Patients Continue to Lose Weight Years After Tummy Tuck

Most patients who undergo “tummy tuck” surgery to remove excess skin and tissue after losing weight continue to lose weight in the months and years after surgery, new research suggests.

The follow-up study appears in Plastic and Reconstructive Surgery.

“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 YS Kim of Northwestern University Feinberg School of Medicine in Chicago. “This postoperative weight loss appears greater and increases at later follow-up times in patients with a higher initial body mass index [BMI].”

Continued weight loss up to five years after abdominoplasty

Abdominoplasty is a cosmetic surgery to improve the appearance of the abdomen. In 2023, ASPS Member Surgeons performed more than 170,000 abdominoplasty procedures, according to ASPS statistics. Many of these procedures are performed on patients with massive weight loss that leaves them with excessive skin laxity.

Plastic surgeons have noticed that patients may continue to lose weight after abdominoplasty. However, there is little research evidence on this topic, including whether the tummy tuck itself contributes to long-term weight loss.

Dr. Kim and colleagues conducted a study to assess changes in body weight in 188 patients who underwent abdominoplasty between 2018 and 2022. Ninety-seven percent of the patients were women. The mean preoperative weight was approximately 168 kg with a BMI of 27.7. Most patients underwent liposuction or a further procedure to remove excess fat (lipectomy) at the same time as the abdominoplasty. Trends in body weight were assessed up to five years after surgery.

Results showed continued weight loss after abdominoplasty. At three to six months, the average weight loss was between five and six kilograms, with about a 3% reduction in BMI. From one to four years, the weight loss was about five kilograms, for a reduction in BMI of about 2%. By five years (in a limited number of patients), the average weight loss was almost ten kilograms, with more than a 5% reduction in BMI.

“Almost constant negative change in body weight” after abdominoplasty

Overall, approximately 60% of patients lost weight during follow-up. Further analysis showed an “almost constant negative change in body weight that did not change significantly over time,” the researchers write.

After adjusting for other factors, continued weight loss was more likely for older patients, those who underwent liposuction/lipectomy, and those who had never smoked. Weight loss was greater for patients who had a higher body weight and higher BMI before surgery and for a small number of patients who used the newer weight-loss drug semaglutide.

The study adds new evidence that “weight loss after abdominoplasty is a measurable phenomenon and that patients who undergo abdominoplasty continue to lose significant 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 confounders.

The study cannot explain for sure why patients continue to lose weight after surgery. However, Dr. Kim and co-authors write: “We found that patients who were able to achieve weight loss after their abdominoplasty were able to develop healthy habits that focused on diet 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.