Q: Dr. Eppley, I have lost 65 lbs over the past year through diet and exercise. At 5’4” and 180 lbs, my BMI still says I am obese. I would really like to go ahead and have my abdominal apron removed now because I am sick of it, it makes me look bad and gets in the way of me exercising. Should I lose more weight before having the surgery or just go ahead and have the apron removed now? I know doctors like to have your BMI below 30 before surgery so I am not sure what to do. I have attached some pictures of my gross stomach for you to see.
A: The timing of when to do an abdominal panniculectomy/tummy tuck in the course of one’s weight loss is a common one. There are no absolute guidelines other than the more weight loss the better. BMI is a useful measurement but it is still just a number. What counts is the size of your pannus, what the rest of your body looks like, and how your weight loss is progressing. Many patients with abdominal pannuses ‘hit the wall’ so to speak in their weight loss and the size and weight of the pannus becomes limiting at that point. Based on the pictures you have shown, I think you would be best served by moving ahead now with your abdominal panniculectomy procedure. Your body is not that big compared to the size of the pannus. You would look and feel so much better if it were removed. This would make it easier to function and exercise and you would be more likely to lose weight if you desire after its removal than with where you are currently.
Dr. Barry Eppley