In our first part of this series, we considered how a patients weight would affect their risks during elective Plastic Surgery. In this second part, we will consider how weight will affect the cosmetic outcome of our surgery and whether patients should or should not lose weight prior to surgery.
A variety of Plastic Surgery procedures may be affected by a patient’s weight. The most common procedures where this may be an issue is in facelift surgery, breast reduction and breast lift surgery, abdominoplasty (tummy tuck), and liposuction. As we discussed previously, we would like a patient to have a BMI < 30 prior to having any elective surgery because this tends to improve their healing and decrease their risk of complications.
For the patient with a BMI < 30, they often want to know if they should lose weight prior to their surgery. This really depends upon how a patients weight affects the area that we are considering performing surgery upon.
When patients lose weight, certain regions are affected more than others. This varies from patient to patient. For example, there are some patients who lose a great deal of volume in their breasts when they lose weight. If we were performing a breast reduction with the goal of creating a certain “cup” size, then weight gain or weight loss after the surgery would significantly affect the result. There are many patients in whom weight loss does not dramatically affect the appearance of a certain region. So for example, if the patient was considering a facelift and their face is not significantly thinner with weight loss, the result would not be expected to affected after surgery.
We also consider the individual and their dieting habits. There are some patients who may have only recently (over the last one or two years) gained weight and they are confident that they can lose this weight and maintain their normal weight. In this patient it may be reasonable for them to try and lose the weight prior to surgery. Clearly, certain areas of the body and certain procedures have significantly enhanced results if the patient has less body fat.
However, weight loss may not be necessary for every patient. For example, say we have a patient that has a stable weight that is 15-20 pounds overweight. The patient is seen because they would like to decrease the volume of the fat in their belly with liposuction and they would like to take that fat and perform either fat injections to their breasts or a Brazilian butt-lift. Weight loss in this patient would eliminate the need for liposuction but it would also eliminate the opportunity to enhance their breasts or buttocks with this method.
Other patients may be yo-yo dieters. This means that they frequently increase and decrease their body fat with dieting. If this patient were to lose weight for the surgery, have their procedure, and then gain the weight back, there is a significant chance that they will be disappointed with their results.
Thus there is no general answer that can be given as to whether it is recommended for all patients to lose weight prior to their surgery. Each patient and their expectations must be evaluated individually.