Why will some surgeons do plus size tummy tuck and others won't?

The ideal situation is to perform a tummy tuck when the patient is at a certain weight. Sounds good in theory but many women will never get down to that weight, so many surgeons bend the rules a bit, myself included. Performing a tummy tuck in obese patients carries significant risks especially with blood clots.   it doesn’t surprise me that some surgeons will perform a tummy tuck on large patients that other surgeons wouldn’t touch. That doesn’t mean it’s a good idea. It just means that some surgeons are not as risk averse as others. I think each patient needs  to be evaluated individually and each surgeon has to use good judgment in determining whether to perform surgery on a patient.

Hi, thank you for your question.Patients with elevated BMI typically have increased risk of complications - some minor, and some major. Some surgeons may not want to assume the risk of causing harm to you. The safest way to approach any elective cosmetic procedure is to make sure you are medically optimized so that you can improve your chances of a successful outcome.I hope this helps. Best of luck! 

All the largest recent studies confirm that high BMI (>30) is associated with increased risk of complications with tummy tucks, including pulmonary embolism which can be life-threatening. There are certainly other factors to consider, and each situation is different, but why take the risk?

Hello and thank you for your questions. Higher BMI is believed to be associated with higher risk of  peri-operative complications. Additionally, results will be better in patients with normal or close to normal weight. Having said that, each case is unique and I have done tummy tuck on heavier patients with good results. I would seek consultation with a board-certified
plastic surgeon for a full evaluation and advice. Best,
Pejman
Aflaki, M.D.
Johns
Hopkins-trained double board-certified plastic surgeon

BMI (body mass index) should be under 35 and closer to 30 for best results and reduction of complications.  A high BMI indicates that you have or may develop most of the cardiovascular risk factors such as high cholesterol, type II diabetes, stress, physical inactivity, hypertension, obesity, stress incontinence, sleep apnea, osteoarthritis, and a poor diet. If your medical history indicates too many risks, I will not perform the TT for the safety of the patient.Always consult with a board certified plastic surgeon for an in-person evaluation of your risks.

Dear awha_96,
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

Each patient needs to be evaluated on a case by case basis. In general, women are considered obese with a BMI of 30 or more and are considered a high risk for surgery, most surgeons are not willing to put their patients at risk. Consult with a board certified plastic surgeon to learn what options are available to you. Good luck.

A tummy tuck is an elective procedure. However, it is still surgery with its inherent risks. With that in mind, potential surgical candidates should be optimized pre-operatively. They should be healthy and have reached a stable weight at which they are content (preferably with a BMI < 30).Candidates with a BMI > 30 have a higher complication rate. For this reason, many providers will be selective with patients whose weight places them at a higher risk profile.As always, discuss your concerns with a board certified plastic surgeon (ABPS).Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic
Surgery, American Society of Plastic Surgeons
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Thank you for your question. It is hard to say that some plastic surgeons choose not to perform plus size tummy tuck; it really is a case by case basis. Having a high BMI is a health risk on its own and it has been shown that there is a higher risk of complication associated with patients with high BMI. Other factors include other health issues that may place the patient at higher risk. Another important consideration is if the patient is able to lose more weight or if the weight has been stable to many months. That being said, I do not think one can say that someone does or doesn't perform plus size tummy tucks since each patient is different and needs to be evaluated for medical risk as well as patient expectations. Hope this helps.

Thank you for sharing your question. Ultimately the decision comes down to a detailed evaluation of the patient medical history, physical appearance of their body, expectations of outcome, and the risk tradeoff for an improved aesthetic.  Patients with an elevated BMI have risks that increase exponentially and the willingness to provide surgery must be on a case-by-case basis.