Do I really need to lose 20lbs before Tummy Tuck with lipo? (photos)

Thank you for your question and posting pictures. This is a very common dilemma and I believe you are a good candidate for lateral tension abdominoplasty tummy tuck at this time without any weight-loss prior to the procedure. I find my patients lose approximately 15% of their body weight after this type of tummy tuck. While classical teaching in plastic surgery recommends weight-loss prior to this procedure, I believe in proper patients who are not obese this is not necessary. The weight-loss after the procedure is more significant, sustainable and realistic.

Patient generally know themselves well, as you seem to, and understand what's realistic and what isn't in terms of losing weight and maintaining that weight. If you planned to lose 20 or 30 pounds, and felt that you could certainly do so, then it would be best to lose that weight before the surgery. If you're not likely to lose more than 10-15 pounds, which seems to be your case, then by all means have the surgery now. Some of my most grateful patients with amazing, life-changing results were 50 pounds or more overweight at the time of their tummy tucks. Some were able to lose significant weight AFTER the tummy tuck, which they could never do in the past, since it became easier to exercise and the results of dieting and exercise became so much more visible and obvious, providing better incentive to continue.

A safe stable weight is important.  Sometimes a goal weight is not achievable.  I think you look like a good candidate for tummy tuck as you are now.Kenneth Hughes, MDLos Angeles, CA

It’s an excellent question. Many patients wonder whether to
lose weight before a tummy tuck procedure.

In this situation it’s important that patients are at a
stable weight. If you intend to lose more weight in the future, then I would
wait to have surgery until you reach that weight. If you’re satisfied with your
current weight, then it makes sense to move forward with surgery.

Why do surgeons recommend being at a goal weight? It has to
do with tightening the abdominal muscles. When tightening the abdominal muscles
the contents inside the abdomen push against the abdominal wall. These contents
include our organs and intra-abdominal fat. This fat sits behind the abdominal
wall. If someone were to lose some of this intra-abdominal fat, then the
surgeon is able to tighten the abdominal wall further. This leads to additional
slimming of the waist after the procedure. It’s possible that the surgeon may
be able to remove additional skin from the tummy if someone were to lose a lot
more weight also.

What if I don’t plan to stay at the lower weight, but just
lose the weight right before the surgery? After the surgery the abdominal wall
will be tight. However, the abdominal wall can be stretched again if someone
gains a lot of intra-abdominal fat. That’s why it’s important to be at a stable
weight.

You should have a great result.

This is a fairly common scenario that comes up and as you can see, there are differing opinions out there.  In general, a patient will get a more ideal result the closer they are to their ideal body weight.  But, for many patients, this is not practical or realistic.  There are a lot of patients who are above their ideal weight and who are still very good candidates for a tummy tuck. Based on the anatomy that I can see in the pictures, you would likely be a good candidate for a Tummy Tuck.   There are a lot of factors that go into that decision, though, and when you meet with your Board Certified Plastic Surgeon, all of that can be addressed.  Take care.

Losing weight before a tummy tuck may be important, especially in cases where the patient's BMI is higher that 35, as that increases the risk for complications like infection, bleeding, deep vein thrombosis, pulmonary embolism, etc. Also by losing the weight the surgery takes less time, less bleeding, the patient will recover faster and finally, losing the weight before the surgery allows the surgeon to remove more skin, the abdomen muscles much easier can be repaired and the final results will be much better.Some patients have very hard time losing the weight before the surgery, in those cases, I will do the surgery, if the risks are not too high, and the patient can start working out again, toward losing more weight, sometimes after losing more weight, then the skin will become lose again, and the patient may need a second procedure to fix that.

I advise that my patients try to be within 10 pounds of their desired weight before tummy tuck or liposuction surgery for the best immediate results, but that is not a hard and fast rule. If you are already exercising regularly and eating a healthy diet, and you have maintained a steady healthier weight for some time, you should benefit from surgery. In fact, some patients have shared that even though they still had some more weight to lose, they felt much better after getting rid of their stomach and other areas of fat so that it inspired them to work even harder to lose the extra 10-20 pounds. Each patient is different, and your own motivation will definitely make a difference in your surgical success. You may want to consult with your surgeon again. He or she may be concerned that you may be expecting the surgery to be the way to achieve your ideal weight. Good luck with your continued healthy habits and your upcoming surgery!

Hello ;i always ask patients to achieve a stable weight that they are comfortable with prior to proceeding with a tummy tuck.Judging from your small photos and your history , it sounds like you have reached a plateau .You should have good results with a high lateral tension tummy tuck in conjunction with liposuction of your back and flanks.A formal consultation would be necessary for more in depth answer.Thank you

My general rule is that I like the patient’s BMI
under 30 and NO smoking. Then we optimize our scenario for the safest operation
and best cosmetic outcome. Based on your photos, I would proceed and expect a
good outcome. Of course, an exam would solidify my decision making.

I typically encourage patient to reach a stable and ideal weight prior to surgery. This varies from patient to patient. Patients should be stable (6 months) and comfortable where they are weight-wise at the time of surgery. This will help avoid post operative weight fluctuations which can impact outcomes (detrimentally).As always, discuss your concerns with your board certified plastic surgeon.