There is no one number that is right for every patient when it comes to how much weight they should lost before having plastic surgery. The answer depends on where they started, where they want to get, their build and how quickly the weight has come off. This is particularly true for post-bariatric surgery patients.
Excessive Weight Loss
Some patients become so excited about losing the weight that they have never been able to get off on their own that they overdo it and get to the point that they are too thin. It is important to set realistic goals and stay at a healthy weight rather than going from one extreme to the other. It is vital to keep in close contract with your surgeon or primary care physician to monitor your weight loss, make sure that you have not developed any vitamin or iron deficiencies and ensure that you stay in positive nitrogen balance.
BMI and Obesity
Other patients who have larger frames would look unnatural going too small and are satisfied once their BMI (body mass index) is below 30. Thirty is kind of a 'magic' number because any number over 30 is considered 'obese'. Many of the risks of surgery tend to go down when the patient's BMI is less than thirty. 'Normal" is less than 25, 'over weight' is 25-30 and 'morbidly obese' is greater than 35. You can calculate your BMI by multiplying your weight in pounds by 703 and dividing that number by the square of your height in inches. For example, a patient that is 5'6" and weight 180 pounds would have a BMI of 29.05 (180 x 703 / 66 x 66).
Target a Happy Weight
I encourage patients to at least get close to the weight that they are going to be happy with long term and would much prefer for that number to be such that their BMI is less than thirty. As previously mentioned, this reduces the risk of complications with surgery and allows me to concentrate on the areas that need the most work without having to worry about where they are going to lose more weight. The final long term result also tends to be much better when a normal or near normal weight is achieved prior to surgery.
It is also not uncommon to see patients who have plateaued in their weight loss at a level that is higher than what they should be and take the attitude of 'this is just where I'm going to be.' If that level is still in the obese range, chances are that high blood pressure and adult onset diabetes are on their way and the risks of complications such as bleeding, infection, blood clots and wound healing problems are higher. If you have already lost a significant amount of weight, you have gone a long way to improve your health. It is a crime to not keep going and get to a healthy BMI. Simply said: Don’t give up.