I’m 5’4”, 189 lbs. If I want to lose more weight, should I wait to have surgery? (Photos)

Question

I have had 4 Children. I have STRUGGLED despite GLP’s, etc to lose weight but my body loves to stay around 200lbs. I have finally hit 185-189 and the lower part of my stomach is so embarrassing. I want to try and lose a few more lbs before surgery but I would love to get it done in November either way. What are your thoughts? I feel like I would love my stomach and size if it was flatter

Moises Salama, MD · Answer

Thanks for your question. I normally recommend that my patients be at or around their ideal weight when they have surgery for a tummy tuck. That said, for a tummy tuck you have to meet a certain BMI requirement. At my practice that BMI is under 33. With the height and weight you provided, you are at 32.4, which is right under. I suggest scheduling a consult for a proper evaluation. Always consult with a board certified plastic surgeon. Take care, Dr. Salama, board certified plastic surgeon.

Elisa Stein, MD · Answer

Nicolescardina,
Whenever we evaluate a patient for skin removal/tightening we recommend waiting until your weight has stabilized where you want it to be for 6 months. That ensures that after surgery weight changes don't affect the results you have worked hard to achieve. Weight loss after surgery can result in the return of some unwanted loose skin.
Dr Stein

Fouad V. Atalla, MD · Answer

When consulting with a board certified plastic surgeon it is important to clearly communicate your goals and expectations for the procedure. Be sure to mention if you are planning to become pregnant or are currently working toward weight loss, as these factors can affect your surgical outcome and timing.
Abdominoplasty is intended for individuals who are at their goal weight but struggle with loose abdominal skin or weakened muscles that have not improved with diet and exercise. It is not a substitute for weight loss, and the best results are achieved when you are at a stable, healthy weight.

Guray Yesiladali, MD, FEBOPRAS · Answer

It helps to look at both sides before making a decision.
On one hand, if you choose surgery before reaching your goal weight, you should know that recovery will limit exercise for several weeks. Swelling is also part of the normal healing process. If you still plan to lose more weight afterward, the results of the surgery may shift, and additional skin laxity could appear.
On the other hand, when you reach and maintain your target weight for a period of time, the body is in a more stable state. The surgeon can remove the skin excess more precisely, shape the abdomen more evenly, and the result is more likely to stay consistent in the long term.
Of course, the emotional aspect is very real. If the excess skin is causing daily frustration and you feel surgery would greatly improve your quality of life, it is reasonable to move forward. In those cases, later refinements such as non invasive skin tightening or small revisions can always be considered.
I have also shared a detailed video where I explain the process in detail and show different patient examples. This may help you better visualize what to expect in both scenarios.
&mdash; Güray Yesiladali, MD

Leila Kasrai, MD, FRCSC · Answer

Congratulations on your weight loss so far!

Losing weight after a tummy tuck can negatively impact results. For this reason, it would be better if you achieved an ideal, stable weight first before undergoing a tummy tuck.

Jeffrey M. Darrow, MD · Answer

Thank you for your photos. If you have given your best effort, with the aid of weight loss medications, and have not been able to decrease your weight any further, but are still bothered by the amount of excess skin and fat of your abdomen, it makes sense for you to proceed with surgery. My recommendation would be to have liposuction of your abdomen and flanks, at the same time as your abdominoplasty. This should help you decrease your weight at the same time as tightening your skin and improving your contour. Patients can be motivated to increase their exercise level once they have had their excess skin of the abdomen removed. For that reason, my recommendation would be to proceed with your surgery and maintain an excellent diet and exercise regiment postoperatively to maximize your results. Best wishes.

Harry T. Haramis, MD, FACS · Answer

Unfortunately, lower belly can be very stubborn even with weight loss. Some patients plateau.

In my experience, many patients benefit from tummy tuck to remove this area. Then can maintain results going forward.

Setting a surgery date to lose more weight prior as goal can be helpful.

An exam and consultation with a plastic surgeon is recommended to confirm this as well as discuss your options and expectations.

Tuan A Truong, MD, FACS · Answer

Thank you for your question. Congratulations on your weight loss journey and consideration of plastic surgery. Getting to your ideal body weight prior to surgery will optimize your results. That being said, if you are ready to proceed due to dissatisfaction with the appearance of your abdomen, surgery first can certainly be performed. It is common to include liposuction with tummy tuck, which will enhance the outcome. You may find yourself motivated to maintain your new look after surgery, and continued weight loss will contribute to overall results. There may be some revision in the future, however, if this is acceptable. Good luck on your journey!

Scott C. Lindsay, DO · Answer

Thank you for your question.
You should be at your goal weight prior to surgery, with a BMI no higher than 32. This will give you the best possible result. Schedule a consultation with a board certified plastic surgeon to discuss your options. Best wishes!

Kamol Pansritum, MD · Answer

Based on your history of multiple pregnancies and current concerns, I would recommend a full lipectomy (tummy tuck with abdominal muscle tightening) together with liposuction of the waist and lower back. After several pregnancies, it’s very common to develop diastasis recti (separation of the abdominal muscles), which makes the lower abdomen protrude even when your weight is stable. This cannot be corrected with diet or exercise alone &mdash; it needs to be surgically repaired. A full tummy tuck will remove the excess lower abdominal skin and tighten the rectus muscles, giving you a much flatter and more toned contour. Liposuction around the waist and back will further refine your figure and enhance the waistline.

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