Should I consider lipo or a new diet and excerise? I am 23, 6'0", 307lbs (BMI42).

you can do "debulking" liposuction but you wil need weight loss. likely bariatric surgery and hormonal optimization (see link) to speed up your metabolism. I suggest consulting. Best, Dr. Emer.

Recommend consulting with your PCP to discuss a diet and exercise plan that would work for you. A BMI of 42 can increase the risks of complications during and after surgery and lead to less than optimal results from the aesthetic procedures.

I may recommend several things to you. First of all, as far as dieting, you need to begin a low fat diet. Second, in terms of exercise, I recommend you begin core exercises such as sit-ups, planks and pilates to increase your abdominal tone. I also recommend you see a weight loss physician board certified in bariatric surgery. You can also consider wearing an abdominal binder to help increase abdominal wall pressure resulting in early satiety and help maintain a reduced weight. After these, you can consider liposuction as a beginning point. In Texas, we can safely remove 10 lbs in one session of liposuction.

Best Wishes,

Gary Horndeski, M.D.