How do I know if I need a full tummy tuck or just skin removal and how close to my weight loss goal should I be? (Photo)

Hello I am currently 239lbs and I started losing weight at 287lbs at the end of April. I am hoping to flatten my stomach and I don't know if I will be able to do it with just diet and exercise. I think my insurance will cover the skin removal but not the muscle repair. I'm nervous I won't be happy with just the skin removal. How do I know if I need the muscle repair or not?

Doctor Answers 9

Full Tummy Tuck for Maximum Effect

Thank you for the question and photos! It is rather difficult to fully assess your situation without an in-person examination. However, based on the information you provide, I can say with confidence that the most tangible results are attained with a full tummy tuck. It is true that liposuction can also remove fat, but it can't effectively fix hanging excess skin, which often persists after weight loss or childbirth. In fact, many of my patients find that combining liposuction with a tummy tuck can go a long way in helping you attain an amazing flat stomach. 
If laxity and excess skin is concentrated below your navel, a mini tummy tuck may be right for you. If you wish to correct excessive skin, muscle separation, and bulging of the upper abdomen, then a full tummy tuck may be your only solution. It is always best to visit a board-certified plastic surgeon and have a full evaluation for your concern. Best of luck! Dr. Michael Omidi.

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 57 reviews

Full tummy tuck or just skin removal.

Congratulations on your weight loss. Skin removal after weight loss refers to lower abdominoplasty also called panniculectomy. Best results however are usually seen with a full tummy tuck which will address the upper abdomen as well. Insurance might cover the panniculectomy, though in our experience coverage for full tummy tuck is doubtful.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.1 out of 5 stars 39 reviews

Tummy Tuck

  • CCongratulations on your weight loss! It is likely you will need a tummy tuck to remove loose and sagging skin Congratulations on your weight loss!  You should be at or near your goal weight before having surgery. It is likely you will need a full tummy tuck to remove excess skin and repair the muscle. Muscle repair is part of a full tummy tuck so you should not have to worry about that issue. I would advise you check with your insurance company to determine if you have any benefits. Even the removal of loose skin is considered a cosmetic procedure and not usually covered by insurance.

Janet Turkle, MD
Indianapolis Plastic Surgeon
4.8 out of 5 stars 50 reviews

Good candidate for a tummy tuck after weight loss

Thank you for your question and photographs and congratulations on your weight loss. You have gone a long way to improve your health and I'm sure that you are already feeling better than you did at your highest weight.  I would encourage you to keep going with what you are doing because it is working.  As far as what your weight should be at the time of surgery, that depends on how tall you are.  I would calculate your BMI and figure out the weight that puts your BMI at least below 30 and the closer you can get to 25 the better.  Don't be in a hurry; slow and steady is best with losing weight.  Having a lower BMI will significantly reduce your risks for surgery and you will get more skin removed as well as have a better final result.  Be sure to see an experienced board certified plastic surgeon. 

James McMahan, MD
Columbus Plastic Surgeon
4.8 out of 5 stars 35 reviews

What a tummy tuck will do for you

A tummy tuck is a great surgery for removing extra skin.  The perfect candidate is someone that only has extra skin and no fat.  That is not usually the case in the real world so I also thin the fat layer to give patients a more sculpted shape.  The muscle repair is something that adds only a little bit of time, and is required in most women that have previously been pregnant.  I imagine that most surgeons perform this routinely.  I have heard of surgeons that add a fee for it.  Personally I think that creating a perfect result is the goal every time.  I would hate to have patients not get that to save a little so I don't change a different fee. But check with your own surgeon.
The two keys to a beautiful result in a tummy tuck are a low hidden scar and a beautiful belly button.  Unfortunately both these are not considered by lots of surgeons and a high scar or an unnatural, ugly belly button is the give away of surgery.  Make sure to see belly buttons that your surgeon has created as this is the difference between ok/good results and an amazing result!
Dr Rodger Shortt is a plastic surgeon striving to provide the best possible plastic surgery results for patients in Toronto, Oakville, Mississauga, Hamilton, Burlington, Milton, Georgetown and the rest of the GTA.

Rodger Shortt, FRCSC
Toronto Plastic Surgeon
5.0 out of 5 stars 49 reviews

How do I know if I need a full tummy tuck or just skin removal and how close to my weight loss goal should I be?

Thank you for the question and pictures. Congratulations on your weight loss thus far.  Generally speaking, it is always best to achieve long-term stable weight prior to proceeding with  body contouring surgery. Doing so, will increase the safety of the operation, will likely improve the outcome of the operation, and will decrease chances that additional surgery will become necessary subsequently. In my practice, I do not ask specific patients to achieve a specific weight prior to proceeding with tummy tuck surgery. I simply ask patients to achieve a long-term stable weight where he/she feels comfortable and does not expect significant fluctuation postoperatively.  As you know, recruiting other professionals such as personal trainers, nutritionists, physicians who specialize in weight loss concerns etc. may be helpful to you.

Generally speaking, the vast majority of patients who present for tummy tuck surgery benefit from muscle plication; as you know, this part of the tummy tuck procedure serves to re-approximate the muscles that have spread during pregnancy or weight gain/loss. Omitting this part of the procedure will potentially leave patients with continued abdominal wall laxity and, in my opinion, a less than optimal result.   Seek consultations with well experienced board certified plastic surgeons who can demonstrate significant experience helping patients achieve the types of outcomes you would be pleased with.
I hope this, and the attached link (dedicated to tummy tuck surgery concerns), helps.  Best wishes.

Panniculectomy vs tummy tuck

Congratulations on your weight loss and thanks for sharing your question. I can appreciate your concern.

further Weight loss will be needed  for optimal outcomes. insurance will cover the removal of skin below the umbilicus. this will not address excess skin to the upper abdomen. The tummy tuck will address not only the skin above the belly button but will tighten the muscles. 
Finally, make sure that you have a consultation with a board certified plastic surgeon.

Wishing you the best in your journey

Healthy BMI

If you can get your weight as low as possible the risks of healing from a tummy tuck will go down significantly. You would need to be down to a healthy weight and BMI before having a cosmetic procedure to insure a safe outcome. Also, being at a stable weight is key to ensure you don't gain weight back after surgery. Good luck! 

Dean Vistnes.
Vistnes Plastic Surgery
San Fancisco Bay Area

#realself #drdeanvistnes #mommymakeover #tummytuck

M. Dean Vistnes, MD
Bay Area Plastic Surgeon
5.0 out of 5 stars 40 reviews

Tummy Tuck - Am I A Candidate? Weight Loss First?

Thank you for your question and photos. I believe it is best to be within 15 pounds of your ideal body weight prior to surgery for optimal results. If this is not possible, your BMI should be below 30 to minimize your risk of complications. Please consult with a board certified plastic surgeon who specializes in 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.

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.