Tummy tuck weight and drain questions

Thanks so much for your inquire,

Whether it's safe for you to undergo a tummy tuck with liposuction at 200 lbs depends on various factors, including your overall health, medical history, and specific anatomical considerations.

Your overall health and any pre-existing medical conditions will be assessed to determine if you're a suitable candidate for surgery. It's essential to disclose any medical conditions you have and any medications you're taking to your plastic surgeon.

t's essential to have realistic expectations about the outcome of surgery. While a tummy tuck with liposuction can improve the contour of your abdomen, it may not result in significant weight loss. It's not a substitute for weight loss through diet and exercise.

Also, the decision to use drains or not during a tummy tuck procedure depends on various factors, including the surgeon's preference, the extent of the surgery, and the individual patient's needs.

Sincerely,
Dr. Emmanuel Mallol

Thank you for the question. At 225 lbs, your BMI is 33.2. I recommend getting down to 32 for improved safety and a better tummy tuck result. I prefer a drainless TT for the improved recovery and the lower seroma rate. Many other surgeons insist on drains for every TT, but the scientific data really support the drainless option.

Dear BKNY718,
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. Also, some surgeons use drains others avoid them. Drains will help prevent seroma formation but they can be a bit uncomfortable. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Drains are patient dependent. Not all surgeons perform drainless tummy tucks. And not all patients are candidate for a drainless procedure. Achieve the best weight you can maintain to get the best and longest lasting results, then schedule a consultation. Eat well, exercise, talk to your primary doctor about options to assist with weight loss that might be appropriate for you.

Thank you for your question. Undergoing a tummy tuck and liposuction with a BMI of 31 can be safe, provided your weight is stable and you are in good health. It's important to discuss with your surgeon whether this is a suitable weight for you. Regarding drains, the choice between using them or not often depends on the surgeon's preference and the specifics of your procedure. Drains can help prevent fluid accumulation, but some modern techniques may allow for a drain-free recovery. Each method has its own pros and cons, so it's best to consult with your surgeon about what's most appropriate for your situation.

Hello BKNY718,

It's great to hear about your journey and your goals regarding a tummy tuck and liposuction. Getting down from 275 to 225 pounds is an impressive feat, and aiming for 200 pounds is a solid plan. I completely understand your thoughts about not reaching the 160 pounds suggested by one doctor. It’s crucial to be at a weight that feels right and sustainable for you.

When it comes to doing a tummy tuck at around 200 lbs, it’s very much about how stable your weight is and how healthy you are overall. The key is not just the number on the scale but ensuring that your health is in tip-top shape for the surgery. In my practice, I’ve seen many patients with similar weight loss stories, and as long as everything looks good in the preoperative work-up – like your overall health, any medical issues, and ensuring you're nutritionally ready for surgery – there shouldn't be a problem.

Regarding your question about drains, I typically recommend using them in tummy tuck and liposuction procedures. While I know there’s a trend towards drainless procedures, my concern is always about the risk of seromas and fluid buildup. If these occur, they often need to be removed with a needle, which can be more problematic and painful in the long run. Drains might seem a bit inconvenient at first, but they play a crucial role in helping with the healing process and avoiding these issues.

Remember, the most important thing is to have a good, thorough conversation with your surgeon. Talk about your weight goals, what you can expect from the surgery, and your concerns, including the use of drains. It's all about making sure you're comfortable and informed before moving forward.

I hope this helps, and I wish you the best on your journey!

Warm regards,

Dr. Katzen

Thank you for the question. You are a good candidate for the tummy tuck procedure bit its always advisable to achieve your target weight before surgery. The procedure will help with removing excess skin and liposuction with help with fat removal. The operation will not address any intra abdominal fat.

Normally i do not use drains and use quilting sutures to minimise the dead space and reduce the serum risk.

It's really simple. Assuming you're not obese, weight really doesn't matter. The only thing that matters is intra-abdominal fat. If there is too much, then muscle plication will be ineffective and the skin tightening part of the tummy tuck will also not be as great. Determining intra-abdominal fat is simple for your surgeon. As for drains, if you aren't having any significant liposuction in the region, then drains are completely unnecessary, and going drainless actually LOWERS your risk of fluid collections under the skin (seroma). Finally, find a doc who knows that the priority is long scar placement in a VERY low position, regardless of how much skin excess you have.

At 200 lbs your BMI is just under 30. Different surgeons have different opinions, but to me this would be a reasonable place to consider surgery especially considering that you are down from 275. Would lower BMI be better? Sure... However, a weight of 160 may not be realistic without a measure such as gastric bypass.
As to your question about drains, I offer no drain tummy tuck commonly but generally place drains if someone's BMI is at or above 27. This is due to the fact that the seroma (postop fluid collection) rate rises with BMI and is probably too high for no-drain tummy tuck when your BMI is 30. Hope this helps!

Hello,These are great questions. It is true that maintaining a stable weight at a "normal" BMI does minimize the risk for wound complications and of course demands less aggressive tissue/fat removal. However I routinely perform abdominoplasty on patients with "high" BMI with generally outstanding results (even with BMI as high as 50!). I think that 5'9" 200lbs is a very reasonable weight to safely undergo tummy tuck and liposuction. I would recommend that you seek out a surgeon who is experienced in operating on similar patients and would not "force" a surgeon into operating if he/she is not interested.
With regards to drains, I feel that they are essential in nearly any tummy tuck, although I admit my colleagues have demonstrated some excellent outcomes without using them. Particularly in larger patients, I think the the use of drains to prevent fluid collection under the tissue flap is extremely important and well worth the inconvenience to assure proper healing.
Best wishes,Alex Neusner MDLos Angeles, CA