Solving the “Catch 22” of Tummy Tuck Surgery for Patients with BMI 30 or Higher
Nearly every day, Dr. Schlesinger meets with a patient who is unhappy with the shape of her stomach and wants a tummy tuck to address extra fat, sagging skin, and stretched muscles to achieve a firmer, flatter, more slender waistline. Most of these women are excellent candidates for tummy tuck surgery. But for some heavier patients, this may not be the case.
Patients who present with a BMI in the “obese” category of 30 or higher have a significantly higher risk for infection, poor healing, and other life-threatening complications after complex surgeries such as a tummy tuck. Moreover, the result won’t look as good as it would should we wait until you are closer to your ideal body weight to proceed with tummy tuck surgery. Obviously, safety is our #1 concern with plastic surgery and, in the case of significantly overweight patients, the risks are greater than the reward.
The obvious solution to this “BMI barrier” is for the patient to lose weight before a tummy tuck. However, most patients in the 30 to 35 BMI range are too light to qualify for weight loss surgery—and too heavy to qualify for cosmetic surgery—placing them in a “Catch 22” type of situation. Plus, losing weight is easier said than done. The hungry fat cell theory has been gaining traction in recent years, and we now know that losing weight is not as simple as restricting calorie intake.
What is the hungry fat cell theory?
Each fat cell in your body is programmed to store the calories you eat as fat—your fat cells are hungry. This was an important survival mechanism in times when food was scarce, and few humans had the chance to tack on too many fat cells.
Today, however, the hungry fat cell mechanism can backfire. If you have excess fat cells (which is likely if your BMI is 30 or higher), your body diverts more calories you eat to these fat cells rather than burning them for energy. You feel hungrier and overeat to satiate that hunger. In short, you’re prone to overeat as a result of being overweight. The science of this hungry fat cell theory goes against the outdated conventional wisdom that assumes we only gain fat because we overeat.
What is your BMI?
Are you a good candidate for tummy tuck surgery, or are you in the “Catch 22” zone? Estimate your BMI here.
Supplied by BMI Calculator USA
Disclaimer: this is a tool for reference only and not to be used as a diagnosis or substitute for a physician’s evaluation. Consult with your doctor before starting any diet or exercise program or before undergoing an elective procedure.
The solution: jumpstart weight loss efforts with liposuction
If an overabundance of fat cells is hindering weight loss, one way to overcome this barrier is to remove excess fat cells with liposuction first, focusing on areas where we would be performing liposuction in conjunction with a tummy tuck anyway, such as the hips, flanks, and lower back.
A much less involved surgery than a tummy tuck, liposuction is typically safe for heavier patients, and it can be a great way to improve a patient’s silhouette, provide a boost in self-image, and help curb hunger by “lowering the volume” of the signals the brain receives from fat cells. All of these factors can make it easier to start losing weight through lifestyle changes—with the ultimate goal of qualifying for tummy tuck surgery once a healthier BMI is achieved.
Interestingly, this is a reverse of the approach to what Dr. Schlesinger recommends for patients whose BMI is in the “normal” range (18.5 to 24.9). For these patients, he will perform a tummy tuck first, and then wait about 90 days to perform liposuction to finish sculpting the beautiful, curved torso shape that patients want. The advantages of this approach, the Ultimate Silhouettplasty, is that the torso has re-established a healthy blood supply before a second procedure is performed, which is key for optimal results and a rapid healing process.
By reversing this process for heavier patients, Dr. Schlesinger is able to help more women safely undergo tummy tuck surgery and achieve the smoother, flatter, and more attractive abdominal shape they want.
Learn more about Hawaii tummy tuck options at a personal consultation
The moral of the story? If you are unhappy with the way your stomach looks, it is worth talking to Dr. Schlesinger about your options for improvement, no matter what weight you’re at right now. Please contact our office in Honolulu for a personal consultation at the Breast Implant Center of Hawaii. During your meeting, he can help you understand what’s possible for your appearance now and into the future.