Can abdominal surgery be done before you have lost all your weight? I am 5'2" at 225 lbs. Age 45.

I have always had a stomach that hangs. After having 2 kids and going up to 315 lbs, it is worse and causes sores and infections in the pubic area. It mentally and physically causes problems and would love help. Is it possible now? At current weight? I understand more surgey in the future is require, but right now, I would just like to not have my stomach in my lap. I believe I would have better overall health and weight loss success without this constant skin flap in my way.

Doctor Answers 10

Weight Loss Before Cosmetic Surgery

Hello,

Thank you for your question. Typically, Plastic Surgeons will want a patient's BMI to be less than 30 and stable in order to reduce health/safety risks in relation to surgery and to achieve the most optimal results. Each case and medical history should be considered individually though. I recommend that you meet with a board certified Plastic Surgeon and discuss your situation, your goals and options for you. Your plastic Surgeon will be able to plan with you to help get you where you need to be.

All the best

Weight Loss Before your surgery

CONGRATULATIONS!!

Yes, you can definitely have surgery before you have lost all of your weight.  The most important part is to be at a weight that you can maintain.  So, for example if you loose a lot of weight by extreme measures, have surgery and then gain some weight back - that will not look good!  On the other hand, if you don't loose alll the weight yet, have surgery and then lose weight, you will look great!

Good luck!

Tummy tuck

Congratulations on your weight loss. It is best for your BMI to be under 30. This will increase your aesthetic result and decrease surgical risks. 

Regards, 

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 426 reviews

Jumpstart to weight loss with abdominal contouring.

Hi Kelree, and congratulations on your decision to get healthy.

I totally understand how you feel, as I have devoted the past 17 years to assisting people just like you.

The answer is yes, however...

The first thing is to get an in depth medical evaluation, and likely, you would do well with dietary/nutritional consultation in collaboration with your doctor.

It may be that your first stop would be to visit with a bartiatric surgeon to get help with weight loss.  Statistically, it will be very difficult for you to attain and maintain a safe and healthy weight.  When the weight is down, many of the issues will resolve or improve on their own.  You will still need the skin/excess fat removed, however at this time, my concern is that you are at a very high risk.

First things first, and that is your safety.

All the best, and don't give up.

Se

Abdominal surgery

As you can tell from the responses, performing any excisional surgery under general anesthesia is prohibitive due to risk until you get your BMI < 30. But that does not help you with your current challenging situation. So your options are limited to bariatric surgery (since you are having difficulty losing the weight otherwise), or and easier option is liposuction. Liposuction of the abdomen (and waist)  can dramatically debulk and reduce the pannus to a manageable size and you would be surprised at how the skin will retract and hang much less. This can be done under conscious sedation and local avoiding general anesthetic and all the associated risks. Depending on how much needs to be done, you may have to stage the procedure with a one week interval. I would strongly urge you to look into this option as it at least gives you a save, effective alternative. I hope this helps, thanks for sharing.

Joel Patrick Maier, MD
Cincinnati Plastic Surgeon
5.0 out of 5 stars 29 reviews

Can abdominal surgery be done before you have lost all your weight? I am 5'2" at 225 lbs. Age 45

Most plastic surgeons suggest that you finish having children, get your weight within 10 pounds of your ideal weight, and have a BMI less than 30 before undergoing an abdominoplasty with repair of the stretched out abdominal muscles and liposuction of selective areas, in order to achieve the best long term cosmetic result with the least potential complications.

Keep in mind that following advice from a surgeon on this or any other website who proposes to tell you what to do based without examining you, physically feeling your tissue, assessing your desired outcome, taking a full medical history and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest that you find a surgeon certified by the American Board of American Plastic Surgery and one who is ideally a member of The American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, M.D., FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Weight loss and tummy tuck

In general, it's best to have your tummy tuck done when you are at your goal weight that you're comfortable with and have been there for a few months. I find that significant weight loss after tummy tuck usually improves the results rather than makes them worse. Having said that, if there is a very thick amount of fat between the muscle and the skin, then sometimes it makes sense to stage this operation by doing aggressive liposuction first. We then would wait several months to do the tummy tuck. Another option is to begin with what's called a panniculectomy, where just the hanging skin below the belly button is removed and no separation of the skin above the bellybutton is done. This would not preclude you from having a formal tummy tuck done after you lose more weight. I would recommend you see a board-certified plastic surgeon in your region experienced in body contouring. Good luck.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 44 reviews

Can abdominal surgery be done before you have lost all your weight? I am 5'2" at 225 lbs. Age 45

Thank you for your question, and congratulations on your weight loss.  The main thing we stress with patients requesting tummy tuck is that they are at a stable, comfortable weight for themselves and in good health.   If you plan to lose more weight, the surgery would not necessarily be advised at this time as your result would be diminished as you continue to lose weight, resulting in more loose or hanging skin.  I recommend seeing a board certified plastic surgery with extensive experience in abdominoplasty/panniculectomy following massive weight loss.  A plastic surgeon who specializes in post-bariatric weight loss should be able to advise you as to the benefits and risks of surgery at your current weight. Best of luck to you.

Steven L. Ringler, MD, FACS
Grand Rapids Plastic Surgeon
5.0 out of 5 stars 61 reviews

Tummy Tuck - Weight loss first?

Thank you for your question and photos. I believe it is best to be within 10 - 15 pounds of your ideal body weight prior to surgery for optimal results. Please consult with a board certified plastic surgeon who specializes in breast and 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.

Yes but much to consider…

Thank you for the question and 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.

Having said the above, occasional patients do benefit from panniculectomy surgery as a “jumpstart” to achieving their final goals. You may find the attached link, dedicated to patients who have experienced significant weight loss, helpful to you as you consider your options. Best wishes.

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.