41yr old female, 5'5", 255lbs. Should I get work done? Considering tummy tuck, arm lift, liposuction, breast lift (photo)

Hi I would like to know if I should get work done I was heavy all my life never had a flat stomach and would love to have also my pubic area always was fat want to get a few things done to fix my body I have 1 child had a c section. 

Doctor Answers 9

Should I get work done?

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Hello Dear, thank you so much for your questions and pictures.

The first thing that I need to take into account for the preparation of any type of surgery is that your BMI is high, that means that the relationship between your height and weight make it prone to post operative complications.

I would recommend that  you  have to lost approximately 60 to 70 pounds, this must be do it   in addition of a medical nutritionist to do it the right way. According with your photos you would be an excellent candidate for Tummy Tuck and liposuction, this would eliminate excess skin from your body and engaged a figure more defined.

Hope to hear from you soon, best wishes!!

Dominican Republic Plastic Surgeon

Safety first

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Hello thanks for your questions. Weight loss is first recommended for you to have a safe and satisfactory outcome.  Consider a nutritionist and exercise physiologist. If needed you may wish to consider weight loss surgery prior to plastic surgery. 

Good luck


Surgery candidate?

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Ideally, you should lose weight prior to surgery. Your BMI is high and that raises the risk of complications.  However, I can well understand why you would want surgery, particularly the tummy tuck.  I would not advise combined procedures given the risk level but believe that an abdominoplasty would greatly improve your appearance and self image. See an experienced, board certified plastic surgeon to discuss and also raise the question of medical clearance with your internist.  Best wishes. 

Candidate for Tummy Tuck and Procedures

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Women and men who have excess skin and/or fat around the abdomen which does not respond to diet and exercise are candidates for abdominoplasty. Many patients complain that they cannot flatten their abdominal muscles through exercise, which also means a tummy tuck may be right for them. Abdominoplasty candidates have:

·         excess abdominal skin which may sag

·         a disproportionate or protruding abdomen

·         weakened or separated abdominal muscles

·         excess fat concentrated in the abdomen

Other tummy tuck patients may recently have lost a lot of weight and need to have excess skin and tissue removed. Many women choose to have an abdominoplasty following pregnancy. Older patients may be candidates for a tummy tuck due to reduced skin elasticity.

Additional procedures that may enhance the result are Liposuction, Breast Procedures, or Thigh Lift. Mommy makeovers usually include multiple operations.  Brazilian “butt enhancement” can be done at the same time to provide best body contours. Arm reduction or brachiaplasty is also common.

It is always a good idea to try and reach your goal weight before surgery so that all loose skin can be tightened and no additional skin will loosen later. Consult with a local board certified plastic surgeon to determine the best options. Good Luck!

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Getting work done

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Thank you for your question. In order to proceed safely, you need to bring your weight down a bit. Nutrition is key in helping you lose weight. Once you have lost 35-50 lb I think you would be a great candidate for a excess skin removal procedure, breast lift,  abdominoplasty and lipo to help contour your shape. Best of luck to you.

Surgery and BMI

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Your BMI is quite high, and I think you might be better off losing weight first before moving forward.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Weight loss first!

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Thank you for your questions and photos.  I agree with the other consultants and strongly encourage you to lose a significant amount of weight before pursuing skin reduction surgery.   If weight loss proves too hard or impossible then perhaps bariatric surgery is a good first step.

Body contouring is safest and most effective when people are optimally prepared for it

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While I certainly understand your concerns and your goals to have a flat tummy and reduced fullness in the pubic area, I personally don't think you are the best candidate for body contouring surgery right now.  Whille I am sure that if you look hard enough, you will find a surgeon who will do that for you, and maybe even everything that you have listed here in one sitting, I advise against it for many reasons.  First, the risks are very high.  At 5'5" tall and 255 lbs., your Body Mass Index - a standard measure of body fat - is roughly 42.  Optimally we would like to see our patients in the range of 30 before we consider body contouring surgery.  That would mean you should be in the range of 200 - 210 lbs at the most before such surgery.  Risks such as infections, wound breakdown, seromas and fluid collections under the skin, blood clots in the legs that break off and travel to the lungs, and contour problems are all things commonly seen when surgery is performed on people who are still too overweight.  In addition to this, much of the fat content that you still have on your body is INSIDE your tummy, around your organs, and not outside where it can be accessed with surgery.  Thus, you will still have a full, round tummy even after tummy tuck surgery, and there will be significant risk that the repair of the muscles would weaken and breakdown under the tension, and you would not have any improvement to the shape.  As I alluded to above, you will more than likely need more than one stage to accomplish everything you want on your list, and to try to force everything into a single surgical procedure is very risky.  You will also want to get very close to your goal weight and stabilize there before surgery, because doing surgery prematurely on someone who is still in the process of losing weight is like shooting at a moving target.  There is no good way to predict the outcome, once the final weight loss is accomplished, and you probably would find that you have undershot the mark and need to go back to remove additional excess skin after the further weight loss.

These are never easy conversations to have with people, especially when they are excited and motivated to make a change in their bodies.  However, it is probably one of the most important things that a responsible surgeon can do.  We have to think of our patients' safety and satisfaction with surgical outcomes first, above everything, and if we believe that a person is not in optimal condition for surgery, we must tell them.  Thus, while I think you will probably be an excellent candidate for the surgery at some point, my best advice to you right now is to work on losing a bit more weight.  I suggest finding a trainer and a nutritional advisor who can help you with a good solid exercise and dietary regimen that will be sustainable for the long term, not one that will be so intense that it will kill you in the short term.  Then commit yourself to a steady, sensible, gradual weight loss that you can maintain, and when the time comes, see a board certified surgeon who has lots of experience with body contouring surgery after weight loss.  I personally like to meet people like you earlier rathter than later, because even though we might not be ready to operate next week, we can meet regularly, get to know each other, discuss your goals, monitor your progress, and ultimately do the surgery that is the icing on the cake.  The results are so much more satisfying for both of us that way, and my patients that do this are usually very comfortable going into surgery once the day arrives.  In addition to being certified by the American Board of Plastic Surgery, your surgeon should also voluntarily participate in the Maintenance of Certification program administered by that board. This is the best way to know that your surgeon not only has the best training and experience for the procedure, but that he or she has maintained currency in the certification requirements as opposed to practicing on a "lifetime" certificate which has only been reviewed once at the beginning of his or her career. For more information on this you can visit ABplsurg.org, ABMS.org, and certificationmatters.org .   Good luck.

Joseph L. Grzeskiewicz, MD
San Diego Plastic Surgeon

Tummy Tuck/Abdominoplasty/Liposuction/Vaser High Definition Procedures/Tummy Tuck Revision

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I appreciate your question.

For health and safety reasons, best to be at a BMI less than 30 or within 10 pounds of your goal weight and stable at that weight for 6 months prior to surgery for optimal results.

The best way to assess and give true advice would be an in-person exam.

Please see a board-certified plastic surgeon that specializes in aesthetic and restorative plastic surgery.

Best of luck!

Dr. Schwartz

Board Certified Plastic Surgeon



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