Is there a BMI limit for every procedure?

Question

I am interested in a tummy tuck and arm lift. I was curious if there is a bmi range or if there is a specific bmi that I have to be under to qualify for both. I would rather know before scheduling any consultations. I have lost 60lbs but my excess skin in my abdomen makes some exercising incredibly difficult and uncomfortable

Daniel Barrett, MD · Answer

Dear Workingonme17,
Almost every plastic surgeon will tell you that you should reduce your BMI to at least 30 to be a candidate for a surgery. However, you should try to reduce it as much as possible because higher BMI is linked to a higher chance of complications. 
I hope this was helpful,
Dr. Barrett,Beverly Hills, CA

Kenneth Hughes, MD · Answer

Reducing the BMI to below 35 and even below 30 can reduce the risks associated with surgery.Kenneth Hughes, MD

Aldo Guerra, MD · Answer

Hello Workingonme17.I appreciate your question. The lower the BMI, the better it is. However, the American Society of Plastic Surgeons recommends a BMI lower than 30. This is based on data collected on 130,000 patients which demonstrated a BMI above 30 doubled the risks of infection and wound healing problems along incisions. Realistically speaking, not everyone can get below 30 even with significant weight loss. I prefer to recommend patients who are above 30 to get in to a medically supervised weight loss program, achieve their goal, and maintain that weight for at least 3 months.I perform surgery on patients with a BMI above 30 and discuss some risks may be higher for them. Best wishes, Dr. ALDO :)

Curtis Wong, MD · Answer

and some will not operate on those with a BMI over 30.  I'm not a gatekeeper like that and will do procedure on people with BMI's up to 40 but they are told they will have more complications and a longer healing time.  My requirement is that my patient's weight be stable on their daily routines (exercise and diet) or they are wasting their time.  If you had your procedure now and lost weight down the road as it appears you may, you must realize that it will impact your results, possibly in a detrimental way.  So not all surgeons will refuse you simply based on your BMI so call around and find those that are more compassionate.

Richard J. Brown, MD · Answer

Well there is a direct correlation to increased complications with surgery the higher your BMI is. BMI is not a perfect measure of health however, but it is what has been traditionally used by most medical facilities. For instance lots of the surgery centers I go to for cosmetic surgery will not accept a patient with a BMI greater than 30. Being that said I have had some taller patients and their BMI is over 30 but they are pretty darn healthy and otherwise fine and the surgery center will allow me to bring those patients. I usually do cases when a patient has a BMI over 30 at a surgery center attached to the hospital to be safe. So, with all this said if your BMI is greater than 30 and you are otherwise cleared by your primary care doctor before surgery it is possible to have you surgery. There is so much more to this discussion that I can not discuss in this forum but would be happy to meet you in my office to discuss. DrRickAZ

Robert Singer, MD · Answer

Congratulations on your weight loss. In general, a BMI of 30 or less
is considered ideal but this is not a hard and fast rule.
Most plastic surgeons suggest that you finish having children and get your
weight within 10 pounds of your ideal weight before undergoing an
abdominoplasty with repair of the stretched out abdominal muscles and
liposuction of selective areas, in order to achieve the best long term cosmetic
result with the least potential complications.
Following the advice of anyone who would presume to tell you what to do without
seeing photos and more importantly without taking a full medical history,
examining you, feeling and assessing your tissue tone, discussing your desired
outcome and fully informing you about the pros and cons of each option would
not be in your best interest. Find a plastic surgeon that you are comfortable
with and one that you trust and listen to his or her advice. The surgeon should
be certified by the American Board of Plastic Surgery and ideally a member of
the American Society for Aesthetic Plastic Surgery (ASAPS). You should discuss
your concerns with that surgeon in person.
Robert Singer, MD FACS
La Jolla, California.

Tom J. Pousti, MD · Answer

Congratulations on your successful weight thus far.  Specific calculations, including BMI,  are not always helpful when it comes to determining a specific patient's suitability to proceed with surgery.
Having said that, it is always best (or ideal) to achieve long-term stable weight prior to proceeding with tummy tuck surgery. Doing so, will increase the safety of the operation, will likely improve the outcome of the operation, and will decrease chances that additional surgery will become necessary subsequently. 
In my practice, I do not ask specific patients to achieve a specific weight prior to proceeding with tummy tuck surgery. I simply ask patients to achieve a long-term stable weight where he/she feels comfortable and does not expect significant fluctuation postoperatively.
 Generally speaking, the “ideal” patient for tummy tuck surgery is one who has completed pregnancies, is psycho socially/emotionally/financially stable, has an excellent social support system surrounding him/her, is capable of arranging enough recovery time, does not smoke and who has reached a long-term stable weight.
 My best advice: select your plastic surgeon carefully. Make sure that he/she has significant experience achieving the types of outcomes you would be pleased with.   Then prepare yourself and your support system for a  significant recovery experience (physical and often emotional).
 
 Best wishes.

Jon A. Perlman, MD (retired) · Answer

In my practice where all of our surgeries are performed in an outpatient setting (with patients going to aftercare following a TT) we do not operate on patients with a BMI above 30 (for safety) and advise against TT surgery unless a patient is within 10 to 15lbs of a maintainable healthy weight.  Operating prematurely when a patient is likely to lose additional weight can decrease the long term benefit of plastic surgery.  No one really knows with accuracy how close to their healthy weight they will end up so at times we proceed if someone seems to be at a plateau and seems unable to lose further weight.  This is done with an understanding that the quality of the outcome may be lessened by future weight loss.Enjoy the video above for additional useful information for you.  Regards,Jon A Perlman MD FACS 
  
Certified, Am Board of Plastic Surgery 
  
Member, Am. Society for Aesthetic Plastic Surgery (ASAPS)     
  
Member, Am. Society of Plastic Surgeons (ASPS)
  
Beverly Hills, Ca

Ronald V. DeMars, MD (Retired) · Answer

Most anesthesiologists and surgeons will not want to give an anesthetic to a patient with a BMI over 35 due to excessive risk when the surgery is purely elective. Most plastic surgeons want their patients to get the best possible results when paying so much for their surgery and will not do a TT on patients with a BMI over 30 if the high BMI is due to intraabdominal fat. It may be OK if the high BMI is due to weight in the hips and thighs as we occasionaly see. If the arms are heavy from fat the armlift will also be a waste of money. If you are dramatically overweight and cannot lose the weight you would be much better served by spending your money on bariatric surgery.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question and congratulations on your weight loss.  There is no formal established limit for BMI prior to cosmetic procedures.  A very general recommendation is that a BMI of 30 or less be achieved before significant body contouring.  However the BMI of 30 is still high and surgical results and recovery are much better and complications lower with lower BMIs.

Is there a BMI limit for every procedure?

Answers (10)

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