Overweight and Considering a Tummy Tuck

I'm 5'3 and about 235 lbs. I'm looking to get rid of my hanging mid-section. I'm wondering if a tummy tuck would take care of the situation or would I have to have the lipo as well.

Doctor Answers 22

Not at this point

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One misconception with abdominoplasty (tummy tuck surgery) and liposuction is that they will help you lose weight and obtain a flatter stomach. This is absolutely not true and in fact, the best candidates for these procedures are those who are within 10-15% of their IDEAL body weight. Given that you are 5'3" and 235 lbs means you are not there at this point. Like many patients, you probably carry a lot of tissue intra - abdominally, and the only way to reduce this is with weight loss. This will benefit you for many reasons - less anesthetic complications, lower risk of wound healing problems, and a much, much better result. Following the general theme of Dr Yuan's advice, really try to get yourself in optimal condition for surgery.

When you do surgery is more important than what you do

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The fact that you are 5'3" and 235 lbs. suggest that perhaps you are not in the optimal condition for surgery. That can be determined by your specific surgeon. In general, you want to be in as good a physical condition as possible. That means good diet habits, regular appropriate exercise or activity level, minimal vice habits like drinking and cigarettes, and good general health. Weight is not an absolute determinant of the appropriateness of surgery for you. If you should lose weight but can't or haven't, then that is a different situation than if you have lost weight and have stabilized or if you have lost weight and gained it back or have recently gained excess weight.
First, try to get in the best possible shape and state of health, what I call the healthy, stable lifestyle, then have a surgeon take a look at what anatomy you have and what realistic goals you desire. The specific surgical treatment will be determined by those factors. This can be any combination of liposuction and skin excision with a variety of abdominoplasty techniques. Good luck.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Panniculectomy would help you.

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You have two separate problems. You have hanging skin in your stomach, and you are overweight.

A panniculectomy is a kind of tummy tuck which is safer because there is no lifting up of flaps. The hanging skin is simply removed. Of course, you will still be overweight afterwards.

I don't think liposuction has an important role for you.

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

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The timing of the procedure will determine your results

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I agree with the other surgeons that you are not an ideal candidate for a tummy tuck at this point. For me, I think that it would give you a minimal improvement, and certainly less of a result compared to if you lost weight first and then had the procedure. In that situation, the risks, in particular of wound healing complications, would be less.

I think that while you could certainly find a surgeon who would perform the procedure for you, you need to carefully consider what your goals are and if the procedure can get you to those goals safely.

No, you are not a good Tummy Tuck candidate

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You should strongly consider either gastric bypass or a gastric restricting device to lose a large amount of weight before considering a Tummy Tuck. You are definitely NOT a candidate for liposuction alone.

Of course, if you can lose a significant amount of weight, at least 75 lbs, through dieting and exercising, that would be best. After that weight is gone, you can re-explore your options of a Tummy Tuck and liposuction.

Ready for a tummy tuck?

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A Tummy Tuck is not a weight loss procedure but instead addresses stubborn areas that diet and exercise have not been able to get to. The ideal Tummy Tuck candidate will be in relatively good shape but want to refine their abdomen. This is not to say that someone who is not in optimal physical shape is excluded from being eligible for this surgery, but it is important for these patients to have realistic expectations and understand that they will not end up with optimal results. I tell my patients that if  they are planning on losing weight or becoming pregnant, I recommend that they wait until your body size and weight stabilize before undergoing the surgery.

Overweight tummy tuck patient

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Are you actively trying to lose weight at the moment? If you are, it's better to reach a stable weight before getting a tummy tuck. Additional weight loss after surgery can leave you with loose skin that would require another surgery.

If you aren't trying to lose weight right now, then you can consider a tummy tuck. However, you may need to find a surgeon that would be able to do this, since many prefer patients to be within a normal weight range. It makes the surgery safer.

Within 10% of ideal body weight is best...

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There’s no question that being close to your ideal body weight improves the results from tummy tuck surgery. It also decreases the potential for complications with this type of surgical procedure. For these reasons, we prefer that patients be within 10% of their ideal body weight at the time of surgery.
Unfortunately, reaching an ideal weight is easier said than done. The vast majority of patients are unsuccessful at losing this additional weight. It’s also important to realize that even when patients are overweight, they can potentially benefit from abdominoplasty. We therefore evaluate every patient on an individual basis.
We encourage patients to lose weight before surgery and prefer that their weight be stable for at least three months. We realize that some patients will have difficulty losing weight. We therefore encourage patients to be in a supervised weight loss program. Even with that help, some patients will be unsuccessful in their effort to lose weight. Even without weight loss, many of these patients will still potentially benefit from tummy tuck surgery.
It’s important to emphasize that abdominoplasty is not a weight loss operation. Patients always do better when they lose weight first. For these reasons, it’s important to thoroughly discuss these issues with your plastic surgeon.

Tummy Tuck Without Liposuction

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Judging from your photos, a tummy tuck alone may be enough to achieve the body contour you want. However, liposuction is frequently performed in conjunction with a tummy tuck as it can safely remove any "hard to reach" unwanted fat deposits, giving you a nicer body contour. 

My only concern is that your weight is a little high, increasing the risks associated with surgery. There is a statistically significant association between increased BMI, an increased number of complications and poorer surgery outcomes. It is safer for you and your surgical outcome would be more satisfying if you could reach a stable BMI of about 25. 

Tummy tuck not a great solution for morbid obesity

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The real concern here is your health. This is not a cosmetic issue. If the hanging skin is a problem with infections and skin breakdown than a panniculectomy which is not a cosmetic operation is an option. However, you should be worried about your cardiac health, risk of diabetes, osteoarthritis, etc. A panniculectomy may reduce your weight by 10-15 pounds at most and this will do little to improve your situation.

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.