Tummy Tuck Considerations for Older Male Patients?

Hi, my husband is considering an Abdominoplasty. He is 63 years old and carries all his weight in his belly. He has back problems and cannot do any significant amount of exercising for the abdomen.

We are not sure whether he is a candidate for a Tummy tuck. What questions and considerations should we raise when we explore options with a plastic surgeon?

Thanks for your comments.

Doctor Answers 10

What makes a man a candidate for a "tummy Tuck"

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Your husband should ask whether his "full abdomen" is secondary to subcutaneous fat (fat between the skin and abdominal wall muscle) and skin excess or more due to fat below the abdominal wall-fat we call visceral fat. An abdominoplasty can treat superficial fat and skin excess but not abdominal fullness secondary to deep "visceral" fat. Visceral fat needs to be addressed with diet and excercise.

If, on the otherhand, he just has excess subcutaneous fat with minimal to no skin excess liposuction would be ideal.

Good luck and I hope this helps.

Pittsburgh Plastic Surgeon
4.8 out of 5 stars 16 reviews

What to consider for Tummy Tuck in older male patients

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In order of importance:

1- Is he fit for surgery? This needs evaluation by an internist. There may be other issues such as heart or lung conditions that need to be tackled before surgery.

2- Are the back problems related to the abdomen? If the back problem is independent of the abdominal girth, he may benefit more from addressing that problem first, as the increased mobility and comfort will help him solve some of the weight related problems.

For this I would have him evaluated by a Physical Medicine and Rehabilitation specialist (Physiatrist, not to be confused with psychiatrist). My wife has back problems and the Physiatrist has been a godsend.

4- Is the fat inside the abdomen? As others have mentioned, if the evaluation by the plastic surgeon is that the fat is intraabdominal, then the solution is weight control.

5- If the back problem is related to the abdomen, the answer may not necessarily be surgery. Remember, Tummy Tuck is a contouring technique, NOT a weight loss technique.

6- If the back problems are a barrier to exercise, consider aquatic therapy or exercises. In the water, the weight is not borne by the back, and a lot of muscle groups are engaged. This may be a wonderful way of achieving several of his goals: exercise, weight loss, increased muscle tone to support the back, etc.

Ricardo L. Rodriguez, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 98 reviews

Male tummy tuck candidates

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As has been mentioned by other doctors, fat can exist in 2 locations on the trunk; within the abdominal cavity (i.e. surrounding the internal organs) and outside the abdominal cavity (i.e. the fatty layer). Tummy tuck and liposuction targets fat outside of the abdominal cavity; these treatments cannot treat fat on the inside. Most men with an "apple" shaped torso have a very large component of fat within the abdominal cavity, and thus aren't candidates for body contouring surgery.

If your husband is in otherwise good health and is unable to lose weight with diet and exercise, he may benefit from evaluation by a bariatric surgeon. This is something that you may wish to discuss with your internist.

Best of luck!

The fat may be inside the abdomen.

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Your husband needs a good physical exam by an experienced plastic surgeon. You need to know exactly where the fat is. In many men with big bellies, the fat is unfortunately inside the abdomen (around the intestines). In that case surgery will not help him.

If the protuberant fat is mostly under the skin and outside the muscles, then either liposuction or a tummy tuck may well help him.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Tummy tuck in a mature male

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It is unlikely that all his back problems are due to the loose skin or fat.

They are more likely related to the abdominal muscles or spine.

After seeing your primary care physician for a general workup to exclude other health considerations, you may want to have his back evaluated.

After completing this, I would highly recommend you either seeing a physical therapist and or undertake a core strengthening regimen.

He may also want to discuss dietary issues with a nutritionist.

After these initial steps, I would then contemplate having him see a plastic surgeon

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Depends on his physical exam.

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It all really depends on his physical examination. There are two placed for fat to go in the belly. One the "inside" and on the "outside." For inside fat, the only really option is weight loss. For fat on the outside, liposuction and/or abdominoplasty may be good. However, you really need an exam to see where he "carries" most of his fat.

Is his fat inside the abdomen or under the skin?

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Most men with large abdomens carry the fat inside the abdomen (beer belly) where it can't be changed by tummy tucks or liposuction.  Only fat under the skin can be changed that way.  Go to a plastic surgeon and see where his fat is and if he is a candidate for surgery.  I am betting he isn't.

Tummy tuck for men

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The best piece of advice I could give you is to locate a board-certified plastic surgeon and go in for a consultation. It's simply too hard to give you more of a definitive opinion without examining your husband in person. But remember, tummy tucks in men or women are not performed for weight loss. They are best used for patients with excess abdominal skin.

If your husband has significant intra-abdominal fat and minimal or no skin laxity then he is probably a poor surgical candidate and weight loss either through diet and exercise or bariatric surgery is the best treatment. Again, a plastic surgeon will be able to best assist you with these questions during a consultation.

Good luck!

Elan B. Singer, MD
Manhattan Plastic Surgeon
4.8 out of 5 stars 26 reviews

Needs evaluation

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A surgoen needs to examine him to see if he is a candidate. Choose a Board Certified Plastic Surgeon who perfoms tummy tucks all the time.

Good Luck.

Andrew T. Cohen, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 48 reviews

Tummy tuck considerations for male patients

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Dear Liz,

I have several concerns with your posting.

1."He is 63 years old ..."

Before considering ANY cosmetic surgery, make sure your husband does not have any underlying risk factors. Especially heart disease.

2. He "... carries all his weight in his belly"

Men commonly have the dreaded "Beer Gut" In these cases, the excess fat is INSIDE the abdominal cavity NOT under the skin and over the muscle where it can either be removed with liposuction OR excised by a Tummy Tuck / Abdominoplasty.

3. "We are not sure whether he is a candidate for a Tummy tuck"

He most likely is not. An abdominoplasty will remove loose abdominal skin and the fat under the skin below the belly button. It will not affect the abdominal fat. He may benefit from liposuction of the "Tire / Love Handles" which would give him a better appearance and may help him feel much better about himself.

See several Plastic surgeons and pick the one you trust the most.

Good Luck.

Peter A. Aldea, MD
Memphis Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.