Tummy tuck for plus sized clients

48-year-old female patient three months after her tummy tuck – frontal view

48-year-old female patient three months after her tummy tuck – left oblique view

48-year-old female patient three months after her tummy tuck – left view

Tummy tucks for plus sized clients provides multiple challenges not observed with normal BMI patients. Plus sized clients possess a BMI of 25 to 35, more generous fat depositions, and skin redundancies. Both of these elements raise their weight which adversely affects their BMI. When skin becomes redundant, several changes result that make a tummy tuck more difficult than routinely performed tummy tucks. These factors include both fat excess and skin redundancy of the abdomen that a) leans over the pubic region, b) creates prominent love handles, and c)creates exaggerated upper body prominence. 

Pubic region fullness

The pubic region is naturally generous in fat. However, skin redundancy from the lower abdomen can lean on the pubic region. This causes not only a full pubic region but one that is often sagging. In order to correct this concern, a tummy tuck with a lower incision than traditionally used is necessary. The lower incision will allow for transposition of the pubic region to an aesthetically pleasing position and size.

Prominent love handles

Clients can observe prominent love handles over the lower back and flanks due to both excess fat and redundant skin. This requires an extended tummy tuck in order to eliminate lateral flank and lower back fullness because these areas are not amenable to liposuction alone. These areas are very fibrotic and high in connective tissue density. Tissues that are high in connective tissue density do not fare well with liposuction which can only remove fat and not collagenous tissues. 

A staged surgery for plus sized clients

Since plus sized clients fall in the 2 to 4 range score on the HDL body scale or a 32 to 36 BMI. This means they will benefit from a staged tummy tuck procedure. Staging of their tummy tuck is recommended for two reasons. First, the generous adiposity of the upper and mid abdomen. Second, the infrequent laxity in both the vertical and horizontal vector. The conventional tummy tuck addresses lower abdominal skin redundancy and fat excess. However, by virtue of performing extensive undermining, it is not amenable to liposuction of the upper and middle abdomen.

In a staged tummy tuck procedure patients must wait three to six months for their abdominal skin flap to heal. After, they may undergo liposuction of the upper and middle abdomen. Clients with generous skin redundancy will have their vertical redundancy eliminated at the time of their initial tummy tuck. However, clients may consider an upper body lift that can eliminate any residual horizontal skin redundancy that remains following healing of their tummy tuck.

Tummy tuck for the plus sized Conclusion

Tummy tuck for the plus sized clients is different from the conventional tummy tuck clients since they possess more generous skin redundancy and fat excess. As such traditional tummy tuck procedures will be modified to minimize a more generous pubic region and eliminate love handles. Finally, a staged procedure is often advocated to address both generous upper and middle fat deposition, and residual horizontal skin laxity that are not amenable to correction during the original tummy tuck surgery.