Richard J. Wassermann, M.D., MPH, FACS
I want to have a tummy tuck. I am a 31 year old female and I have had two c-sections. The last one was just over two years ago. With my first pregnancy I had Gestational Diabetes and gained over 100 pounds. My starting weight was 140. After I had my first child I was able to get my weight down to 185 pounds. I then found out that I was pregnant again. In the last seven months I have lost another 25 pounds and my current weight fluctuates between 158 and 162 pounds. I can't seem to get any lower than that. Should I wait to have the tummy tuck surgery until I have lost more weight or will having the surgery now make getting to my goal weight of 145 easier? If I proceed with the surgery now, will losing the additional weight afterwards have any impact on the results of the surgery?
The problem you describe is a common one. It is sometimes better to determine what is your current healthy baseline weight rather than your weight prior to any pregnancies. It is hard to evaluate your current weight without knowing your height. A measure called body mass index relates height to weight and may give us a better idea of when you might be a better candidate for surgery. The changes to the post partum female abdominal wall can be severe. Once a patient has reached a healthy baseline weight, then they may consider surgery. Usually with a successful breast or body contouring surgery, patients experience an increase in self esteem and may actually experience a slight drift down in weight which ultimately enhances the result. A post surgical weight loss of 10-15 pounds can enhance a result. I usually recommend to patients an aggressive procedure called an anterior torsoplasty which includes suction assisted lipectomy of adjacent areas, strengthening of the abdominal wall, repair of hernias if encountered, and re-suspension of the inguinal crease and mons. A global approach to the post partum female abdominal wall is required. Although it is a comprehensive procedure, additional procedures can be safely added at the time of surgery, e.g., breast surgery. In your case, a personal consultation with a Board Certified Plastic Surgeon will likely give you a better idea of what your options are at your current weight.