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Do I need to lose weight before liposuction or a tummy tuck?

The quick answer is maybe. I general, if your BMI is over 30-35, you probably need to lose some weight before pulling the trigger on a tummy tuck or liposuction. Here’s why:

Your trunk is made of multiple layers as you can see in this illustration. Importantly, we have both external AND internal fat. 

EXTERNAL FAT

This is the layer a fat that exists between the skin and the muscle layer. Essentially, it is proof that God doesn’t love us. It’s what you typically grab when you’re trying to demonstrate to your friends how shittily your diet is going. Picture a soft, jiggly layer of yellow jell-o, and that’s pretty much what it looks like. Its natural purpose is to act as a back-up energy storage in times of food scarcity, and, to ruin our summer Instagram pictures at the beach. 

Here’s the take-home point: THIS is the ONLY LAYER of fat that your surgeon can affect with a cosmetic procedure, be it liposuction or tummy tuck. Since it exists OUTSIDE of the internal organ-containing compartment, we can heat it or freeze it (thought this barely works), poke it with suction cannulas, or directly cut out chunks of fat without taking any risks to vital structures. 

 Internal fat is the core fat which sits UNDER the muscle layer, surrounding and cushioning your \ organs. Because it WITHIN the abdomen and intermingled with the vital organs, It CAN’T be reached by liposuction or cosmetic procedures. Hence, the only way to shrink this fat is by diet, exercise, or GI “weight-loss” surgeries reserved from those with high BMI’s. People who have an excess of this internal fat tend to have a round shape to their core, often bulging outwards in the classic “beer belly”. I’ll say it again: if you have an excess of this internal fat, YOUR SURGEON cant remove this with liposuction or tummy tuck. Furthermore, this fat will limit how tightly your surgeon can cinch your muscle with stitches. Typically, if your BMI is over 30, your levels of tyhis “visceral” fat are going to limit your result to some degree for the above reasons. — 

INTERNAL FAT

 Every week I see at least two patients who have been told by other surgeons looking to make a quick buck that they are an acceptable candidate. If your surgeon actually cares about your results, he or she will insist that you get your BMI close to 30 before performing surgery. If that is impossible, the only option is to lower the expectations of a washboard tummy. Any surgeon that seems too eager to get you on the operating room table is probably desperate for patients….for a reason.🤷🏻‍♂️🤷🏻‍♂️🤷🏻‍♂️.

This post has been written and illustrated by Dr. Subbio, a board-certified plastic surgeon specializing in tummy tucks in Philadelphia, the Main Line, South Jersey,  and beyond.