Ask Dr. Pane! What is the ideal BMI for a tummy tuck, a BBL, and a mommy makeover?

At Atlantic Coast Aesthetics, we often get questions from patients who are concerned that they may be too heavy to undergo certain types of cosmetic surgery. In many cases, these fears are unfounded, but in some cases, a higher BMI can make the difference between undergoing a certain procedure and not. Dr. Thomas Pane, our founder and Chief Medical Officer, tackled this topic during a recent Ask Dr. Pane segment on Instagram Live, during which the question was posed, What is the ideal BMI for a tummy tuck, a BBL, and a mommy makeover? We’ll listen in on what Dr. Pane had to say about this important topic, but first, let’s review what BMI is.

BMI stands for “Body Mass Index,” a calculation based on an adult human’s height and weight that defines what is typically considered an ideal weight range. A BMI of 18.5-24.9 is considered an ideally healthy weight. Anything under 18.5 is underweight and anything over 24.9 is overweight. A person is typically considered to be obese when their BMI exceeds 30.

It’s important to note that BMI by itself is not necessarily the be-all, end-all of determining a given person’s health and may not apply perfectly to every patient or situation, such as transwomen, who might be considered within the ideal range for their assigned gender at birth but may fall into the overweight category for their actual gender. However, despite its well-documented flaws, the BMI scale remains one of the most enduring metrics for determining a healthy weight range, at least until something better, more inclusive to trans people or more specialized to different body types comes along and achieves wide acceptance within the medical community. For this reason, your BMI is still a very useful and important piece of information.  

Dr. Pane had this to say about BMI for various applications.

“For a BBL, we like to be 32 or less because the results tend to be less dramatic when you get into the higher ranges. It can be done, but we’d need to see the patient in person and get a feel for what’s going on.” Again, this is partly to ensure optimum results, but also to account for the fact that different people carry weight differently in certain areas of their bodies even at a lower but technically overweight BMI. Remember that everybody is unique, and what holds true for a given person may not be for the next, even though on paper they’re functionally identical in terms of their vital stats and BMI.

“For the other surgeries, we really wouldn’t want to go over a 38. Those are surgery center rules because the anesthesiologists don’t like to put somebody to sleep over that number, but I think the rule in Florida is [a BMI of] about 40 [for a ceiling]…If someone shows up for surgery on a given day and [the anesthesiologist is] not comfortable with 39.5, the case could end up getting canceled. That’s a big deal and we don’t want to have to do that. So we like a 38 or less.”

While this may seem arbitrary, Dr. Pane explains there is a valid medicolegal reason behind it. “Also, for people who are higher that can’t be done in an office setting [under Florida state law]. I do [procedures of that kind] at an ambulatory surgery center, and in those cases,1 we can go higher if everything else is okay. They don’t have the kind of rule there that they have for the office.”

Speaking from his own experience, Dr. Pane notes, “I have not found that high BMI by itself is a really big deal, it’s just the way they made the [office and surgical] center rules. I think the reason is because 40 and above is considered an ASA 3, which is the anesthesia rating. If it’s a 3 or above, you can’t do office-based surgery. Some people don’t really believe it’s that critical, but that’s just the way the current rules are.”

While diet and exercise are crucial to good overall health, increased longevity and better short-term and long-term surgical outcomes, it’s never a good idea to get too hung up on one metric or married to the idea that “this number must mean that procedure is out of the question.” However, if you are considering cosmetic surgery, you should definitely speak with both your regular healthcare provider and a board-certified cosmetic surgeon like Dr. Pane to properly evaluate the potential risks and benefits, as well as to set reasonable expectations for the outcomes you can expect from the procedure. Also, along with diet and exercise, avoiding habitual factors such as smoking and alcohol consumption will not only help speed up the healing process in many cases but help cut the risk of postoperative complications and deliver better results in the long run.

If you have a question or concern about anything to do with cosmetic surgery, Dr. Pane and the staff of Atlantic Coast Aesthetics are always happy to discuss your interests with you. Simply

click here to contact us via our website; follow us on Twitter, Facebook, Instagram and/or LinkedIn; or call us at (561) 422-4116. Your question might even be taken up as the focus of a forthcoming Ask Dr. Pane segment, allowing you to get the straight talk and honest answers you need to make informed decisions about your cosmetic surgery journey while informing and educating others who want to know the same things. Remember, at Atlantic Coast Aesthetics, we believe the only bad question is the one you DON’T ask!