Lipo 360 and Tummy Tuck. Is a BMI of 40 a strict cut off for these procedures?

Question

I am interested in getting a tummy tuck and 360 lipo as well as a breast reduction. I know most doctors have a cut off BMI of 40 but is this a strict cut off? I carry most of my weight in my abdomen with so much loose skin after weight loss and having a c-section. But I also weight lift and the BMI number seems like it can be thrown off by factors such as that. I have a consultation in January so hoping to lose a little more weight prior to that. Current BMI is 42. Height 5’3. 240 lbs.

Alan Gonzalez, MD, FACS · Answer

Hello @kmeadows8 and thank you for your question. The weight limit is only a measure to analyze how risky the surgery can be, in terms of complications that the patient could have. However, being at a BMI of 40 already puts you at high risk for a tummy tuck and liposuction. I suggest that you lose weight with a healthy diet low in fat and sugars and thus not only prepare for your surgery, but also start to create awareness to take care of your body when you're ready for your surgery.

Ryan E. Austin, MD · Answer

Hi, thanks for your question. Typically, we recommend that your BMI be under 35 in order to safely undergo surgery. That being said, if you have already lost anywhere from 50-100lbs or more, you may be exempt from having a BMI of less than 35, but this will be largely dependent on a number of factors and on your surgeon's pre-operative guidelines.

Gary M. Horndeski, MD · Answer

Your current BMI of 42 puts you at high risk for complications from surgery. The only operation that could be done safely would be liposuction since there are minimal incisions and wound healing is almost certain. I recommend you begin a low fat diet, core exercises such as sit-ups, planks, pilates and consult a bariatric surgeon.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Nelson Castillo, MD · Answer

Thank you for sharing your question.  For most surgeons a BMI in the 30-32 range is the cutoff for most body contouring procedures as the risks of surgery above this range outweigh the benefits.  I would focus on continued weight loss for now and then pursue surgery at a later date.

Kenneth Hughes, MD · Answer

BMI is just one measure of your fitness for surgery. In my practice I look for a BMI approximating 30 to lessen the risks of complications during and after surgery and to enhance the results of the procedures. It is best to be within 10 pounds of your weight goal for three months prior to the BBL and TT. A BMI of 35 is probably the upper limit that a plastic surgeon would consider for this procedure.

Daniel Barrett, MD · Answer

Dear kmeadows8,
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

Israel Manon, MD · Answer

Hola, Gracias por compartir la información, es un placer para mi responder tu pregunta.  Mi recomendacion siempre es bajar al peso o IMC ideal antes de cirugia. En tu caso inmediatamente realizariamos abdominoplastia, reparacion muscular y lipo de los flankos. Seria muy peligroso estar boca abajo para hacer lipo de espalda o bbl. 
 Espero que esta respuesta te ayude Muy buena suerte!

Andrew M. Ress, MD · Answer

BMI is a simple measure that was developed in 1830. Its simplicity has kept in use but it is imperfect and other factors must be taken into account such as if you have side effects of obesity such as diabetes, hypertension and others of metabolic syndrome, your muscle mass, ethnicity, etc.
That said, from a practical standpoint you should get to within 10 pounds of the weight you can maintain since post operative weight loss can change the results of your surgical results dramatically. 
Twenty pound weight loss will get you to a BMI of 39 and 40 pounds to BMI of 35. Good nutrition helps the healing process. I hope this is helpful information for you.

Darryl J. Blinski, MD · Answer

I think you are incorrect, most boarded plastic surgeons would not approve elective cosmetic surgery on BMI over 30-32! You might need to lose much more then "a little more weight..." Have you considered gastric bypass or gastric sleeve surgeries?

Camille Cash, MD · Answer

You will want to reduce your weight prior to considering elective plastic surgery.  The recommendation is to have a BMI below 30.  Those above this threshold are at higher risk of complications such as poor wound healing, seroma, and infection.  Losing weight will also allow your surgeon the opportunity to maximize your results.