Is there an ideal weight for a person having plastic surgery? That’s an important question that has a number of issues attached:
- Having a stable weight before surgery is important. If a person loses weight after surgery, the improved appearance obtained at surgery may suffer. For instance, a person who undergoes a tummy tuck and then loses weight will often accumulate additional loose skin in the tummy area, or a facelift patient will sag again in the face and neck region. Generally a weight loss of up to 10 pounds is well tolerated after surgery, but even this can be detrimental in a 100-pound female since it represents 10% of their total weight. On the other hand, a modest weight gain after surgery does not usually pose a problem for the surgical result.
- A person who is overweight may have health issues that arise in the course of the operation or in the post-operative recovery period. Studies have documented that a person with a BMI over 30 has a greater chance of complications, and that the greater the BMI, the greater the risk.
- Does this mean that a person with a BMI over 30 should not have plastic surgery? No. The policy that I follow is to counsel the patient to see if weight loss is possible or desirable in their eyes. Many patients may have difficulty losing weight before surgery or may be unwilling to do so. If their weight does not pose an unacceptably high risk for anesthesia and if they are in otherwise good health with an OK from their medical doctor, I will consider performing surgery. Interestingly, my major complication rate following surgery does not seem to bear any relationship to the patient’s weight, although I rarely operate on anyone with a BMI over 35. My minor complication rate may be slightly increased, but these minor issues are easily dealt with.
- Interestingly many patients who are overweight may go on to lose significant weight after surgery since their improved self-image may motivate them to seek further improvement in their appearance by weight loss. In a very real sense plastic surgery is the catalyst that gets the weight loss process going!
- What about a person who is underweight? Certainly an abnormally low BMI can also be a problem, particularly if it is associated with malnutrition. The patient should be evaluated by their medical doctor. If there is a question of anorexia, psychological evaluation is required since this type of patient should not be undergoing a cosmetic surgical procedure.
- A person who has undergone a significant weight loss (> 25% of their body weight) should wait until their weight is stable and then defer surgery for several more months. Skin shrinkage may change the surgical plan, and physiological adaptation to the new weight may take several months to occur. Before embarking upon surgery, medical clearance is appropriate to make certain that the timing of surgery is appropriate.
Should you have further questions, please contact my office.
George Sanders, M.D.
