60 more pounds to lose - Would a tummy tuck and lipo be beneficial? (Photos)

It is more helpful to mention your height and weight in numbers so we could know your BMI. My comments relate to patients with a BMI of 33 or less, occasionally up to 35.
Sometimes patients like yourself are concerned about the problems that the overhanging abdominal skin and fat pose, like rashes under the skin, real obstacles to working out, quality of life issues. The 60 lbs. more to lose are not all on the abdomen, and all the extra fat and skin on the abdomen, and the fat on the waist and flanks, along with the bra rolls can be removed with a lipoabdominoplasty, 360 lipo plus tummy tuck.
The extra weight will be on the rest of the body where you store fat, usually hips, thighs, buttocks, and some intra-abdominally. By having an abdominoplasty and losing the rest of the weight, you won't "mess up" the abdominoplasty, because the "weight" you lose afterwards will not be from the abdomen (see attached photo). Your question: "would a tummy tuck with lipo make a difference in appearance". Yes, and a difference in your workouts. You can see patients on my website with BMI's over 30 and determine if this approach would be appropriate for you. You have to go to a surgeon who is comfortable doing both extensive liposuction and a tummy tuck at the same time. Obviously, the concensus is to wait until most of the weight is lost. This can be very difficult or take a very long time for some patients. In my practice, timing is dependent on goals and expectations, tempo of weight loss, quality of life, acceptance of some trade-offs in immediate vs later results.

Your appearance would be improved if you had a tummy tuck now, but the outcome would be notably better if you completed the weight loss first. As the procedure is not an emergency, it would be prudent to lose the weight prior to having surgery.

A full tummy tuck with liposuction would significantly improve the contour of your midsection by removing excess skin and fat from the lower abdomen, tightening separated abdominal muscles, and sculpting the waist with liposuction. However, if you plan to lose more weight, it’s best to lose it before surgery because losing significant weight after a tummy tuck can lead to loose skin again and affect your final result.

Dear Loving979103,

congrats on the weight loss! 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.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for your question. It’s best to hold off on a tummy tuck until you’re closer to your goal weight because losing more weight after the tummy tuck can lead to additional loose skin which can affect your final results. However, if the hanging skin is making things difficult for you, a procedure called panniculectomy that includes removing just the overhanging skin could be an option to improve comfort and mobility while you continue losing weight. Once you're closer to your goal and have maintained it for a while, a full tummy tuck with lipo will give you the best contouring and skin tightening. Meeting with a surgeon for an in-person consultation will give you the best idea of what will work for your body.

I think a 60 pound weight loss after a tummy tuck may loosen the skin a bit, but say 20 pounds probably would not. If working out becomes so difficult with the large overhang, sometimes it is not a bad trade off to time the surgery earlier and except a little loose skin when you have reached your goal weight.

Congrats on the ongoing weight loss. Keep going.
As a result of this level of massive weight loss, you will be healthier, feel much stronger, and have much more energy. The trade off is lots of extra skin...everywhere. The lower Body lift (Belt lipectomy) is likely to be your first procedure which entails the circumferential mid sectional skin removal, elevation of the lateral (outside) thighs, and buttock lift, all in the same procedure. The breasts, inner thighs, arms and/or neck will be addressed later, as per your priority choices.

Hello, and thank you for your question regarding whether a tummy tuck and liposuction would be beneficial while you still have 60 more pounds to lose. I appreciate your history and your pictures, and congratulations on your incredible 82-pound weight loss so far! That is an amazing achievement, and I commend you for your dedication to your health.

Based on your photos, you have excess abdominal skin (cutis pleonasmus), loose skin (dermatochalasis), excess fat (lipodystrophy), and rectus abdominis muscle weakness (diastasis recti). These conditions would be best treated with an abdominoplasty (tummy tuck) or even an extended tummy tuck if the excess skin extends laterally. However, the timing of your surgery is crucial to ensure you get the best long-term results.

Most experienced, board-certified plastic surgeons specializing in reconstructive plastic surgery after massive weight loss strongly recommend that you lose as much weight as possible before undergoing surgery. If you proceed with a tummy tuck and liposuction now and then lose an additional 60 pounds, you will likely require a revision surgery later, as further weight loss can lead to new skin laxity and changes in body contour. This would result in additional procedures, recovery time, and costs that could have been avoided.

Instead, I encourage you to focus on achieving your goal weight first. Once you have stabilized your weight for a few months, that would be the best time to undergo an abdominoplasty with liposuction for optimal contouring and long-lasting results. Losing the extra weight now will also make your workouts easier and improve your overall fitness, further enhancing your final surgical outcome.

If you have any more questions regarding tummy tucks, abdominoplasty, or abdominal liposuction, I recommend consulting an experienced, board-certified plastic surgeon who specializes in post-weight loss body contouring. Do your research, check their before-and-after photos, and ensure they have extensive experience in tummy tucks for patients who have undergone significant weight loss. If you can’t find an expert in your area, you may want to consider traveling to a surgeon who specializes in these procedures.

Best of luck on your weight loss journey, and I look forward to seeing you reach your goals!

Sincerely,
Dr. Katzen, MD, MBA, FACS, FICS

Thank you for your question. Since excess skin interferes with your workouts, a tummy tuck can remove loose, hanging skin, making exercise more comfortable and improving mobility.
Liposuction also can help contour your waist and flanks, but if you plan to lose 60 more pounds, your results could change post-surgery. So, you should be closer to your goal weight by at least 3 months before undergoing a tummy tuck and liposuction, because significant weight loss after surgery could lead to more skin laxity and affect your final outcome. If your hanging skin severely interferes with workouts and daily life, a panniculectomy (removing excess skin without muscle repair) could be an option before a full tummy tuck later.

Nice job on losing so much weight! Weight loss after a tummy tuck can negatively impact results, so if you get one now and continue to lose weight after, you might “undo” your results, making another procedure necessary. If you’re not at your ideal stable weight, it would be a better idea to wait until you are before proceeding with a tummy tuck.

Until then, keep up the great work!