Body Contouring of the Obese Patient I do not recommend body-contouring procedures (liposuction, tummy tuck, flank lift, thigh lift etc.) for most patients who are obese. Liposuction and body contouring rarely removes more than 5 - 10 pounds of fat. That’s not much weight if you are obese. Also, the fat removed surgically does not make you healthier. It does not lower your blood pressure, lower your blood sugar or cholesterol. Losing the fat through diet and exercise does have the above benefits in addition to your improved appearance and sense of accomplishment. If you gain weight following body-contouring surgery, it is unpredictable where the fat “will go”. It often will accumulate in untreated areas leaving the patient not only still obese but with sometimes bizarre and unnatural fat distribution. Obese patients are at much greater risk for surgical complications such as blood clots in the legs or lungs, healing problems, fluid collections at the surgical site, and wound infections. Such complications can prolong your recovery or even land you in the Intensive Care Unit (or worse). The risks will often outweigh the benefits in obese patients. Many obese patients are disappointed with their surgical result. No matter how much I tell you and you tell yourself this type of surgery will not make you thin, deep down inside that is the expectation of many obese patients. It is so painful for the patient (and the surgeon) to realize that all that surgery, recovery time, discomfort and expense did not get you where you want to be. It is a fallacy that this type of surgery will “jump start” a diet and exercise program. I have never seen this happen. After surgery you are sore and have activity restrictions for several weeks. This is hardly the time to start an exercise program! Also, you will need narcotic pain medications, which are taken with food to reduce nausea. You also need some extra protein and calories to help with healing. This is hardly a time to start a diet! It is not at all unusual for patients to gain weight after surgery because of a decrease in activity and exercise. In patients with normal weight and health eating habits, this weight gain is temporary. In obese patients, it is often not. I recommend you do something else for yourself to “jump start” your diet and exercise program. You may want to hire a personal trainer, a lifestyle coach, a nutritionist or join Weight Watchers or Overeaters Anonymous. To paraphrase Oprah, a recognized expert on weight loss, “The big secret is that there is no secret.” To paraphrase her personal trainer, Bob Greene, “Losing weight will not change your life. But you will lose weight if you change your life.” I hope this clarifies why I do not recommend surgery for most obese patients. Please make an investment in yourself and make the lifestyle changes necessary to loose weight and in the process gain health. I would be happy to see you again once you have stabilized at or near your target weight. Any bulges or sags left over can likely be treated safely and effectively with surgery. If you “shop around” enough, you will likely find someone willing to do your surgery. It is possible that this someone has a different opinion due to different training and experience. It may also be that this someone is using poor judgment with patient selection. Proceed with caution.