Can someone please help me or point me in the right direction?

I am 20 years of age. I am overweight and because of that I have high blood pressure. Also I have big breasts that is giving me back problems. I want to get a breast reduction, tummy tuck, and some liposuction. How to go by doing that in the safest way possible. I'm 320lbs.

Doctor Answers 10

The Ideal Weight to Undergo a Mommy Makeover

The Mommy Makeover is a combination of procedures to bring a woman’s body back to the way she looked prior to pregnancy. Most commonly some variation of a #TummyTuck and #BreastSurgery are performed. Additional procedures can include liposuction, umbilical hernia repair.  The most common #breastprocedures include #mastopexy or #breastlift, #breastaugmentation, or #breastreduction. 

In addition to one-on-one consultations with a board certified Plastic Surgeon, patients always need to be seen by their primary care doctor prior to such procedures.  We screen every patient and their medical records for risks of blood clots (DVT) and then take appropriate measures.  MWL (massive weight loss patients of  75 lbs or more) tend to have poor skin elasticity and will frequently need additional tightening even after 6 -12 months regardless of who or how their surgery is performed. This is simply the nature of such body tissues and the ability to heal with the lack or limited elasticity. It is also suggested to wait at least 6 months after pregnancy to undergo a Mommy Makeover.

Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews

Weight loss

Thank you for your question.  The first thing that is most important for you is to lose weight not only to undergo the procedure but also to live a healthier life in general.  In order to determine what you goal weight should be before undergo a procedure, you should be seen in person by a board certified plastic surgeon.  Together, you and him/her can put together a weight loss and surgical plan for the future.

All the best,

Dr. Results
Miami, FL

Jose M. Soler-Baillo, MD
Miami Plastic Surgeon
4.7 out of 5 stars 92 reviews

Safest plan for surgery


Thank you for your question. The safest way to proceed will be to get your weight down to a healthy level that you can maintain before considering surgery. Most Plastic Surgeons will recommend a BMI of 30 or less for your safety and also for optimal aesthetic results. I recommend you speak with your family doctor or dietician about a plan to get you to your goal before seeking a board certified Plastic Surgeon for consultation.

All the ebst!

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 179 reviews

Ideal body weight and cosmetic surgery

Hi! Thank you for your question. I can imagine it must be frustrating struggling with such health issues. While breast reduction will help with lower back pain it's ultimately most important that you are positioned for the safest most effective surgery possible. Being significantly overweight before a mommy makeover increases your surgical risks substantially. In addition your results will not be ideal. As you continue to lose weight your form will change and this can effect your outcome. I agree with the other surgeons that it's best to talk with your primary care physician about a weight loss strategy before getting cosmetic surgery. Once you have reduced your weight to a healthier BMI you will have a safer surgery with better results. Wishing you all the best! 

Carolina Restrepo, MD
Colombia Plastic Surgeon
5.0 out of 5 stars 18 reviews

Cosmetic surgery is not the answer for you.

At any age, 320 pounds weight does not make cosmetic surgery the "cure" for elevated blood pressure, large breasts, a protruding abdomen, or fat you want to liposuction. There is no "safe" way to perform elective surgery at this weight, unless it is bariatric surgery designed to produce the weight loss you have failed to achieve otherwise.

Let me be clear but frank. Losing weight is the "solution" to high blood pressure, large breasts, protruding abdomen, and excess fat. Even if you are 7 feet tall, you need to lose nearly 200 pounds to be at a "normal" weight, after which you will be a candidate for breast lift, circumferential beltlift (lower body lift), and perhaps other cosmetic surgeries to remove the stretched and loose skin that remains after you have solved the morbid obesity problem you have. Your hypertension will likely be reduced or eliminated along with the weight.

This is not only possible, but essential for your ongoing health, as your premature hypertension clearly shows. If you do not do this now, you will not only die young, but unhappy that you did not act as you should have at age 20. Please see your family physician first and ask about bariatric surgery referrals. Then you can decide if this is for you, or if renewed will power, diet, and exercise is truly an option for you (it works on about 3% of individuals, but those 3% are awesome). Click on the web reference link below for examples of what lower body lift surgery did for many of my patients (including case 3 who lost over 450 pounds by diet and exercise).

This is not intended to be unkind or uncaring--rather, quite the opposite. This is the ONLY way for you. God bless and best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

Pointing You in the Right Direction

I would recommend first visiting with your primary care physician to discuss your weight concerns and develop strategies to help you with weight loss in a safe effective manner.  Significant weight loss is a journey.  You should get this particular concern in order and then if it is even needed seek plastic surgery attention.

Combination surgery and obesity

Hi, sassykb85.  Thanks for your surgery.  Although breast reduction may help you to relieve back pain, shoulder pain, and neck pain, being overweight has higher risk for surgical and post-surgical complications.  In addition, if you lose weight after your breast reduction (and tummy tuck), your overall result will not look as good.  I advised my patients to lose weight first and to get down to their stable, goal weight prior to performing surgery.  If you cannot lose weight through diet and exercise, bariatric surgery may be an option.  Best regards.

Sugene Kim, MD, FACS
Houston Plastic Surgeon
4.7 out of 5 stars 76 reviews

Can someone please help me or point me in the right direction?

At 20 years of age and a weight of 320 lbs, you top priority should be to get your weight down first, before having your surgical procedures.  If you can get your BMI below 30, the risk of these procedures will be less and the results better.  Work with your primary physician on a diet and exercise program that you can live with for the long term.  Once your weight is down all of these procedures are possibilities.  Best wishes, Dr. Lepore.

Vincent D. Lepore, MD
San Jose Plastic Surgeon
4.8 out of 5 stars 56 reviews

Can someone please help me or point me in the right direction

Thank you for your question.  You are very young and you have all your life ahead of you and some lifestyle changes are needed to make sure that you are healthy in the future.  At this point I recommend seeking a weight loss center to see how they can help you .  They may also have surgical options for you.  Best of luck. 

Allen Gabriel, MD, FACS
Portland Plastic Surgeon
5.0 out of 5 stars 161 reviews

Can someone please help me or point me in the right direction?

Thank you for your question.  There is no substitute, nor better option, than pursuing a healthy diet and exercise regimen to lose weight, and many options are available to help you on this journey, including personal trainers and nutritionalists.  They can help you make the right decisions, and with dedication and hard work, you will be able to start losing weight, and more importantly, improve your health and quality of life.  Surgery is not an option for you at this time, but as you are young, you may never need any if you change your habits now.  Best of luck on your journey!

Nelson Castillo, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 68 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.