Why can't I get approved for a Tummy tuck? (photo)

I have been turned down for a tummy tuck because my BMI was above 30% and my upper abdomen protrudes. But they will not examine it to determine that it is not visceral fat. I have had 3 large children (9 1/2 lbs, 9 lbs, and 8 1/2 lbs) and my abdomen muscles are severely separated. I have exercised and changed my diet to lose lbs and lower BMI but the plastic surgeon still does not want to do my surgery. I have so much extra skin and fat hanging and want a flat stomach again! Please help!

Doctor Answers 14

You need an in-person exam

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You're right, you need to be examined.  What does your belly look like when you lay down? If it is flat, then a large portion of what you are seeing is a diastasis that can only be repaired with a tummy tuck.  BMI is just a guideline -- not a rule. Having said that, the closer you are to your ideal weight, the fewer complications you may experience after surgery.  If you shop around, you'll find someone to do your surgery -- just make sure they are qualified though.  Good luck!

Columbus Plastic Surgeon
5.0 out of 5 stars 17 reviews

Tummy Tuck

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Hello, thanks for your picture and for your inquiry. It is important for the patient to be closer to his  or her ideal weight prior any kind of elective surgery, it is safer and the results are the best that can be achieved. You might still consider to lose more weight before if you want to have a better result. I know that losing weight is so hard to do, but try to cut all carbs except in veggies, avoid gluten and fats. Make 5 to 6 small portion meals instead of 2 or 3. Workout 4 times a week and you will see the difference. 

Please make sure that you and your surgeon are on the same page. Don't forget to discuss all your concerns, options and expectations thoroughly. Have a safe and pleasant PS Journey!
Dr. Jaime Campos-Leon
Board Certified Plastic Surgeon

Jaime Campos Leon, MD
Mexico Plastic Surgeon
4.4 out of 5 stars 257 reviews

Why can't I get approved for a Tummy tuck?

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Without the opportunity to examine you we can only go by the single tiny photo of a side view. From that it seems you have a bulging upper abdomen and so not a good candidate for a TT until you lose that. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Refused for TT

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Hi hcastro

congratulations on your weight loss, good going!

There are increased risks of complications with BMI's above 30, and the risks tend to increase with the BMI.  You don't mention your exact BMI.  The BMI does not differentiate between viseral fat, and other fat.

A tummy tuck, I think will give you a great result, but this is an elective, cosmetic procedure, and as such, it is prudent to optimize the patient prior to surgery.  

I can't imagine that the doctor refused to tell you his reasons for the rejection, and what you may need to do to become an acceptable patient.  However, it would be wise to ask him to explain to you those reasons.  Another consultation with a board certified plastic surgeon might also be a good idea.

Best of luck to you .


BMI above 30 and a Rectus Diastasis

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It looks like you probably have both a large amount of visceral fat in addition to widely separated rectus muscles. To achieve the best result and to decrease your risks of complications during and after surgery, it would be best for you to get your BMI below 30.   However, this is easier said than done.   If you are able to, consult with a physician who specializes in weight loss.   Hopefully, you will be able to start on a healthy weight loss program and lose the weight.   Your tummy tuck results will be significantly better if you are first successful with your weight loss.

Best Wishes!

Please seek second opinion

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You picture shows severe diastasis recti and and I do not think your BMI is 30% based on the attched picture. You will need to have in person examination for better evaluation. Each surgeon knows their limitations and that does not mean that your are not a candidate. Please see the attched  link

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.8 out of 5 stars 154 reviews

Why can't I get approved for a Tummy tuck? (photo)

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      The recommended BMI is less than 30. This is the recommendation of the American society of plastic surgery. The reason simply, is increased chance of complications. These include but limited to, pulmonary embolus, deep venous thrombosis, delayed wound healing and increase infection rate.  Please put your front,back, side pictures. These pictures are easier to see if they are taking by someone else not close to the camera of the area you are interested only to give you a better answer. Many surgeons, including myself, offer online virtual consultations where you send us your photos and we can estimate the cost. I, like many surgeons, also offer free consultations so that you can be examined and given the most accurate quote possible. Please be mindful that the in person physical exam is the most important and could potentially alter your treatment plan.


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Thank you for your question an the photos. It is important to get close to a healthy weight before having surgery done. a high BMI means more risks during and after surgery and that we would like to avoid. Sometimes it is impossible to get below that 30BMI and it depends on the case in particular if he/she will accept you. Best of luck

Derby Sang Caputo, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 99 reviews

Tummy tucks in patients with a BMI over 30

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Patient's with higher BMI's have more complications after surgery. That could be one of the reasons that your PS may not want to go ahead with your surgery. If you have tried losing weight and feel you are stuck, maybe seeing a second PS to have a second opinion is a good idea. 

Good luck!

Ryan Hoffman, MD
Philadelphia Plastic Surgeon
4.9 out of 5 stars 45 reviews

Why can't I get approved for a Tummy tuck?

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Thank you for your question and for sharing your photograph.  I am sorry to hear of your difficulties in obtaining a tummy tuck procedure but commend you for taking the steps to get an approval.  As surgeons we know that the risk of complications and healing issues increase as a patient's BMI crosses over 30 and your surgeon is trying to avoid problems for your recovery.  That said they should be encouraging your weight loss and providing you with the reassurances of your candidacy for surgery once your weight has stabilized at a lower level.  If you are finding weight loss difficult you may want to consider investing in a nutritionalist or personal trainer for further support.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

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.