Higher Risk Abdominoplasty in Raleigh, NC

Higher Risk Abdominoplasty for Challenging Health Issues 

Hello, I’m Dr. Glenn Lyle, a board-cert ified plastic surgeon based in Raleigh, North Carolina. Abdominoplasty, or tummy tuck surgery , is one of the most rewarding procedures I perform. Seeing my patients regain confidence and feel more comfortable in their own body makes this procedure particularly meaningful for me. 

Abdominoplasty is a very common procedure which can help improve the appearance of the abdomen especially in women with prior pregnancies, loose skin and excess fat as well as split muscles (diastasis recti).  The procedure can be performed safely in many patients but there are significant risks that have to be taken into account.  Careful selection of patients should make this a fairly routine surgery but things like DVT and pulmonary embolism, infection, wound healing complications and fluid collections can happen even in healthy patients. 

While it’s highly effective in transforming the appearance of the abdomen, it’s important to understand that certain factors—such as a higher BMI or underlying health issues—can increase the risks involved. That’s why I’m dedicated to helping patients navigate their options and achieve life-changing results safely. 

Studies show that despite a higher complication rate with patients with risk factors - patient satisfaction can be high and results can be life changing.

Abdominoplasty Options for Higher BMI Patients 

Many people think they can’t have a tummy tuck because of their weight. Abdominoplasty can be an option for patients with a BMI between 30 and 40, provided it’s done under carefully controlled conditions. Patients often refer to these procedures as "plus-size abdominoplasty," "oversize tummy tuck," "big tummy surgery." or “Queen size tummy tuck.” These terms are popular on forums because they acknowledge the unique challenges and goals associated with higher BMI cases, making the procedure feel more approachable. 

BMI 30-35: For healthy patients in this range, surgery may often be performed in my office-based surgical suite. 

BMI 35-40: For patients who are otherwise healthy, these cases are typically done by me in a nearby hospital’s operating room to ensure the highest level of safety. For these patients, I may recommend an overnight stay for monitoring depending on your general health. 

It’s important to note that abdominoplasty is not a weight-loss procedure but rather a body contouring surgery that removes excess skin and fat while repairing stretched abdominal muscles. If you’re committed to improving your health and appearance, even if you’re carrying extra weight, we can work together to develop a safe surgical plan. 

Weight loss prior to surgery is always encouraged. Many patients may benefit from using GLP-1 medications or getting help from a physician-directed weight loss program. If you have not made sufficient efforts at weight loss, especially in the higher BMI category, I do not recommend surgery. You should use the money  that  you would have used on surgery for a more serious attempt at weight loss. 

Addressing Risks and Reducing Complications of a Challenging Abdominoplasty   

Abdominoplasty, particularly in higher-risk patients, requires meticulous planning and care. Risks include deep vein thrombosis (DVT), pulmonary embolism, infection, wound healing complications, and fluid collections. Here’s how I work to minimize these risks:     

• Preoperative Assessment: During your consultation, I’ll review your medical history, BMI, and lifestyle factors like smoking or vaping. Together, we’ll determine if abdominoplasty is a safe option for you.     
• Smoking and Vaping: Smoking significantly increases the risk of complications, including tissue damage and poor wound healing. Studies show that smoking can raise the risk of wound healing complications by up to 50%, making it essential to quit or reduce smoking for some time before & after surgery. If you smoke or vape, I’ll work with you to create a plan to cut down or quit before surgery. Many patients find this surgery is a great motivator to improve their overall health and quit altogether.     
• Hospital-Based Surgery for High-Risk Patients: For patients with higher BMIs or underlying medical conditions, surgery in a hospital setting with overnight monitoring can provide added peace of mind and safety.     
• Optimizing Your Health: If you have a condition like asthma, diabetes, or high blood pressure, we’ll coordinate with your primary care provider or specialist to help ensure these are well-managed before surgery. Poorly controlled medical conditions would preclude the safe performance of an elective surgery .     
• Conservative Approach: In some cases, I may recommend forgoing liposuction or combining procedures to keep surgery time shorter and reduce risks.     
• Efficient Surgery: I have performed over a thousand tummy tucks so I expect the surgeries to proceed in an orderly and predictable fashion. Every case is unique but being an experienced and efficient plastic surgeon allows for more expeditious procedures and this can reduce complications such as DVT and infection which can increase with increased operative time.    

As I always tell my patients, “Safety first, always.” A thorough evaluation and personalized surgical plan go a long way toward minimizing complications and maximizing your results. 

What Constitutes Higher Risk?    

• Smoking - NOTE - no active smokers should have abdominoplasty    
• Hypertension - must be well controlled and not associated with heart disease    
• Diabetes - only well controlled patients are considered    
• Pulmonary issues - this is one of the most important risk factors. General anesthesia can affect your breathing and patients with major breathing issues( asthma, pulmonary fibrosis, emphysema, etc ) would preclude a safe operation    
• History of blood clots - abdominoplasty alone can increase your risk of deep venous thrombosis, so if you have had a clot before, you may not be a candidate or need blood thinners post operatively.    
• Other medical conditions must be discussed with Dr. Lyle to determine the wisdom of proceeding with surgery.  

Life-Changing Results of a Tummy Tuck Surgery

Despite the higher risks, the results of a tummy tuck can be transformative. Patients often report a boost in confidence, improved mobility, and greater comfort in clothing. For some, the surgery is the first step toward a healthier lifestyle, as they feel more motivated to maintain their results through diet and exercise. 

Many patients describe feeling more confident, comfortable, and motivated to maintain a healthier lifestyle after surgery. One of my favorite parts of my job is seeing my patients’ reactions when they see their new contours for the first time. “This is why I do what I do,” I often say, “to help people feel better about themselves.” 

Real Patient Results - A Higher Risk Tummy Tuck

This 61-year-old woman desired an abdominoplasty but she had pretty significant pulmonary problems including asthma that often-required steroids and she has had prior hospitalizations for this condition.  She was very motivated to have this procedure.  After clearance by her pulmonologist and maximizing her medical management, the patient underwent an abdominoplasty in the hospital setting with a planned overnight stay for monitoring.  She did very well without any postoperative complications and no pulmonary issues. (see photos above)

Contraindications to tummy tuck are usually somewhat relative. Selected higher risk patients can undergo this procedure as long as they are aware of the risks and proper perioperative management is followed. In some cases, a more conservative approach is taken to reduce risks.  Adding liposuction for example may increase risks so it may not be offered and combining other procedures may not be wise.   

NOTE:  Dr. Lyle prefers to do higher risk patients in a hospital setting often recommending an overnight stay for safety reasons.

Take the First Step 

If you’ve been considering abdominoplasty but worry that your weight or health might hold you back, I encourage you to schedule a consultation. Together, we can discuss your goals, address your concerns, and develop a customized plan that prioritizes your safety and satisfaction. 

At my practice in Raleigh, NC, I specialize in helping patients of all shapes, sizes, and backgrounds achieve the confidence they deserve. Let’s explore what’s possible for you—no matter where you are on your journey. 

Abdominoplasty is a very common procedure that can help improve the appearance of the abdomen, especially in women with prior pregnancies, loose skin and excess fat, as well as diastasis rectus.  The procedure can be performed safely in many patients but there are significant risks that have to be taken into account.  Careful selection of patients should make this a fairly routine surgery, but things like DVT and pulmonary embolism, infection, wound healing complications, and fluid collections can happen even in healthy patients. 

The suitability of this procedure should be determined by consulting with a board-certified plastic surgeon.  Issues like body mass index, underlying health conditions as well as smoking status affect the decision as to whether you are healthy enough to proceed. 

Contact Us Today 

Ready to take the next step? Call our office or fill out our online contact form to schedule your consultation. I look forward to meeting you and helping you achieve your transformation. 

Medical Reference      

• Abdominoplasty in the Overweight and Obese Population: Outcomes and Patient Satisfaction. Plast Reconstr Surg 2019 Oct; 144(4) :847-853. 

About Dr Lyle - Plastic Surgeon in Raleigh NC 

Dr. Glenn Lyle is a board-certified plastic surgeon serving the Raleigh, NC community at Lyle Plastic Surgery & Aesthetics Center since 2002. With over 30 years of experience, he specializes in breast surgery and body contouring, to enhance patients' appearance after weight loss, pregnancy, and aging.  

Dr. Lyle completed his medical degree at Wayne State University School of Medicine, followed by a general surgery residency at the University of Massachusetts and a plastic surgery residency at the University of Texas Medical Branch. He is certified by the American Board of Plastic Surgery and is a member of both the American Society of Plastic Surgeons and the American Society of Aesthetic Plastic Surgeons.  

Throughout his career, Dr. Lyle has contributed to the field through research, publications, and presentations at national meetings. His practice emphasizes patient safety and personalized care to achieve natural results. 

Next Steps 

If you’re considering an abdominoplasty surgery in Raleigh, NC, and want personalized advice about your suitability, recovery, risks and results, I’d be happy to meet with you for a consultation. Let’s work together to help you achieve your best results—safely and beautifully. 

To book a consultation please fill in the contact form or phone the office on 919 307 85 85.