5’7 190 lbs. Tummy tuck - do I need to loose weight first? Can I expect a flat stomach after? (Photos)

Hello, and thank you for your question regarding being 5'7" and weighing 190 pounds, considering a tummy tuck, and specifically wondering if you need to lose more weight first, and whether you can expect a flat stomach after a tummy tuck. Thank you for your history and your pictures. At 5'7" and 190 pounds, your BMI is 29. Even though your BMI is less than 30, most plastic surgeons would agree that it would be best if you lost more weight. By losing weight, you will lose both subcutaneous (under the skin) and visceral (under the muscle) fat. The more fat you can lose, the better your tummy tuck results. Most plastic surgeons suggest you eat a high-protein diet with minimal carbs and low sugar. It is recommended to exercise for at least an hour a day. If these are too difficult to do, consider taking a GLP-1 medication to help with further weight loss. In your case, most plastic surgeons suggest at least a 10- to 15-pound further weight loss. This will help to reduce your visceral fat significantly and will keep your tummy from bulging. Currently, your abdomen bulges on profile due to too much visceral fat. During a tummy tuck or abdominoplasty, three anatomic areas are repaired. The rectus abdominis muscle is repaired, excess abdominal skin is removed, and excess abdominal fat is removed. If, however, the rectus abdominis muscle is being distended by visceral fat, the muscle can only be repaired to a certain extent. Even though the skin and fat are pulled tightly over the rectus muscle, the abdomen may still be distended due to the presence of visceral fat pushing the rectus abdominis muscle outward. Therefore, in your case, it would be best to lose as much visceral fat as possible, undergo rectus abdominis plication to achieve a flat tummy on profile, and then the skin and fat can be redraped. This would yield the best results. Therefore, it would be best to lose more weight before your tummy tuck and lipo flank and back surgery. Good luck. I hope I’ve answered your question regarding whether you need to lose more weight first and whether you can expect a flat stomach after a tummy tuck, considering you are 5'7" and weigh 190 pounds. Good luck.
Most plastic surgeons offer complimentary virtual or in-person consultations. Therefore, explore what other plastic surgeons have to say. If you have any further questions about a tummy tuck, please consult an experienced plastic surgeon. Please consult an experienced, board-certified plastic surgeon with a proven track record of performing tummy tucks. Ensure they have performed numerous tummy tuck surgeries and have before-and-after pictures to prove it. Carefully examine their before-and-after pictures and check their reviews on RealSelf. If you cannot find an experienced plastic surgeon in your area, consider traveling to another state. Sincerely, Dr. Katzen. (Plastic Surgeon, President of the American Society of Bariatric Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

It's always best to be your ideal weight before surgery. However, if you are healthy, active and have medical clearance, surgery could be done at this point. Abdominal wall tightening will help the bulge, but it is unrealistic to expect a perfectly flat abdomen.

Thank you for your question. You’re a good candidate for a tummy tuck with flank and back liposuction, but the best results happen when you’re at or very close to your goal weight and have been weight-stable for 3–6 months. The tuck will release your previous C-section and hysterectomy scars, remove excess skin, and repair any diastasis, while lipo contours your waist. However, it cannot remove visceral fat, so you might not be “board-flat.” If you plan to lose more than 15–20 pounds, do that beforehand to improve your contour and reduce the chance of loose skin later. If your weight is stable and you aren’t planning to lose more, you can go ahead now with realistic expectations: a flatter, smoother abdomen and a better waist, but not a fat-free midsection. Schedule an in-person exam with a board-certified surgeon to verify skin versus fat distribution, assess diastasis, determine scar treatment, and decide the right timing related to any future weight loss.

It would depend on how much weight you are planning to lose prior to surgery. A modest amount of weight loss (~5 lbs) isn’t going to have a tremendous impact on the aesthetic result. Moderate weight loss (10-20 lbs) is going to have a more significant effect, partially because you’ve lost weight in other parts of the body, which is going to complement the results of the tummy tuck. If you are planning to lose more than 15-20 lbs, I would recommend doing that BEFORE your tummy tuck. If you have a tummy tuck, recover from that procedure, and then lose 20 lbs AFTER that, you’re more likely to have some loose skin in areas that could have been addressed with the tummy tuck procedure.
Regardless of how much weight you plan to lose, I would recommend doing in a safe, gradual manner. I would recommend staying away from crash diets and any regimens that result in significant weight loss in a short period of time. Proper nutrition is very important before this type of surgery.

Fat that’s located below the skin (subcutaneous) and around the internal organs (visceral) can both contribute to a protruding belly. Abdominal muscle separation can also contribute. While a tummy tuck can remove loose skin and subcutaneous fat, as well as repair abdominal muscle separation, it cannot remove visceral fat. Visceral fat can only be removed with diet and exercise. Therefore, it would be best to ask your surgeon how much fat can be removed and how flat you may be after surgery to determine whether it would be satisfactory to you.

You do appear to be a good candidate for an abdominoplasty, which would remove your pouch you dislike and help to smooth and tighten your abdomen. In order to achieve the flattest abdomen possible, you should try to bring your weight down as close as possible to your ideal body weight. Your present BMI is slightly over 29 so some weight loss would complement your results. Best wishes.

At 5'7 and 190 lbs., your BMI is 29, which is overweight. You would benefit from losing weight but can have a tummy tuck at this time. The technique I recommend is abdominoplasty with mesh reinforcement. The mesh creates a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight.

Best Wishes,

Gary Horndeski, M.D.

Thank you for your question and photos. Your BMI is 29, you are a good candidate for VASER liposuction 360 degrees (full abdomen, pubic area, full back, waist, hips, lateral chest wall and rib cage) with a full tummy tuck. See a board certified plastic surgeon with experience in advanced body sculpting techniques for an in person consultation/evaluation. Good luck.

Thanks for your question! I do think you would be a good candidate for both procedures. If you can lose a little bit more weight, it will help flatten your belly. However, if this is your normal weight, you will still get a good result here. Best of luck!

Hi there! Thank you so much for your question and for sharing this here.
Looking at your photos, I believe you can achieve a beautiful and flatter abdominal contour with a tummy tuck combined with liposuction to the flanks and back. These procedures address the excess skin and residual fat deposits that can remain after prior abdominal surgeries such as fibroid removal or hysterectomy.
The most important factor before surgery is to be at your goal or ideal weight—and just as importantly, at a weight you can comfortably maintain long-term. The closer you are to this stable weight, the better your contour and longer-lasting your results will be. If you plan to lose additional weight after surgery, the skin could become lax again, which may affect your final outcome.
Every patient is unique — anatomy, history, physical exam, tissue quality, goals, skin elasticity, and surgical risk profile all change what is indicated/recommended. Because of this, this should not be taken as personal medical advice. The next step is always an in-person evaluation with a board-certified plastic surgeon that can examine you and discuss individualized plan options.
Hope this helps!
— Georgina Nichols, MD, FACS