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I am female, 69 years old, 5' 2" and weigh 230, which puts me in the morbidly...

Q:

I am female, 69 years old, 5' 2" and weigh 230, which puts me in the morbidly obese category. As far as I know with the exception of all the weight I am carrying and probably high cholesterol, my heart is strong and I am as healthy as one can be at this height and weight. For the last 20+ years I have tried to lose weight on every diet I can find, but I lose very little and stay consistently between 200 and 228 pounds.  I absolutely cannot stand how I look and want to talk to someone about the possibility of having a tummy tuck (though that term seems inadequate for the problem I have with the stomach).  I had two Caesarians about 40 years ago. My stomach has been hanging down ever since. Until I was 40, it was a problem that could be hidden with the right undergarments and clothes. Now, at 230 pounds there is no hiding my large hanging stomach, the discoloration of the tops of my thighs and all around ugliness. It is causing me to be so ashamed.  The chances of me losing all this weight are very small, yet I know my size and age are against me. Is it possible that a tummy tuck can be done?  I know the answer is to lose my weight before the tummy tuck, but I have known that for at least ten years and it still hasn't happened. I am desperate for someone's help with problem. I cannot stand to look at my stomach, clothed or unclothed any more.  I am not trying to look 20 or even 40, but I do look younger than my age and feel this would give me some sense of confidence and feeling feminine again. PLEASE, in your opinion, is there any competent surgeon who will do a tummy tuck or at least talk to me about it?  How do I go about finding one?

A:

It all depends on understanding your expectations and accepting the RISKS.  It seems you are informed and educated enough to understand both issues.

The tummy tuck you are asking for would be more like a "panniculectomy" with repositioning of the belly button, and maybe tightening of the muscles (very gently).

The result will be to remove the overhanging skin and fat, THAT IS ALL.  At your present weight, the risks (including death) are high .

Consult a Board Certified Plastic Surgeon to discuss your options, risks and results.

 

A:

I am a Board Certified Plastic Surgeon who sees many patients just like you and have done body contouring for 20 years.  Although a tummy tuck is not out of the question depending on your health, I would not recommend it as a first line choice.  In reality, even with a perfect surgery and additional liposuction, your improvement with "tummy tuck " surgery would be modest at best and it would actually fall more into the category of a "panniculectomy."  You seem to be seeking a significant improvement in your appearance and this would only make you look "less overweight" as opposed to giving you the look you have sought for so long.  In addition, the procedure would carry moderate risk in terms of deep vein thrombosis and would require several hours at your current weight.  Many surgeons would not perform it all , although there are also a number of very experienced surgeons who would do this if you were in good health,  had no other alternative, and had failed weight loss programs multiple times. So, what is my recommendation?  I have had absolutely excellent results with patients just like you with laparoscopic gastric bypass procedures ( LGB). After all, at your current weight and age, the primary issue is actually living a longer life and you need to do something significant soon or you will have more serious issues due to your weight. The term "morbid" obesity is used because of the secondary morbidity from being more than 100 pounds over ideal body weight. Many patients do not seek gastric bypass due to inaccurate anecdotal stories they have heard.  While there is some risk, it is actually quite small and the overwhelming majority of these procedures are very successful in the hands of qualified doctors.  In addition, there is risk to continuing like you are as well.  If you had LGB, then you would lose around 100 pounds in a year and then you would be an excellent candidate for truly significant body contouring surgery, which would be less risky at a lower weight.  Then you would have both the tremendous change in your weight as well as the health benefits from being closer to ideal body weight. You can find a reputable LGB surgeon through the American Society for Metabolic and Bariatric Surgery (ASMBS).  Lastly, and perhaps most importantly, I would encourage you to find out the answers to any concerns you have about weight loss surgery from the doctors themselves and not websites or friends.  I wish you all the best.

A:

I do recommend that patients lose weight before any cosmetic surgery procedure rather than after it, but if a person does not plan on losing weight then I definitely can do a tummy tuck.  It may be more involved but the results are usually satisfying for the patient.  All the excess skin and fat can be removed.  This I usually perform as an outpatient.  I recommend you watch my videos and get more information on my website (www.surgery-plastic.com).  We have excellent financing available as well as several specials.

Dr. Domanskis

Edward J. Domanskis, M.D., FACS - View Other Answers by this Doctor
Newport Beach, CA

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