Dear Dr B.,
Thank you for this service. I am 54 yo, 5'5' weigh 235 with a bmi and bf of 33 (just checked this morning.). I lift weights, do cardio, and currently shedding the pounds. I'd like to loose about 50 lbs more and see how my skin bounces back. I have an old vertical c section I want removed with a tummy tuck.
To date I've talked, not consulted with at 2 surgeons who insist my weight is not an issue. I do not want to loose so much weight that I'm left with a bag of bones but I'm also trying not to become too anxious and have the surgery too soon. My goal is to loose the weight but my markers are to gain more muscle definition in my arms and thighs and reduce a fat pad between my thighs.
Please help me identify markers in my body that determine the correct time for a tuck? Am I being realistic?
This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.Weight loss and surgical sculpture is a series of compromises.
What suites any one individual will vary.
I saw many patients in the middle of their weight loss asking for my advice who had seen other surgeons who offered surgery booking right away. They came to me uncertain about the offers asking for my advice. This is all part of the process of How to Pick a Tummy Tuck Surgeon
The issue here is what timing is best for the patient optimizing recovery and return to their lives.
The problem is that surgery is not an alternative to losing weight. We saw many patients who wewr frustrated with trying to lose weight. Excess fat on the female body goes to the belly, buttocks, thighs, and breast and comes off those regions last. Surgery does not manage global fat contour issues. Compromise surgery does not look as good as surgery done after the weight is lost.
I saw many patients unhappy after surgery done elsewhere who had expected more than what they got. That is why for my patients not happy with their weight, I recommend weight loss before surgery. Get to a weight you are happy with first. Losing weight is a coarse tool. Plastic Surgery is better used for refinement. Do the surgery before the weight loss results in a gamble.
Tighten tissues with a compromise global fat problem and then lose more weight? The skin will almost certainly loosen again. Sometimes a revision can be done, at additional cost. Sometimes bridges are burned such as with belly button or nipple placement. Why should the skin magically tighten after surgery followed by weight loss vs. just waiting for the weight to finish being lost and the skin stabilized first?
Ideal sequence that I recommended for my patients:
Body Shaping Garments
- Get to a weight body fat percentage you are comfortable living with.
- Let the skin adjust as much as it will. It can take from 6 to 18 months for skin equilibration after a gastric bypass and major weight loss.
- After Massive Weight Loss, Consider Tightening Lower Tissues First. There is little sense to lift the breast and then have a tummy tuck, lower the breast result, requiring a revision breast lift.
- Then Address the Breasts.
- Use No Surgery Body Shaping Garments as emotional support not to rush the process.
which will hide and stabilize the excess tissues while being worn. They are not a replacement for the surgery but, what I like to call, and emotional band-aide. Check out Female Body Shaping Garments
and for the male weight loss individual: Body Contouring Clothing for Men
The next question is how to verify just how bad a problem was, how good the surgeon did, or if the skin has stopped shrinking. That is where my Standard Tummy Tuck Pictures
or Before and After Tummy Tuck Videos
come in for assessment of loose skin issues. I do not feel that loose skin is really demonstrated nor the quality of surgery revealed by one or two views with the individual standing upright only. Check out our How to Evaluate Tummy Tuck Pictures
Some of my patients used such critical documentation for their own loose skin tightening endpoints when they felt there were no further progress on their skin improving, that is a reasonable time to consider the skin tightening. Starting with my Standard Tummy Tuck Pictures to Weight Loss Photos progress, just how can this factor be better documented? That is the point of this forum, to stimulate progress and improvements after my retirement.
Hope this helps,
Michael Bermant, MDLearn More About Tummy Tuck Abdominoplasty Surgery