beverly
Hills Breast and Body Institute

#RealSelf100Surgeon

Losing weight can be frustrating and difficult. I would suggest talking with a nutritionist or personal trainer if you are stuck trying to lose the weight on your own. But you absolutely can lose it. Tummy tuck surgery on patients that are notably over their ideal body weight is very often associated with complications and results that are less than ideal. You will always have best results with the fewest complications if you can lose the weight first. I know it is difficult, but I think that your consultation surgeons have given you good advice. 

Hello, Thank you for your question. A recent study has confirmed an increase in the occurrence of complications related to body contouring surgery in patients with a high Body Mass Index (BMI). The study appeared in the Aesthetic Surgery Journal (July/August 2008 issue), published by the American Society for Aesthetic Plastic Surgery (ASAPS).The Aesthetic Surgery Journal study consisted of a retrospective review of 129 patients who had undergone a single body contouring procedure in 1993 or 2002. In order to assess whether or not a relationship existed between obesity and body contouring complications, participants were placed into groups based on their BMI, a clinical formula for determining the degrees of weight.These groups consisted of patients considered to be at an ideal weight (BMI 18.5 to 24.9), overweight (BMI 25 to 29.9), obese (BMI 30 to 35), morbidly obese (BMI 36 to 40) and severely morbidly obese (BMI greater than 40). The researchers recorded their health complications into minor and major categories. Postoperative wound infection, seroma (pockets of fluid) and haematoma (blood around the wound) were placed in the minor category. The major category included any need for hospital readmission, prolonged hospital admission, any wound requiring dressing changes, required re-operations and death.The survey demonstrated interesting results. Three patients from the ideal BMI group reported either minor or major complications while both groups of complications were found in six of the overweight group, in 10 in the obese group, in eight patients from the morbidly obese group and in 22 of the severely morbidly obese group.These figures drew the researchers to conclude that there is a statistically significant association between increased BMI, an increased number of complications and poorer surgery outcomes. When rendered as a percentage, the study found that complications increased as the weight categories increased. While the ideal weight BMI group suffered from minor complications at a rate of 3.3%, the severely morbidly obese group reported 46.9%. Major complications were found in 6.6% of the ideal weight group and in 43.7% of the severely morbidly obese group.The Aesthetic Surgery Journal study is significant in that very few researchers have looked into the possibility of a link between increased BMI and health complications as the result of body contouring treatment. Its findings are especially important to note as body contouring procedures become increasingly popular.Senior study author, Dr. D. Mackay, a board certified plastic surgeon at Penn States’ College of Medicine, agreed with the significance of the study, stating that “the rising demand for body contouring procedures” makes it essential that plastic surgeons “be cognizant of potential predictors of poor outcomes and/or complications” that can arise from performing surgery on obese patients. He also described how obesity represents “a significant risk factor when considering operative procedures, particularly due to secondary conditions, such as hypertension, diabetes, sleep apnea, cardiovascular disease and poor healing” that are often found in obese patients.We take your safety and satisfaction very seriously. Before undergoing a body contouring procedure, ask yourself this: “Am I overweight?” It is highly recommended that you reach a normal and stable weight for your safety.All the best. 

Thank you for your question. A tummy tuck or abdminoplasty has the best results when you are close to your desired weight. You surgeon will be able to better predict what you final outcome will be is you are near your weight loss goal. As you mentioned, the procedure can help you lose additional weight after surgery by "kick starting" you. However if you lose additional weight you may have additional skin that you may want removed. Also, additional weight loss reduces complications such as delayed wound healing or infections, etc. Hope this helps and good luck.

Thank you for your question and photos. I believe it is best to be within 10 - 15 pounds of your ideal body weight prior to surgery for optimal results. Please consult with a board certified plastic surgeon who specializes in breast and body contouring for an in-person examination. Ask to see a lot of before and after pictures of their work to understand what can be achieved. Hope this helps and good luck.

I have found that performing tummy tucks for patients whose body mass indexes (BMI) are at or below 30 results in happier patients and better outcomes. I definitely understand your frustration and disappointment.  I know it is not easy to lose weight, but in the long run your results from the tummy tuck will be better.  By the way, it isn't easy to tell a patient who really desires a tummy tuck that it would be best to wait until he/she loses some weight, but it's the right thing to do.Additionally, I have found, and studies show, that complication rates also go down as a patient's weight is lower. Best of luck to you! Thanks for sharing.

There are studies showing that the risk of complications increases with weight, especially when the Body Mass Index (BMI) is greater than 30. Because a tummy tuck is elective surgery, there is no reason to take unnecessary risks. Your BMI is more than 32 so your surgeon is looking out for your safety in recommending more weight loss first.

Thank you for your question.If all factors were optimized, you would be most likely to get a great cosmetic result with longest lasting results if you were at a stable weight near your ideal weight. Your risks of having surgical or post-operative problems could also decrease.That being said, certainly not all patients are there at the time of surgery.Stability in weight will make your results last longer as weight loss after body contouring often leaves an appearance which is less desirable.But you need to assess your goals, your willingness to have additional procedures in the future, and your acceptance of doing a procedure with increased risks.At some point, as your risks increase based on any factors, qualified surgeons will draw the line and not offer you a procedure even if you are willing to take the risks.Sometimes we see patients and figure out that one of the primary goals is to get rid of the overhang on their lower abdomen in a limited operation called a panniculectomy. The cosmetic results of this surgery will be much, much less than a formal tummy tuck but in some cases, it can allow patients to increase their activity and motivate them for increased future weight loss. Following this, another procedure is usually necessary to optimize the cosmetic results. Are you willing to go through this?So the answer to your question is that in the best scenario, you would lose weight before the procedure and have a single procedure which would give you the best cosmetic results. Your goals, willingness to have another procedure in the future, and your thoughts on surgery with increased risks will have to be considered if you contemplate surgery before you reach your target weight.You should discuss your goals and thoughts with a qualified plastic surgeon who will help direct you.Good luck!

Hi There,we can add some medications to help you control the craving for sugars, and this will help a lot in weight loss. we have a lot of patients losing weight pre-op. for a safer surgery and recovery.best of luck,F. Mussat MD