Obesity and Abdominoplasty- What BMI is Too High?*

Patients seeking abdominoplasty frequently are turned away because of obesity. Certainly abdominoplasty is ideally performed in patients who are either normal weight or moderately overweight. However, with proper patient selection, there are some patients you might benefit even in the obese category. This patient is a 59-year-old woman who has always been large framed. She has had difficulty losing weight through diet and exercise. She formerly was a weight lifter and has always had large muscle. She sought improvements in her abdomen. She did not expect to be slim. She had considered weight loss surgery but did not want to go through it. She was otherwise fairly healthy and her goals seemed to be realistic. She underwent abdominoplasty with liposuction of the abdomen and flanks. This was performed in a hospital operating room with an overnight stay because of her health risks. She was considered morbidly obese ( BMI 40) and this increases risks such as deep venous thrombosis, infection and wound problems. She did very well postoperatively with no significant wound healing problems. She did have drains in place which remained in for 2 weeks. After only 3 months she had significant improvements and has lost 20 more pounds. Morbid obesity is a relative contraindication to abdominoplasty; but with proper patient selection and conservative surgery, safe predictable good outcomes are possible.