Can I have a tummy tuck? I'm 57, have sleep apnea, HBP, and Type 2 diabetes. (photos)

Thank you for your question. Looking at your photos it looks like you have something called Intra abdominal fat. This is fat down by the intestinal area which is causing the shape of the belly and is very common in diabetics. The only way to lose this type of fat is low carb diet and exercising. In regards to the other health issues as long as you are medically cleared and your surgeon feels comfortable moving forward it shouldn't be a problem. Considering your medical issues your surgeon may choose to have your procedure done in the hospital vs an ambulatory setting. I would suggest seeing a Board Certified Plastic Surgeon in person to evaluate you and discuss your options. Best of luck to you.

Thanks for the question.

In this regard, I recommend you a Tummy Tuck to get a flat abdomen and waist and back Liposculpture, getting better curves especially in the waist, improving your body contour.


Kind regards,
Dr. Emmanuel Mallol Cotes.-

Thank you very much for your question, in your case I recommend a liposculpture to define the body contour and a mini-tummy tuck to remove the excess skin, as I see the photo it is little skin, however it requires a full tummytuckLiposuctionThe surgical procedure of liposculpture,may or may not be associated with technology. Many times the characteristics of these lumps under the skin or retractions are secondary to a conventional fat extraction technique. We handle fat from the use of laser technology, which is light, or vaser, which is internal ultrasound associated with microair (PAL- Power ssisted liposuction) the first two devices allow us to vase or Laser produce lipolysis (is to pass the fat of a solid state to a liquid state so that there are no irregularities under the skin) and the microaire or the PAL allows us to make the extraction of the melted liquid without so much trauma.The problem in your case, is that not only has the sequelae of the lipo, but besides, I think you can have a little diastasis of the abdominal muscles secondary to pregnancy.It is important to be able to evaluate the case a little more to determine if only with a new lipolysis from the combination of technology can be improved. If it is only a lipolysis of the body contour, we will be able to improve the appearance by 50% towards 70% of the result you currently has; because fibrosis behaves as a scar inside the tissue and it is very difficult to be able to remove it completely. Associated with that if the skin is flaccid in order to give a little more reaffirmation, we complement it with a technology called Jplasma, the equipment is known as Renuvion, this produces plasma energy and this produces collagen retraction working inside the tissue The liposculpture that we practice is always associated with technology. What we use is Vaser, that is, internal ultrasound, laser, which is something from the light that is produced from the breakdown of fat, these two equipment fundamentally to produce lipolysis that is to pass fat from a solid-state to a liquid state This allows us to maintain that patients are not left with fibrosis or irregularities under the skin. As a complement always use microaire for the extraction of fat that is liquid, and in the final part if it is the case that the patient requires because it presents sagging skin in determinate areas, arms, back, abdomen, etc we use Jplasma, which is a specific equipment to produce
Removal of excess skin and fatAbdominoplasty is a surgical procedure whose purpose is to remove excess skin and fat from the middle and lower abdomen and to strengthen the muscles of the abdominal wall.With the tummy tuck you get a flatter and firmer abdomen and a narrower waist.It is especially suitable for women whose abdominal muscles have relaxed after one or several pregnancies and do not regain the tone they had before.It is indicated in women and men who are concerned about the accumulation of fat and excess skin in the abdominal area and that does not improve despite diet and physical exercise.In addition, in women and men who have moderate obesity and with the passage of time, the abdominal skin has lost elasticity and there has been a localized accumulation in the area that we know as the "belly"BeforeThe plastic surgeon will determine the best surgical option to improve your silhouette: sometimes, in limited accumulations below the navel, a mini-abdominoplasty procedure or liposuction may be sufficient, sometimes it may be necessary to associate a liposuction with the abdominoplasty. flanks or hips to harmonize your contour and achieve an aesthetically attractive silhouette.
DuringAbdominoplasty is performed under general anesthesia in the operating room. The duration depends on whether it is complete or just a mini tummy tuck, it can last from 2 to 4 hours.
AfterYou should wear a girdle for approximately three months. It may take weeks or a few months for you to feel like you were before and depending on your physical condition, you can return to work in 2 weeks or after a month.

If your blood pressure and diabetes are well controlled, and you reach a BMI of 34 or below through exercise and weight loss, you could have a TT. You may qualify for weight loss surgery if your BMI is over 35 and you have a serious weight-related health problem, such as high BP, severe sleep apnea, or type 2 diabetes. Consult with your PCP for guidance in finding a weight loss and exercise program that you can pursue.

Thank you for the detailed information. If your BMI is greater than 32, you are not deemed a safe surgical candidate. Diabetes will ensure that you have a harder time healing. Diabetes with a higher BMI puts you at even greater risk of not healing well. Currently, it also appears that you have excess visceral fat (fat around your stomach, colon, intestines) and excess SubQ fat.(fat under skin, the only fat that can be addressed with surgery/lipo) Visceral fat is cause for a protruded look, even after an abdominoplasty. I would advise a diffuse weight loss first. Once your BMI is lower than 32 and your Ha1c is lower than 7.0, you could safely consider abdominoplasty with a clearance from your Doctor/s.

Hi and thanks for your question. Based on your photos you are not good candidate for tummy tuck. Your weight is too high for this surgery and also you are DM patient and it can cause wound healing problem for you. There are two ways for you , one is losing weight with diet, second is gastric surgery. After lose weight you can get tummy tuck surgery.
Best of lucks.

Unfortunately, you have not told us your height and weight. However, it appears your BMI would be greater than 32, which puts you at a high risk for complications from surgery. I recommend you begin a low fat diet and core exercises such as sit-ups, planks and pilates. You may also need to see a bariatric physician for weight loss. Once you get your BMI at 30 then you can consider a tummy tuck. The technique I recommend is abdominoplasty with mesh reinforcement. The mesh creates a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight.

Best Wishes,

Gary Horndeski, M.D.

There are two points I want to make based on what I see in your photographs, a tummy tuck will remove some of the excess skin in the lower abdomen, but you look like you have a lot of intraabdominal fat that is causing a protrusion in the upper abdomen. Even with muscle tightening, this will not completely flatten. You will achieve your best results by losing some of this intraabdominal weight through diet and exercise before having a tummy tuck.
The second point is in response to whether or not you should pursue cosmetic surgery with your history of sleep apnea, diabetes and hypertension. the answer to this is yes with certain stipulations. One, preoperative weight loss will likely improve all three of these conditions and make your surgery safer. Diabetes and hypertension if well controlled, do not significantly increase your risks, but they do if you are not in good glucose or blood pressure control.
Two, because of your sleep apnea, I would require you to have your surgery in a hospital based OR with an anesthesiologist present in the facility. Third, most sleep apnea patients should spend at least one night in the hospital having their oxygen levels monitored to ensure that you don't have any respiratory problems due to your postoperative sedation and pain.

Dear judithqnd,
generally speaking, you want to reach your goal weight before you consider a tummy tuck, otherwise your results will be suboptimal if you continue to lose weight after the surgery.If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for sharing your question and photographs. If your are otherwise a good candidate for surgery and your medical conditions are optimized then yes you can have a tummy tuck. That said looking at your photographs I would pursue natural weight loss to improve your surgical results and minimize risks. Best wishes.