Can I get a tummy tuck with a BMI of 42 (male)?

Question

Looking to get a tummy tuck but not familiar with what is needed to get it done. I see some are saying a bmi of 30, but isn't that the point is to be lower after surgery?

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding whether you can get a tummy tuck with a BMI of 42. Ideally, your BMI should be less than 30 for elective plastic surgery. However, some patients are unable to obtain this ideal number. Therefore, more and more plastic surgeons are finding that this ideal BMI is often unobtainable for their patients. If you are healthy and deemed medically stable by your internist, it is possible to undergo surgical procedures with a higher BMI. Though it would be ideal for your BMI to be lower, this may be unrealistic. However, I would counsel at least a good 6-8 months of conscientious eating, low carbs high protein, and eliminating sugar and alcohol. I would also suggest 30-40 minutes of exercise every day. With this regimen, I am certain you will lose some weight. If obtainable and you are still healthy, you are still able to have an abdominoplasty even with a high BMI. The goal of plastic surgery is not necessarily to reduce your BMI. The goal of the surgery is to get rid of excess skin and fat associated with weight loss. Another option to consider would be a surgical procedure to address weight loss. I would suggest a vertical gastric sleeve but it is important to consult with a professional weight loss general surgeon. Please seek an expert in your area. The vertical gastric sleeve usually yields excellent results. I hope this helps to answer your question about whether you can undergo a plastic surgery procedure like a tummy tuck or liposuction with a higher BMI.

Sincerely, Dr. Katzen.
(“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Sincerely, Dr. Katzen. 
(“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and ​member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Jeffrey M. Darrow, MD · Answer

A patients safety is top priority when undergoing any procedure. It is well documented in the plastic surgery literature that a BMI greater than 30 is associated with an increased complication rate and lower patient satisfaction with their results.  Therefore, plastic surgeons will require their patients to achieve a BMI of 30 or less before proceeding with surgery.  While some patients BMI may drop below 30 after surgery, it is the BMI before surgery which predicts the rate of complications and patient dissatisfaction.  There are many avenues available for patients to lose weight and all plastic surgeons should encourage their patients to take advantage of them to achieve their ideal BMI.

Moises Salama, MD · Answer

Thanks for your question. For a tummy tuck, at my practice, you need to be under a 33 BMI. Based on your BMI being 40, you are not eligible for surgery at this time. I would recommend meeting with your physician to develop a weight loss plan to be eligible for surgery. Hope this helps. Please always consult with a board certified plastic surgeon. Take care, Dr. Moises Salama, board certified plastic surgeon.

Matthew Schulman, MD · Answer

A tummy tuck is a shaping and contouring procedure. It is not a weight loss procedure. You should lose weight before having elective plastic surgery.  Most people lose very little weight after a tummy tuck because the skin removed does not weigh that much.

Lane Smith, MD · Answer

It is a hard spot to be in. You just want to fix your body but you have to do it safely. BMI over 30 is considered overweight. 42 is considered obese. Unfortunately with obesity comes accelerated & unnecessary risk from anesthesia, complications, delayed healing, etc. I recommend seeing a weight loss specialist. There are many options, pills, shots, gastric bypass, etc that can help you lose weight and change your lifestyle before having the excess skin removed. This would be a longer, but safer option to reach or possibly even exceed your goals. If you’d like to go over weight loss options and surgery options, feel free to reach out to my office. Smith Plastic Surgery 702-838-2455

Kenneth Hughes, MD · Answer

Knowing your BMI is one of the first steps in your strategy to feel better about your image and your health. To reduce possible complications during and after surgery, and to get the best results, you need to consult with your PCP to join weight reduction and exercise plan. Being obese (a BMI over 35) can lead to other health issues such as heart problems, diabetes, and high blood pressure.

Daniel Barrett, MD · Answer

Dear Scotevo,
based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

If you have some overhang and are in fairly good health except for obesity, then a full or mini tuck might be an option. If blood pressure is not controlled and you have a hemoglobin A1C over 7, then the invasive tummy tuck is not an option for you. You might also consider liposuction first to remove excess fat from the abdomen and flank areas. Once thinned, more excess skin can later be removed.

Felix Omar Márquez, MD · Answer

Hi, Thanks for your question. Sorry, the answer is No. It's not a good idea to go for Tummy Tuck if you have obesity. The procedure will not help you, and it would be a waste of time and money. I recommend going for a weight-loss procedure. After that, you can have excellent results to eliminate saggy skin with Tummy Tuck. Good luck!

Jonathan McCue, MD · Answer

The surgery gets a little risky with a BMI over 37 in terms of blood clot risk and wound complications, and the results aren't as good with BMI over 30. Think of a tummy tuck as a good operation for extra skin, not extra fat. With a BMI of 42 you're more of a safety risk so I would get you to a weight loss provider with a goal weight to shoot fore.