I'm considered obese my BMI is at 40.9 liposuction or tummy tuck be safe for me? (photo)

Thank you for sharing your concern with us. I recommend you to lose weight before considerate get these procedures done. You must be a healthy person, within an appropriate BMI of below 30, for safety reasons, to be a good candidate for the procedures you want at the same time, your labs and cardiovascular preoperative evaluation must be optimal.
Respectfully,Dr. Emmanuel Mallol Cotes.

You need a formal evaluation by an expert in body shaping and contouring to determine what is best. You will likely need to lose weight first before undergoing any cosmetic procedure to get the best outcome. For best results, it is recommended to be at your ideal or stable weight before getting a sculpting liposuction procedure. Liposuction is not a weight loss procedure; rather, it is for sculpting, defining and removing problem areas that cannot be removed with weight loss, diet and exercise alone. If skin is very loose before surgery, then it will need to be removed: tummy tuck/abdominoplasty for lower abdominal skin; breast lift for excess breast skin; and/or a brachioplasty for loose arm skin. In the meantime, I recommend getting a formal evaluation with a bariatric doctor or dietitian. Best, Dr. Emer

With a BMI of 40.9 you are at a high risk for complications.  I recommend you try to lose as much weight as you can to get your BMI down to 30 before undergoing surgery.Best Wishes,Gary Horndeski, M.D.

Thanks for your question. We never want to do anything that might jeopardize our patient's health. Unfortunately, your BMI is too high at 40.9 making you ineligible for cosmetic surgery at this time. 
High BMI poses high surgical risk and reduces the likelihood you will receive optimal cosmetic results. It's best for you to reach a BMI closer to 30 before considering cosmetic surgery to help minimize risks and to maximize results. 
If you have been unable to reach your goal weight with diet and exercise we recommend you schedule a consultation with a Board Certified Bariatric Surgeon. 

Different surgeons will have different opinions and comfort levels with regard to performing lipo, or a  TT on a patient with a BMI of 40.9 so it is best to ask various board certified plastic surgeons about your goals through virtual or in-office consultations. The two main reasons for targeting a BMI close to 30 is to lower the risks of complications during and after surgery and to the increase the probability of attaining your ultimate goals in one surgery. 

Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon
Los Angeles, CA

With a BMI over 40 you are at greater risk for complications. To get the best results you should try to get your BMI closer to 30. Liposuction will only remove fat but will not tighten the skin, so when you are closer to your goal weight you should consider a tummy tuck which will also remove loose skin. be sure to consult with a board certified plastic surgeon. Good luck.

Hello dear!
Thanks for the question and provided information as well.
Unfortunately no, your BMI needs to be 33 or less, for you to be considered a good candidate for plastic surgery.
l recommend you to make an appointment with a board certified plastic surgeon to talk about your goals and the best options for you.
Good luck :)

Liposuction is not likely to give you the result you want and I would not reccommend it. A tummy tuck might be an option depending on what your goals are. If you have a lot of overhanging, heavy lower abdominal skin this can be removed with a tummy tuck. What the tummy tuck won't accomplish is making you look thin. Your upper abdomen would likely still be more full then you would like. To improve this will require a lifestyle change involving diet and exercise. Body contouring surgeries on patients with BMI's over 30 carry increased risks for complications such as DVT/PE and heling issues. Some Doctors will simply not operate on you if your BMI is that high and will instead encourage you to lose weight first. I don't disagree with this approach and often give patients the same advise but if your main concern is the heavy,hanging excess skin then I will consider a tummy tuck if I feel my patietns understand theincreased risks

Tasha, it is great that you are thinking about safety before jumping into a surgery. With your current BMI, there are considerations for both the safety of either surgery but also what can be accomplished and how satisfied you are likely to be with the results. You would be less likely to have complications from surgery and/or anesthesia at a lower BMI. After tummy tuck in particular you will certainly be more satisfied your hard-earned dollars got you at a lower BMI. No one's body is "perfect" but with BMI less than 35 (or better yet 30, but we have to stay realistic), the results of tummy tuck and liposuction are much  more ideal. I would recommend consulting with your primary doctor and/or a nutritionist to establish a healthy weight loss plan that you can stick with and have long-term success. And then, once you're on track schedule a consult with at least one Board Certified Plastic Surgeon in your area. Best wishes, and good luck in your journey!

my heading said choosing appropriate procedures but perhaps it should be appropriately choosing procedures.  I'm a big fan of high-volume liposuction in moderately overweight patients.  Of course I always encourage people to choose weight loss first.  My experience has been that heavyset patients with high volume liposuction give it some of the very best patient satisfaction scores.  These cases typically involve removing 4 to 8 L of fat.  When we remove more than 5 L of fat the procedure is split into two procedures that can be done relatively soon with a minimum of 48 hours apart.  1 L of fat is approximately 2 pounds.  This means removing 5 L of fat which is considered fairly substantial and high-volume by most providers standards is only taking 10 pounds.  Of course the 10 pounds are taken in the areas that are most beneficial for the aesthetic appearance etc.  Still, if someone away is 280 pounds that only brings them down to 270 pounds.  My experience has been that very heavy patients can lose 10 pounds in a couple of weeks with fairly modest changes in diet.  Can you justify having an invasive surgical procedure that costs between 5000 and $10,000 for something you could achieve on your own in a couple of weeks with not all that much effort?  Again, having the fat removed in the most desirable areas is better than simply losing 10 pounds.  That said, there is no health benefit to removing fat surgically.  There is significant health benefit with losing weight if someone is obese.  So, losing weight and removing fat are not the same.  My hand limit hovers around 220 pounds. The final decision has more to do with confounding factors and weight distribution.  If someone is 225 pounds but has a very distinct fat distribution that's highly undesirable and everything else makes them a perfect candidate that I may consider doing the procedure.  If someone is 195 pounds but has had a 100 pound weight loss, lots of loose skin, excess intra-abdominal fat then most likely I would not offer liposuction to this patient.  I am more liberal about offering liposuction to heavyweight patients than most plastic surgeons.  At least what they admit to when posting on real self.  A BMI of 30 or less seems to be a fairly typical number plastic surgeons post as being the high-end for being a candidate for liposuction.  The complication rates from liposuction are extremely small.  I would venture to say liposuction is one of the lowest complication rates of any surgical procedure.  It's not zero but close to it.  That's not to say it's completely safe.  People have certainly died from getting liposuction.  Whether that's from incompetence on behalf of the surgeon or simply a statistical chance complication is a different topic.  Obese people do you have slightly higher chances of certain complications but when it comes to liposuction it's really more about the inappropriateness. The simple fact that in order to obtain impressive results patients require so many rounds of liposuction that can be achieved safely with weight loss.  Taking my 280 pound patient as an example.  In order to lose 80 pounds someone would require an eight rounds of liposuction removing 5 L of fat during each procedure.  That still leaves the person weighing 200 pounds.  Liposuction simply doesn't make sense and becomes unethical on people that weight. Let me briefly touch on tummy tucks in patients with a high BMI. The biggest drawback to performing a tummy tuck on high BMI patient is the increase in complication rates.  In particular wound healing issues with wound separation and tissue necrosis.  In its worst case this could represent a large loss of skin with an open wound that may require several months to heal.  Not a small undertaking from the patient or surgeon.  There are other complications as well.  A tummy tuck primarily treats skin laxity and muscle separation from previous pregnancies.  The best candidates are thin, have lots of loose skin and muscle separation from previous pregnancies.  The ideal liposuction patient has tight skin, excess fat in undesirable areas, minimal muscle separation from previous pregnancies and minimal excess intra-abdominal fat.  Your best choice is weight loss. You probably didn't need us to tell you that.  I personally lost 50 pounds about 15 years ago.  I've had the opportunity to literally talk to thousands of people who struggle with obesity because of the work I do.  My practice is devoted exclusively to liposuction and fat transfer procedures.  The majority of patients who seek liposuction have some level of obesity.  There are of course people who are lean and healthy and just want a small amount of fat removed.  There are a multitude of recurring themes that I learned. I wrote up a short  summary of what I learned from talking to so many people as well as my own experience and how I was able to lose the weight successfully.  I'm happy to send you a copy of my summary if you contacted me  directly.  My contact is on real self.  I hope that was of some use for you. Best, Mats Hagstrom MD