Your BMI, or Body Mass Index, plays a big role in surgical complication risk assessment. All cosmetic surgery patients should have a BMI assessment prior to surgery. High BMI’s create higher surgical risks.
BMI’s > 35 create increased surgical risk
Since cosmetic surgery is optional, you should plan your elective surgery so that you limit as many surgical risks as possible. BMI is definitely one of the risks you can control and your BMI should be at an acceptable level before considering surgery. If your BMI is greater than 35, you have an increased risk of surgical complications.
BMI and surgical risks
Your BMI is a function of your weight and height. It is calculated by your body weight divided by your height squared. The more you weigh, the higher the number.
Surgical risks are definitely increased with higher BMI. These surgical complications include problems that can occur both during the cosmetic surgery procedure, as well as problems which manifest post operatively. Intraoperative risks include anesthesia and airway complications, which can both lead to serious injury or even death. Postoperative complications include pulmonary embolism and poor wound healing issues.
Here is the BMI guideline that I use to help determine eligibility for elective cosmetic surgery. These guidelines apply to all cosmetic surgery procedures performed under anesthesia, but they are most frequently addressed with Tummy tuck and Brazilian butt lift patients.
|BMI||Surgical Risk Level (Cosmetic Surgery)|
|25 – 29||low risk|
|30 – 35||relatively low risk if otherwise healthy|
|35 – 40||potentially high risk; surgery on case by case basis|
|over 40||high risk; will not perform elective surgery|
BMI less than 35
Patients who have a BMI less than 35 with no other medical conditions are reasonable candidates for cosmetic surgery. However, if you have any health issues, also known as comorbid conditions, it will definitely factor into the decision to have surgery.
BMI between 35-40
If your BMI is between 35 – 40, I will make the determination based on your current health profile. If you have NO medical conditions, I may approve you as a candidate for surgery, but I will also ask you to lose weight before surgery. However, if you have any medical conditions such as diabetes or high blood pressure, I will likely not approve you for surgery.
BMI greater than 40
If your BMI is above 40, you are not a candidate for elective surgery. I will NOT, under any circumstance, perform surgery on any patient with a BMI greater than 40 as the risk of surgical complications is just too high. If you are in this group, you should be focusing on weight loss and improving your general health first.
When patients come to my office with a BMI greater than 40 we generally spend a lot of time talking about ways they can reduce caloric intake and ways to increase their activity level. I ask patients to concentrate on losing some weight and then come back to see me in 3 to 6 months.
Reducing your BMI
Keep in mind that having a healthy BMI is not only good for lowering surgical complications, but also good for your general health. With a lower BMI, you will likely feel better. If I ask you to lose weight, do not despair, as this is a solvable problem!
Sometimes the extra boost of having a physician say ‘you need to lose weight’ even helps move the weight reduction process along. My experience is that patients are usually more committed to losing weight once a physician has explained the increased surgical risks associated with a high BMI. Fear is a great motivator!
While losing weight before having a cosmetic surgery procedure may seem counter-intuitive, a lower BMI will not only lower surgical complication risk, but you will very likely get a ‘tighter’ surgical result for procedures like Body lift and Tummy tuck. I always encourage patients to lose as much of their targeted weight loss as possible before surgery. However, it is totally fine to continue losing another 10-20 pounds after a procedure is performed without compromising the results.
Cosmetic surgery and BMI calculation
If you’re not sure where your BMI falls, you can use this quick BMI calculator for adults from the CDC by entering your height and weight and letting it do the math for you.
NIH BMI calculator app & BMI Table
If you’re tracking your BMI as you concentrate on losing weight, you can also download the National Institutes of Health’s BMI calculator app (available for iPhone). If you prefer the old-school method, you can use this BMI Table available at NIH to find your BMI range.
Please feel free to ask me any questions about BMI and co-morbid conditions below.