Tummy tucks or abdominoplasties are a very popular body contouring procedure because it is tremendously effective.While diet and exercise are extremely important for weight loss, it will not get rid of loose skin. Conversely, tummy tucks are not a substitute for weight loss and should not be performed in a persistently obese patient under most circumstances.
But an interesting question about weight loss and tummy tucks, often asked by patients, is how much weight will be lost after surgery.While a tummy tuck is not a weight loss surgery, clearly some weight is lost from what is removed during surgery. If so, is more weight eventually lost than what is physically removed? And if so, how much and at what point after surgery will that weight loss be seen?
These very tummy tuck questions were addressed in the February 2013 issue of the journal Plastic and Reconstructive Surgery in an article entitled ‘Weight Reduction following Abdominoplasty: A Retrospective Case Review Pilot Study’. In the studied patients who underwent abdominoplasty, all patients had weight loss after surgery that eventually exceeded that of the tissues actually removed. The maximal weight loss was achieved at roughly 12 weeks after surgery. The weight loss was attributed to an increase in satiety in most patients. In those patients that had a body mass index greater than 24.5 kg/m2 and tissues removed that weighed greater than 4.5 lbs, their weight loss was sustained at one year after surgery.
This study supports what I have seen in many tummy tuck patients. Weight loss will always be greater than what was removed in surgery and will appear at the following times after surgery. Initially in the first weeks after surgery the patient will actually weigh more than before surgery due to fluid retention. This is why I tell patients to never weigh themselves at this time. By three weeks after surgery, the retained fluids are lost and the weight loss will nearly match the tissues removed. (surgical weight loss) Over the next month, the weight loss will almost double reaching its peak 8 to 12 weeks after surgery. The study attributes this is due to satiety, and this is certainly one factor, but another important reason is the calories consumed by the body to heal a large tissue wound. Less intake and more calories burned equals more weight loss. (what one might call surgical healing weight loss) It is the combination of surgical and healing weight loss that accounts for why more is eventually lost than what is just removed.
This study also shows that the weight loss after a tummy tuck is sustained at one year after surgery, an encouraging finding for patients. Whether this is due to some change in neurocrine function or sustained enthusiasm based on the physical and financial investment in the surgery is not yet clear.
Dr. Barry Eppley