– Wait, my weight is too high?

– Why are you telling me I am not a candidate?

Isn’t that the whole point of having plastic surgery??”


Actually… No! Plastic Surgery is considered elective because it is being done for cosmetic purposes.
Therefore, ideally, the patient should be optimized so that he or she can obtain the best result, for as long as possible!


What’s your BMI?

In order to figure out who is a good candidate for body contouring plastic surgery, i.e. liposuction, abdominoplasty, brachioplasty, BBL, liposculpture, thigh lifts, body lifts, etc, etc. Most Plastic surgeons are guided by the BMI: body mass index. This is a scale that takes into account your weight against your height. The higher the weight for any given height, the higher BMI. Use this BMI calculator, or the chart below to see where you stand.

What's Your BMI - BMI Chart - Jennyfer F. Cocco MD - Plastic Surgery



The Ideal BMI

The ideal surgical candidate has a BMI lower than 25. Why? Because the higher the BMI, the more chances there is a lot of fat trapped within the core of the abdomen. We call it central fat or visceral fat (see graphic below) because it envelopes the internal organs. This is fat that cannot removed by means of liposuction. Doing surgery in this case will leave the patient with a round figure, not thin, and it is the reason why many are unsatisfied after plastic surgery.

What's Your BMI - Visceral Fat / Grasa Visceral - Jennyfer F. Cocco MD - Plastic Surgery

Visceral Fat is the Culprit

Plastic surgery in the means of body contouring liposuction only modifies the fat that can be pinched within the fingers. If there is excess skin that can be pinched off such as in the lower abdomen, or in the arms, then it is removed by means of a tummy tuck or an arm lift. For a quick assessment of where you stand follow these easy steps:

  1. stand straight.
  2. Pinch the lower abdomen using your two hands.
  3. What is the thickness between your thumb and fingers? and is there excess skin, even folds?
  4. Imagine what it would be like to simply cut away everything you are pinching off?
  5. Next, imagine putting together the skin to close back the large wound left behind. If there is a significant difference between the thicknesses of the upper wound with the lower wound, there is a higher chance the wound will not heal quickly.


The higher the BMI, the higher the risk

Lastly, the most important reason as to why optimizing BMI is paramount, is because the higher the BMI the more risks and complications can happen with anesthesia and in the postoperative period. Such as higher risk of developing blood clots. As surgeons, we are trained to evaluate these risks and optimize them as best we can. I always tell my patients if they shop around enough, they will eventually find a surgeon that operate without optimizing (this is supposed to be scary), the more ethical surgeons will advise the patient and wait to do surgery until the he or she has lost weight. This can be extremely hard for the patient and the surgeon. I feel bad, I seem to turn a lot of patients away as loosing even 20 pounds is not a simple feat, but the way I see it, it is for the patient’s safety. In the end, he or she will have better results and I will sleep well, knowing that my patients will be happier and with less risk.

Dr. Cocco | Jennyfer Cocco, MD

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