Tummy tuck eligibility - Subcutaneous fat or visceral fat

Question

I am curious about whether I predominantly have subcutaneous fat or visceral fat. Since I can move and pinch the fat, I assume it's mostly subcutaneous. For individuals with a body type like mine, is it still preferable to reach a BMI below 30 for tummy tuck and 360 lipo, or could I now be a candidate now and expect good results?

Carmina Cardenas, MD · Answer

Your abdominal protruding appearance is mainly because of Visceral fat and it will be mandatory weight loss (ideally naturally by changing your diet habits and adding consistent exercise 5-6 times a week) in order to have a safe procedure and a fantastic result. 
Based on your photo I consider at least 20 hopefully 30 lbs weight loss will be ideal. 
I foresee a beautiful flat abdomen, tapered waist and a wonderful figure after all. 
Be encouraged. 
Dr. Cardenas

J. Timothy Katzen, MD, FACS · Answer

Hello, and thank you for your question regarding tummy tuck eligibility and whether you have subcutaneous or visceral fat. I appreciate your history and the pictures you provided.

Based on your pictures, you have excess abdominal skin and fat, along with a combination of subcutaneous and visceral fat. While you do have a noticeable amount of subcutaneous fat, most of the fat in your lower torso and abdomen appears to be visceral fat. Visceral fat is located deep inside the abdomen, surrounding the organs, and cannot be removed with liposuction or a tummy tuck.

Most experienced, board-certified plastic surgeons would recommend further weight loss before proceeding with surgery. Ideally, it would be best if your BMI were below 30 to ensure the best and safest results. If losing weight through diet and exercise alone has been challenging, you may consider medically assisted weight loss options. FDA-approved GLP-1 medications like Ozempic, Mounjaro, Zepbound, or Tirzepatide can be highly effective in promoting further fat loss, including a reduction in visceral fat. For patients looking for a more aggressive and long-term solution, vertical gastric sleeve surgery is another option that could significantly help with weight reduction.

It is important to note that liposuction (including 360 lipo) can only remove subcutaneous fat and does not address visceral fat or skin laxity. If you proceed with 360 liposuction alone, you would likely be left with hanging skin, requiring a tummy tuck for optimal results. Therefore, most plastic surgeons would suggest losing the weight first, reducing visceral fat, and then undergoing a tummy tuck to achieve the best contour.

I hope I have answered your questions regarding tummy tuck eligibility and the difference between subcutaneous and visceral fat. If you have any more questions about a lower body lift, circumferential 360 body lift, belt lipectomy, belt abdominoplasty, or belt dermolipectomy, please consult an experienced, board-certified plastic surgeon specializing in these procedures. Since body lifts and tummy tucks are major procedures, it is crucial to research your surgeon carefully. Ensure they have performed at least 100 lower body lifts, have extensive before-and-after photos, and have positive reviews on RealSelf. If you are unable to find an experienced lower body lift surgeon in your area, consider traveling out of state for the best possible care.

Good luck, and I hope this helps answer your question!

Sincerely,
Dr. Katzen

Ira H. Rex III, MD · Answer

From your photographs, it seems that you probably have quite a bit of visceral fat.  Depending on your health and other factors, you may be a candidate for abdominoplasty, even with a BMI of greater than 30.  If you could drop your BMI to 30, yes, you could expect a nicer result.  For now, you may be happy with liposuction and skin removal and consider muscle tightening in the future if you can decrease the visceral fat.

Chet Mays, MD · Answer

Thank you for your inquiry! You have excess abdominal skin making you a great candidate for an Abdominoplasty procedure. We would love to see you in person and help you reach your goals. Schedule a consultation with a Board-Certified Plastic Surgeon like myself and we can create a surgical plan for you!

Leila Kasrai, MD, FRCSC · Answer

While you may be able to pinch a lot of your fat, you most likely have some that is visceral (a physical exam by your surgeon can verify this.) So, if a tummy tuck is performed and the subcutaneous fat is removed but the excess visceral fat remains, you may still be left with a protruding mid-section and dissatisfying results.

Daniel Barrett, MD · Answer

Dear Makemeovedr,

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 surgery, I would suggest you 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

Azita Madjidi, MD, MS, FACS · Answer

From your side picture without you pinching the skin, you have a prominent abdomen on top right below your chest. That shows that you do have a large amount of visceral fat and liposuction will not address that. The only way it reduces, is weight loss. It's like having a large balloon inside your abdomen. A tummy tuck will not be able to properly done and tighten the muscles against it. That's why the best candidates for tummy tucks have a BMI of less than 30. You could have liposuction but it will make your skin looser and will not make you look flat. You can have first liposuction then weight at least 6 months and lose weight then get a tummy tuck with better result.

Daniel Careaga, MD · Answer

subcutaneous fat is the fact that lives between the skin and the muscles. Visceral fat is the fat that lives within our abdominal cavity, around your organs such as your liver, intestines, etc&hellip;. Subcutaneous fat can be removed via tummy tuck or liposuction. The only way to remove visceral fat is by weight loss. People can have a different distributions of that, but in general women have more subcutaneous fat and men have more visceral fat. Based on your pictures, I see about an even distribution of visceral versus subcutaneous fat. I would recommend weight loss to improve your result. The problem with visceral fat is that when you go to reconstruct the muscle separation it is like trying to close a suitcase that is too full.

Rajaie Hazboun, MD, MBA · Answer

Thank you for posting your question here !From your pictures you do appear to have a component of both , excess visceral (intra-abdominal fat) and subcutaneous fat . Tummy tucks and liposuction will not address the visceral fat and the only way to address that is weight loss. I would recommend that you discuss your situation with your plastic surgeon so you can come up with a weight loss plan together and once you hit the goal BMI you and your plastic surgeon have set to safely perform the surgery and to get the best results then you can plan your future steps. I would likely recommend a lipoabdominoplasty (liposuction inconjunction with an abdominoplasty )( possibly an extended one ) but once you reach your weight loss goal.
I hope this helps, best of Luck!

Gary M. Horndeski, MD · Answer

From the appearance of your abdomen with your hand grasping it, you do have excess subcutaneous fat. Visceral fat is in the abdominal cavity. You would have to have a BMI of less than 30 to undergo liposuction. Liposuction will remove fat but the skin will hang as you already have excess skin.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Tummy tuck eligibility - Subcutaneous fat or visceral fat

Answers (16)

More Tummy Tuck Questions

How can I tell what would be removed during a tummy tuck with 360 lipo?

Will I need to stagger BBL, tummy tuck and liposuction?

Tummy tuck - Perimenopausal?

Stretch mark + excess skin above belly button - Is this fixable with tummy tuck or is their a less invasive procedure? (photo)

Tummy tuck + Renuvion to thighs, chin and upper arms. Too much at once?

Full tummy tuck, BBL, HD Vaser lipo and skin tightening - How many drains would you use?

WE SEND PRETTY
EMAILS