Obese Woman for Tummy Work?
In an ideal world you would lose another 80 pounds, getting your BMI to 30, and that would decrease your operative risk and improve your outcome. Congratulations on what you have accomplished so far.
It would take another 80 pounds to reach BMI of 30. That number is a guideline,and not an absolute. The basis is that risks of wound problems and other complications is higher, and the outcomes are not as good.
But the decision may be to go ahead anyway. When I say the outcome is not as good, one possibility is that you will go on and lose 80 more pounds and you may be looking at another tummy tuck because there will be more excess tissue.
Best bet would be a consultation with a plastic surgeon, as this will not be resolved on line. When you are ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified, but also is a member in good standing of the major plastic surgery organization in the U. S. T (Jourdan Gottlieb, MD, Seattle Plastic Surgeon)
However we cannot get the best result while you are at your current BMI. To get into a weight range that would be appropriate for your height would be 220-240 pounds, the closer to 220 (or less) the better. It has to do with safety of the surgery also as well as the final result.
Once you get into that weight range, see a board certified plastic surgeon that has considerable experience in body contouring after major weight loss (it is not the same as the usual cosmetic tummy tuck) and get a consultation. You will be very surprised at the pleasing result you can get at that point. (Ronald V. DeMars, MD, Portland Plastic Surgeon)
Tummy tuck in the obese patient
You would benefit from the tummy tuck. You need to understand that the risks are higher in the obese patient and that you would also need to be medically cleared by your internist. I would recommend that you see him first before exploring plastic surgery.
If he feels that you can undergo surgery, then understand that the operation will be costlier and more difficult than in the thinner patient and that, if you continue to lose weight afterwards, revision, at an additional cost, will be necessary. (Robert L. Kraft, MD, New York Plastic Surgeon)
It sounds like you have made some very nice improvements. A tummy tuck is a cosmetic procedure and you want to be in the best condition possible. Most of the time a patient should be in a weight range that is safe for surgery and reduces the chance of a complication. The best indicator for this is the BMI scale. In my practice I ask that the patient be below a BMI of 30 to do a final body shaping procedure. Less invasive procedures that might be used in the mean time is a panniculectomy and lift of the pubic area. Some liposcution could also be done to help with the most significant areas of excess. Many times this will help the patient on the way to the final goal weight where they can accomplish the nice cosmetic tummy tuck. (Marcus L. Peterson, MD, Saint George Plastic Surgeon)
Tummy tuck or liposuction for Plus size women
Obese women who have excess abdominal fat as well as skin folds might cosider several options prior to undergoing a tummy tuck. They can either undergo a large volume liposuction to remove excess fat in the upper abdomen, flanks, and lower back; or they can undergo a gastric bypass surgery. For patients who don’t want to undergo bariatric surgery I have been able to successfully deliver dramatic results with a stage large volume liposuction and extended tummy tuck. (S. Sean Younai, MD, FACS, Beverly Hills Plastic Surgeon)