Most patients undergoing “tummy tuck” surgery (abdominoplasty) to remove excess skin and tissue after weight loss continue to lose weight in the months and years after surgery, suggests a follow-up study in the July issue of Plastic and Reconstructive Surgeryยฎ, the official medical journal of the American Society of Plastic Surgeons (ASPS). The journal is published in the Lippincott portfolio by Wolters Kluwer.
“We found that patients not only maintained their weight loss after abdominoplasty, but also continued to lose weight over time – up to ten pounds, on average,” comments senior author John Y.S. Kim of Northwestern University Feinberg School of Medicine, Chicago. “This postoperative weight loss appears greater, and increases at later follow-up times, in patients with initially higher body mass index [BMI].”
Continued weight loss up to five years after tummy tuck
Abdominoplasty is a cosmetic surgical procedure to improve the appearance of the abdomen. In 2023, ASPS Member Surgeons performed more than 170,000 abdominoplasties, according to ASPS statistics. Many of these procedures are performed in patients with massive weight loss that leaves them with excess, sagging skin.
Plastic surgeons have observed that patients may continue to lose weight after abdominoplasty. However, there is little research evidence on this issue, including whether the abdominoplasty procedure itself contributes to long-term weight loss.
Dr. Kim and colleagues performed a study to assess changes in body weight in 188 patients who underwent abdominoplasty between 2018 and 2022. Ninety-seven percent of patients were women. The average preoperative weight was about 168 pounds with a BMI of 27.7. Most patients underwent liposuction or a further procedure to remove excess fat (lipectomy) at the same time as abdominoplasty. Trends in body weight were assessed through up to five years after surgery.
The results showed continued weight loss after abdominoplasty. At three to six months, average weight loss was between five and six pounds, with about a three percent decrease in BMI. From one to four years, weight loss was about five pounds, for a BMI reduction of about two percent. By five years (in a limited number of patients), average weight loss was nearly ten pounds, with more than a five percent decrease in BMI.
‘Near-constant negative change in body weight’ after abdominoplasty
Overall, about 60% of patients lost weight during follow-up. Further analysis showed a “near constant negative change in body weight that did not significantly change over time,” the researchers write.
After adjustment for other factors, continued weight loss was more likely for older patients, for those who underwent liposuction/lipectomy, and those who had never smoked. Weight loss was greater for patients who had higher body weight and BMI before surgery, and for a small number of patients who used the newer weight loss medication semaglutide.
The study adds new evidence that “post-abdominoplasty weight reduction is a quantifiable phenomenon and that patients undergoing abdominoplasty continue to lose a significant amount of weight for up to five years after surgery,” the researchers write. They note some key limitations of their study, including varying follow-up times and potential confounding factors.
The study cannot definitively explain why patients continue to lose weight after surgery. However, Dr. Kim and coauthors write, “We have found that patients who were able to achieve weight loss after their abdominoplasty succeeded in developing healthy habits that centered around nutrition and exercise.” They highlight the need for an “evidence-based platform” to assess weight changes after abdominoplasty and to identify factors associated with long-term weight loss.