Are there certain exercise(s) I should do (cardio, weights, core, etc) or to avoid to not cause additional problems? (Photos)

Question

I'm 5'5 weighing approximately 277 so my BMI about 46. I want to lose weight before my tummy tuck so I can get good results in the tummy area. Is there certain exercise(s) I should do (cardio, weights, core, etc) or to avoid to not cause additional problems. I want to give the doctor something good to work with. I want to reach my goal by 1/2023

J. Jason Wendel, MD, FACS · Answer

Thank you for your question about exercising before tummy tuck procedure and for including photos. 
​
​It is best to be at a stable weight that you can realistically maintain after surgery.  If your weight changes significantly, then this makes the results unpredictable.

To be sure, see two or more experienced, board-certified Plastic Surgeons for a complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery.

I hope this helps.

Semih Yildiz, MD, FEPOBRAS · Answer

The photos show extra abdominal, flank, and back soft tissue, and at 5'5" and 277 lb your BMI is about 46. The most important step before a tummy tuck is not a specific abdominal exercise, but safe, sustained weight loss and medical optimization. A tummy tuck is usually safer and gives a better result when your weight is stable, nutrition is good, and the BMI is lower. Many surgeons prefer a BMI under about 30 to 35 for elective abdominoplasty, though exact limits vary by surgeon and by your overall health.

For exercise, a balanced program is best: low-impact cardio such as walking, cycling, swimming, or elliptical work; progressive strength training for the legs, back, arms, and core; and flexibility/mobility work. Core exercises are fine if they do not cause pain, bulging, or pressure, but they will not repair loose skin or significant muscle separation by themselves. Avoid crash dieting, extreme calorie restriction, and very aggressive sit-ups or heavy lifting if you notice a painful bulge, possible hernia, dizziness, chest pain, or shortness of breath. Because your BMI is in a higher-risk range, it would be wise to work with your primary doctor, a nutrition professional, or a medical weight-loss team before surgery. Once your weight has been stable for several months, a board-certified plastic surgeon can examine skin quality, muscle separation, hernias, and incision planning to decide when a tummy tuck is appropriate.

Daniel Barrett, MD · Answer

Dear nhamilton90,
every plastic surgeon has his own preoperative protocol which he recommends to his patients. I would suggest you to discuss this with your plastic surgeon.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Jose A. Munoz, MD · Answer

Hi and welcome to our forum!Any type of physical exercise is satisfactory preoperatively.BMI, or body mass index (weight in kg / square of height in meters) is an important criterion to determine the results of a cosmetic surgery. You can find BMI calculators on the internet. If your BMI is greater than 30, the cosmetic result will not be optimal. If your BMI is greater than 35, your operative risk will rise beyond what is felt safe for a cosmetic surgical procedure. In our practice we recommend a BMI of less than 30. We recommend that you be at a healthy comfortable stable body weight at the time of surgery. The cosmetic effect improves with lower BMIs. We recommend a regimen of diet and exercise to reach a safe and healthy body weight. If not achievable, one may consider a bariatric procedure such as a gastric sleeve to achieve dramatic weight loss. This procedure is now being performed on an out-patient basis! When at a safe and comfortable body weight, visit a board certified plastic surgeon. If considering a bariatric procedure, contact a bariatric surgeon for advice.Best wishes...

Alan Gonzalez, MD, FACS · Answer

Hello @nhamilton90, thank you for your question. It is very necessary to accustom the body through habits to maintain an exercise routine that allows weight loss such as cardiovascular exercise and accompany it with a healthy diet. This way you can achieve your goal of losing weight for surgery with optimal results and maintain it over time which is very critical. It is important that you have a consultation with a board certified specialist to determine a surgical plan according to your needs. Best wishes! Alan Gonzalez MD, FACS.

Lourdes Rodriguez, MD · Answer

Hello, thank you for your question and pictures.

After evaluating your case you seem to be a great candidate for a Tummy Tuck to remove the skin excess on the abdomen combined whit 360 liposusuction to reshape your body. The BMI neet to be under 33 for surgery. By combining these procedures we can achieve good results.

Make sure to approach to a certified surgeon to help your clear all your doubts.

Best wishes!

Connie Hiers, MD, FACS · Answer

Eating less and the proper foods and exercising can help you obtain your weight goal. Once you have reached your goal and have been stable for 6 months, then consider a tummy tuck.

Jessica Walker, MD · Answer

You should do whatever exercise regimen works for you to achieve your goals. For everyone this can be different. For some, cardio is all they need. For others, they will plateau with cardio and need to at weight training. No specific exercise will affect your surgical outcome, but it is very great of you to get a ump start on weight loss as this will optimize your surgical outcome and ultimately will be safer to undergo elective surgery.

Camille Cash, MD · Answer

Congratulations on dedicating yourself to your health!  Cardio and weight lifting exercises are great tools to help tone your body and burn fat.  Working with a trainer and dietician can be helpful in designing lifestyle changes that best fit you and your goals.  To optimize your surgical results it is best for you to have a BMI of 30 or under to minimize risk of complications and maximize results.  Best wishes!

Mats Hagstrom, MD (license on probation) · Answer

At one point I weighed 248 pounds.
I was able to lose almost 60 pounds and I have interviewed thousands of patients who struggle with weight loss.
These are some of the things I’ve concluded about obesity and weight loss.
A few thoughts on the weight loss .
While liposuction is generally not prescribed as a treatment for obesity most patients who get liposuction are somewhat overweight.
From having met thousands of people interested in liposuction I have had ample opportunity to talk to many people about their struggle with weight.
A few repeating patterns seemed to emerge.
Perhaps the most common one is people not eating frequently enough. Losing weight by not eating is a fallacy. In reality we tend to over eat when we eat after having gone hungry for long periods of time. This was my personal issue and when I addressed it by eating frequently I lost weight(60 lbs)
Another common misunderstanding is the relationship between weight and exercise. Most patients are not successful at losing weight by exercising without changes in diet. In my opinion weight is 90% diet and 10% exercise. Exercise has to do with fitness and good health and certainly can help with weight loss. Exercise also helps us feel better about ourselves and that's key in successful weight loss. 
Think of diet and exercise as two separate entities with two separate purposes. 
That said I encourage everyone to exercise on a regular basis. 
The majority of people get hungry from working out and tend to over eat afterwords. Sometimes feeling justified to do so after a strenuous workout. 
The number of calories burned during a typical workout session is far less than people believe.
Any successful weight reduction program has to be based on permanent change. Any temporary diet plan will ultimately fail if not followed by permanent changes in behavior. This one is fundamental. 
Understand the role that insulin plays in obesity and what causes insulin surges. If you read the late Dr. Atkins book(old school now called ketogenic diet) you will learn that his obsession was with controlling insulin much more so than with eliminating carbohydrates.
Learn what glycemic index and glycemic load's are. Avoid eating meals that give a high glycemic load. This is somewhat similar to saying avoid eating large carbohydrate based meals though understanding what foods constitute as bad carbohydrate meals is critical. This will be learned after mastering the concepts of glycemic index and glycemic load.
Here are my rules to keep weight under control. 
1. Never go hungry
2. Never eat a large meal. 
3.  Never, never, never eat a large meal when your hungry.
4. Avoid large carbohydrate based meals with a high glycemic index.
5. Don’t expect exercise to get your weight down. Don't blame the lack of exercise or the inability to exercise for not being able to maintain a healthy weight.
6. Step on the scale every day after you get out of the shower in the morning.
7. Accept weight fluctuations. None of us stay at the same weight or continue to go down in weight.   Don't beat yourself up if you gained a few pounds. It's the long term, rest of your life, progress that matters.
I hope that is of some help.
Good luck,
Mats Hagstrom, MD

Are there certain exercise(s) I should do (cardio, weights, core, etc) or to avoid to not cause additional problems? (Photos)

Answers (11)

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