Cosmetic Surgery Tips

The Best Tummy Tuck Surgeon In Miami FL

It is the worlds most effective way to remove loose skin and fat, tighten the muscles of your abdomen and flanks, and get rid of excess skin. It is also possible to perform a tummy tuck on people who have undergone massive weight loss. A tummy tuck procedure removes excess abdominal skin that sags as a result of dramatic weight loss as well as other causes.

The most important goal of having this surgery done is to enhance the appearance of your body profile by removing loose skin which can cause embarrassment in public and make you feel less confident about wearing shorts or bathing suits. Because it’s so safe with minimal risks, our tummy tucks are performed on men as well as women both out of towners and residents alike.

Even a healthy diet and consistent exercise aren’t always enough to eliminate unwanted stomach “pooches” and achieve a desired midsection. If pregnancy, aging, or weight fluctuations have resulted in sagging skin or weak abdominal muscles, a tummy tuck might be right for you.

Tummy tucks are one of the most desirable cosmetic surgeries, providing slimmer figures and defined waistlines. A tummy tuck from Careaga Plastic Surgery in Miami can give you a slimmer, more contoured stomach and midsection, improving the look and feel of your body for a boost to your confidence and self-image.

Tummy tuck surgery, also known as abdominoplasty, removes excess skin, fat, and tissue from the lower abdomen while restoring separated abdominal muscles, leaving you with a leaner profile and a firmer stomach.

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Why Choose Careaga Plastic Surgery?

Careaga Plastic Surgery offers an immaculate and serene setting for your cosmetic surgery needs with cutting-edge technology such as the Sientra Mirror (for breast augmentation). This device simulates postoperative results with life-like realism so you can envision your new body.

Dr. Daniel Careaga and Dr. Paul Durand are highly skilled, board-certified plastic surgeons with years of experience. Your tummy tuck will be curated to your specific needs and conducted with the highest level of precision to ensure optimal results.

Additionally, the dedicated staff at Careaga Plastic Surgery are highly professional, with extensive experience in the beautification industry. We strive to provide excellent support, communication, and service throughout your aesthetic journey to make your tummy tuck procedure as comfortable and beneficial as possible.

Tummy Tucks Are Ideal for:

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SIGNIFICANT WEIGHT LOSS

Sudden or substantial weight loss can result in a significant amount of excess, stretched skin in the abdominal area that cannot contract after the weight loss. This skin can diminish the appearance of the midsection you worked so hard to achieve throughout your weight loss journey. The sagging skin can cause discomfort as well as affect your self-esteem. Tummy tucks remove the excess skin and provide a smooth stomach to go with your trimmer waistline.

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POST-PREGNANCY

Pregnancy causes the skin to expand rapidly and the abdominal muscles to separate. Even after the delivery and weight loss, the muscles are weakened and don’t always come back together on their own, leaving a “pooch” in the lower abdomen. A tummy tuck tightens and reconnects the abdominal muscles, creating a firmer core and allowing you to return to your pre-baby body.

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AGING SKIN LAXITY

As skin and muscles age, it is common for them to lose their elasticity and become lax. This event is tough to prevent, and while diet and exercise may keep you slim and keep fat at bay, no amount can reverse the natural aging process. Tummy tucks help restore the firm contour you once had and help you regain a youthful aesthetic.

We Offer Several Tummy Tuck Options in Miami, Florida

Our tummy tuck and body contouring specialists in Miami, Florida, create specialized treatment plans to give you the appearance you desire. Dr. Careaga and Dr. Durand believe plastic surgery procedures are not one-size-fits-all: each surgery is as unique as the patient.

We offer multiple variations of tummy tucks to provide the best possible outcomes.

FULL TUMMY TUCK

  • Ideal for those wanting a full “flat stomach” effect
  • Allows the entire abdomen to be reduced and smoothed
  • Involves an incision that runs from hip bone to hip bone under the bikini line
  • Trims loose skin and tightens abdominal muscles
  • Removes stretch marks from the lower abdomen

MINI TUMMY TUCK

  • Ideal for those who have sagging skin and loose muscles confined to the lower abdomen
  • Shorter incision and faster recovery time
  • Removes excess skin and fat from the lower abdomen
  • Tightens abdominal muscles below the navel

PANNICULECTOMY/FULL BODY LIFT

  • Also known as post-bariatric surgery
  • Ideal for those who have lost a significant amount of weight and have large folds of excess skin
  • Removes hanging fat and skin
  • Can be combined with a tummy tuck to tighten the abdominal muscles

MEN AND WOMEN IN MIAMI, FL CHOOSE DR. NATHAN FOR TUMMY TUCK (ABDOMINOPLASTY)

Does a busy career leave you with little time for the gym? Has your pregnancy pudge refused to budge? Do you carry a genetic predisposition for abdominal fat? A flat, toned abdomen looks youthful and fit, and makes clothes fit better. It gets harder, though, to maintain it as we get older. Board-certified plastic surgeon, Dr. Nirmal Nathan, suggests tummy tuck (abdominoplasty) to help his patients in the Miami, FL area feel good about their midsections.

MIAMI, FL SURGEON EXPLAINS TUMMY TUCK (ABDOMINOPLASTY)

A surgical operation known as an abdominoplasty flattens the stomach by removing extra skin and fat and by strengthening the rectus abdominis muscles. The less invasive mini-tummy tuck procedure merely removes extra skin and fat below the navel without tightening the abdominal muscles. Both procedures are regarded as major surgeries, which usually entail risks and a lengthy recovery period. Benefits, though, are striking.

Only accredited hospitals and surgery centers in Miami, Florida, where tummy tucks are done as outpatient procedures, are used by Dr. Nathan. He collaborates with board-certified anesthesiologists and makes use of the most recent monitoring, diagnostic, and surgical technology. The ambiance is relaxing and cozy. Should a longer stay be required for any reason, arrangements for an overnight stay and a hotel can be made.

The tummy tuck procedure is generally straightforward, thanks to careful pre-planning that addresses your unique physiology and goals.

A full tummy tuck follows these basic steps:

  • Consultation: The surgical support team begins by gathering background data on the patient’s general health. The process is then thoroughly explained by Dr. Nathan in a private, leisurely conversation, including any risks, side effects, and advantages. To assist you in developing a reasonable anticipation for the outcome, he responds to your queries and makes use of visual aids.

The administrative staff talks with you about financing options. Since this is considered a cosmetic procedure, insurance does not typically cover tummy tuck cost. However, if Dr. Nathan believes abdominoplasty is justified for medical reasons, we are happy to assist in obtaining an estimate of coverage from your insurer.

When you decide you are ready for a trimmer, toned midsection, your surgical date is scheduled, and you receive prep instructions.

  • Prior to your surgery, Dr. Nathan orders a physical examination and a few lab tests. You are advised to stop taking certain prescription drugs and dietary supplements that could result in bleeding issues. If required, he consults with your doctor to decide the best course of action.

Smoking impairs your body’s ability to heal properly, so you must stop using tobacco for several weeks before and after a tummy tuck. The procedure involves sedation or general anesthetic, so please arrange for someone to drive you home after surgery and spend at least the first night with you.

  • ANESTHESIA– You will be instructed what time to arrive on the day of your surgery, and what type of clothing to wear. After you have changed into a surgical gown and are settled comfortably, IV sedation or general anesthesia is started. After you are fully relaxed, the surgical area is thoroughly numbed.
  • INCISION– It is important to know that you will have a scar from abdominoplasty. However, with extensive background in cosmetic surgery, Dr. Nathan is known for a suturing technique that usually leaves a fine, smooth white line in time. The tummy tuck incision follows the crease of thighs and across the public mound, so it is hidden by undergarments and swimwear. The precise shape and length of your incision depends on the amount of excess skin to be removed. If a woman has an existing C-section scar, Dr. Nathan may be able to incorporate it into the tummy tuck incision.

An incision is also made around the navel to release it. Then abdominal skin is lifted and tailored to the patient.

  • REPAIRS– The weakened abdominal muscles tend to separate vertically, impacting posture and allowing the belly to distend. This separation is called a rectus diastasis. Dr. Nathan draws these “six-pack” muscles back together and supports this proper positioning with a column of sutures.

If fat reduction is desired, liposuction can also be performed at the abdomen, waistline, or flanks. This promotes a shapely hour-glass figure.

  • CLOSURE– Dr. Nathan re-drapes abdominal skin pulling it downward. Excess skin and attached subcutaneous fat extending below the incision line is excised. (If this skin is marred by stretch marks, they are removed.) The incision is closed with sutures. A new opening is created for the belly button, and it is stitched into place. Sutures are protecting with dressing.
  • RECOVERY– You will receive thorough instructions to aid in prompt, uneventful recovery, including pain control mediations and antibiotics. You are encouraged to ambulate (move around) the night of your surgery. You may shower after two days, and most people return to light duty work within seven to ten days. You must avoid swimming and heavy lifting for six weeks, though.

Dr. Nirmal Nathan is a plastic surgeon who operates in Miami, Florida. He obtained his medical degree through the University of Miami’s Honors Program in Medicine. Dr. Nathan is one of Miami’s most sought-after plastic surgeons due to his extensive training, skill, and method of patient care. With his practice, The Nathan Clinic Plastic Surgery and Aesthetics, he imparts the knowledge that comes from experience.

Thin drain tubes are inserted under skin at either end of the incision to keep fluids from building up. They are removed in about a week at your follow-up appointment, and sutures come out shortly after that. Plan to wear a compression garment for a few weeks. It promotes abdominal repairs, guards sutures, and lessens swelling as you heal.

  • RESULTS– While improvement is immediate, you may not be able to see it right away since there is some swelling, and you probably won’t be comfortable standing fully erect for a week or two. When normal posture returns, you see noticeable change in your side profile and in the frontal abdominal contours. Your flat, strong stomach helps to balance your body’s proportions and provide the impression that you are carrying less weight overall.

While Dr. Nathan cannot halt the aging process, with an ongoing healthy lifestyle, improvement in abdominal tone and contour can be lifelong.

WHEN ABDOMINOPLASTY IS A GOOD CHOICE

TUMMY TUCK CAN BE APPROPRIATE FOR A MAN OR WOMAN WITH A LOOSE, PROTRUDING ABDOMEN AND SAGGING SKIN. THIS SITUATION MAY BE THE RESULT OF:

  • Pregnancy (more pronounced with multiple pregnancies)
  • Significant fluctuations in weight
  • Aging
  • Heredity
  • Prior abdominal surgery

A excellent candidate for a belly tuck is healthy, fit, and has a steady weight. This person is aware that an abdominoplasty is neither a weight-loss cure or a replacement for a good diet and exercise, and that any ensuing significant weight swings will harm the outcomes. Abdominoplasty should be delayed until a woman’s family intentions are realized if she intends to become pregnant in the future.

Your appearance, self-image, and well being deserve the care of a Board-certified plastic surgeon. Call (305) 614-4539 to talk with Dr. Nathan in Miami, FL about tummy tuck (abdominoplasty) options.

MIAMI SURGEON EXPLAINS THE MEDICAL BENEFITS OF TUMMY TUCK SURGERY

Pregnancy or extreme weight loss may result in an unwanted abdominal pouch. Although often considered a cosmetic procedure, there are medical benefits of a tummy tuck surgery. Located in Miami, Dr. Nirmal Nathan offers tummy tuck procedures to remove the sagging, stretched skin and excess fat that is causing the unwanted belly bulge.

TUMMY TUCK SURGERY

Also known as an abdominoplasty or tummy reduction, a tummy tuck involves the surgical removal of fat and skin from the abdominal area. Weak or separated muscles are also corrected to create a smooth, firm abdominal profile.

Many people desire a flat, toned abdomen. Unfortunately, even the best diet and exercise habits are not enough to achieve this goal. Patients who are at or near their ideal body weights may still have loose skin or a belly bulge. Common causes of an abdominal pouch may include:

  • Age
  • Genetics
  • Pregnancy
  • Prior surgery
  • Significant weight change

Tummy tuck surgeries are often performed following weight loss or pregnancy. When an individual gains weight, the skin stretches to accommodate the body change. When the same person suddenly loses a significant amount of weight, the skin may not be elastic enough to return to its original form. The result is loose, sagging skin. An abdominoplasty removes the excess fat and skin. The skin is pulled tight and the muscles are repaired. Both men and women are eligible for this surgery.

MEDICAL BENEFITS OF A TUMMY TUCK SURGERY

Although a tummy tuck is often part of a mommy makeover or a cosmetic procedure, it is also beneficial for patients who have undergone extreme weight loss. Even as a cosmetic surgery, an abdominoplasty comes with several medical benefits for patients.

  • IMPROVED ABDOMINAL TONE– After weight loss or multiple pregnancies, the abdominal muscles may be stretched out or swollen. Regular diet and exercise may not help. During a tummy tuck, the weakened muscles are tightened and excess fat is removed. The end result is a flat abdomen.
  • IMPROVED POSTURE– When the abdominal muscles are weak, the posture suffers. Tightening the muscles through an abdominoplasty provides support for the spine and an improvement in posture. Patients who experienced back pain prior to surgery may experience relief after a tummy tuck.
  • VENTRAL HERNIA CORRECTION– If the abdominal wall is weak, it is possible for a hernia to form. A ventral hernia develops when the intestine or abdominal tissue pushes through the abdominal wall. Surgery for a ventral hernia correction is similar to an abdominoplasty. The weakened muscles are corrected relieving pressure on the skin. Combining a hernia repair with an abdominoplasty is safe and helps prevent future hernias.
  • REDUCTION IN STRESS URINARY INCONTINENCE– After childbirth, it is possible to develop stress urinary incontinence. Patients experience urine leakage when they cough, sneeze, exercise, or laugh. A tummy tuck can reduce the problem. Soft tissue near the pelvic area creates a slight bladder obstruction which reduces incontinence.

A tummy tuck brings cosmetic and medical benefits. However, it is not a replacement for a healthy diet and exercise but it can help you achieve the figure you desire. Schedule your consultation with Dr. Nathan in Miami. Call (305) 614-4539.

WHAT IS A TUMMY TUCK? PLASTIC SURGEON IN MIAMI, FL EXPLAINS

Genetics, pregnancy, and weight gain can all lead to storage of extra fat and loose skin in the abdominal area. If self-consciousness about your stomach is holding you back from wearing a swimsuit, walking into social or work situations with confidence, or simply feeling and looking your best, a tummy tuck may be a great option for you! Below, Dr. Nirmal Nathan, a board-certified plastic surgeon at The Nathan Clinic in Miami, FL, explains what a tummy tuck is, who is a good candidate, and what to expect.

WHAT IS A TUMMY TUCK?

A tummy tuck is a surgical procedure that helps patients feel more confident by reducing extra fat and skin in the abdominal area and tightening the rectus abdominis muscles. It is also called an “abdominoplasty.”

A less invasive procedure called a “mini tummy tuck” is also available that does not tighten the muscles but reduces extra fat and skin beneath the navel. With a mini tummy tuck, a shorter incision is necessary, so it has a shorter recovery time.

Dr. Nathan will discuss the two options with you in the context of your unique shape and goals to determine which tummy tuck procedure is best for you.

WHO IS A GOOD CANDIDATE FOR A TUMMY TUCK?

Tummy tucks can be a great choice for patients who have:

  • Stretched skin and muscles in the abdominal area due to pregnancy
  • Lost a significant amount of weight, resulting in extra skin in the abdominal area
  • Pockets of fat that are resistant to diet and exercise due to a genetic predisposition for storing abdominal fat or natural aging processes

Because tummy tucks are considered invasive surgeries and do carry risks, patients who are non-smokers and are in good physical condition are the best candidates for recovering well from the procedure. If you are planning to lose more weight or may become pregnant again, we recommend that you wait until you have reached a stable weight and are not planning to have any more children before undergoing the procedure so that your results are not diminished. It is important to have realistic expectations about the results and to understand that a tummy tuck is not designed to be a weight-loss tool, but rather a stomach flattening procedure.

HOW THE PROCEDURE WORKS

A tummy tuck is performed under general anesthesia for your comfort, so we will give you detailed instructions on how to prepare for the surgery. Once you are completely relaxed and numbed, Dr. Nathan will strategically create an incision along the crease of the thighs and pubic mound so that scarring is easily hidden, as well as around the navel. He will then carefully remove the extra skin, and if you are undergoing a full tummy tuck, tighten the underlying muscles. If you have suffered from a separation of muscles called rectus diastasis due to pregnancy or weakened muscles, Dr. Nathan will move your abs back together for a more natural “six-pack” appearance. At this point, extra fat can also be removed to promote a more shapely, thin figure. Dr. Nathan will then close and suture the abdominal area and protect it with sterile dressings. We provide you with thorough post-op instructions to aid in healing and recovery.

TUMMY TUCK RESULTS

Many patients see an immediate improvement in their abdominal area after surgery, but there will be some swelling that hides your true end results. After you have begun to heal and are able to stand with a fully upright posture, your stomach will be flatter, firmer, and more balanced in comparison to the rest of your body. Even if the amount of weight lost from the procedure is minimal, many patients feel like their whole body looks many pounds lighter!

While aging and genetics will continue to play a role in how your stomach appears in the years after your tummy tuck, an ongoing commitment to a healthy lifestyle can help you maintain your results for your lifetime.

COMBINING TUMMY TUCK WITH LIPOSUCTION

Dr. Krau believes that to get the most aesthetically pleasing outcome with an easier recovery, it’s best to perform combination liposuction and little surgical undermining. This is helpful to preserve a lot of the original blood supply to the abdominal wall skin and fat. Also, the results are superior. The patient enjoys much more of a waistline, recovers faster and there are very few complications. “Keeping up with the latest techniques is crucial if you want to provide patients with the best possible procedures and care,” Dr. Krau says.

TUMMY TUCK RECOVERY

The first few days of tummy tuck recovery will be the toughest. You will be sore, swollen and bruised. However, these side effects subside over time. Dr. Krau will prescribe oral pain medication to take if you need it.

You should rest your body as much as possible while it heals. Short walks within one to two days of surgery are encouraged for good circulation. You can resume light activity when it feels comfortable (usually 10 to 20 days after surgery), but avoid vigorous exercise or sports activities for approximately six weeks.

TUMMY TUCK RISKS

Though any surgical procedure carries some risk, rest assured that you lower the risk of complications by working with a board certified plastic surgeon like Dr. Krau. Minor complications that do not affect the ultimate outcome occur occasionally, and major complications are very unusual.

Possible complications include:

  • Infection
  • Bleeding
  • Hematoma/seroma
  • Changes in skin sensation
  • Unfavorable scarring

During your preoperative consultation Dr. Krau will explain the possible tummy tuck risks, and you will have the opportunity to ask questions.

Miami Tummy Tuck Cost

The cost of a Tummy tuck in Miami typically ranges from $3,000 to $10,000. However, it’s important to note that this price range can vary based on several factors, including the surgeon’s experience and expertise, type of anesthesia used, facility fees, the complexity of the procedure, and pre- and post-operative care.

FACTORS THAT AFFECT THE COST OF A TUMMY TUCK IN MIAMI

SURGEON’S EXPERIENCE AND EXPERTISE

The experience and expertise of the surgeon play a significant role in determining the cost of a Tummy tuck. Surgeons with extensive experience and a reputation for delivering excellent results often charge higher fees. It’s also worth considering a surgeon who is Board-certified by the American Board of Plastic Surgery, as they have undergone rigorous training and have specialized knowledge in the field.

TYPES OF TUMMY TUCKS

The specific type of Tummy tuck you choose will influence the overall cost. Different Abdominoplasty techniques, such as the traditional Tummy tuck, Mini Tummy tuck, Extended Tummy tuck, Fleur-de-lis Abdominoplasty or Circumferential Tummy tuck (body lift), have varying complexities and requirements. The extent of the procedure and the surgical techniques involved will impact the overall cost.

TYPE OF ANESTHESIA

The type of anesthesia used during the Tummy tuck procedure can affect the overall cost. General anesthesia, which puts the patient to sleep throughout the surgery, is generally more expensive than local anesthesia, which numbs the area while keeping the patient awake. Factors such as the duration and complexity of the procedure will also impact the anesthesia cost.

FACILITY FEES

In addition to the surgeon’s fees, the cost of a Tummy tuck includes facility fees, which encompass the expenses associated with the operating room and necessary equipment. The location of the facility can also influence the cost. Typically, having the procedure in a hospital setting will be more expensive compared to an outpatient surgical center.

ADDITIONAL PROCEDURES

Sometimes, an Abdominoplasty may be performed in combination with other procedures, such as Liposuction or hernia repair. If additional procedures are necessary or desired, they will contribute to the overall cost of the surgery.

PRE- AND POST-OPERATIVE CARE

The cost of an Abdominoplasty in Miami also incorporates pre- and post-operative care. This includes consultations, lab work, and follow-up appointments. Patients should consider the expenses related to any prescribed medications, dressings, and any post-operative care requirements like physical therapy or potential revision surgeries.

Plus Size Tummy Tuck Miami

Cosmetic procedures, such as BBL in Miami, tummy tuck, liposuction, breast augmentation/reduction, etc., allow people to improve their aesthetic appearance and self-confidence. 

A tummy tuck or abdominoplasty is a well-known cosmetic procedure. Hundreds of thousands of men and women in the U.S undergo the tummy tuck to eliminate excess fat and achieve a flatter midsection and improved physique. 

The procedure benefits men and women, including plus-sized individuals with higher BMIs. Today’s article will answer a few essential questions people ask with high BMIs. Read on! 

Can you get a tummy tuck with a high BMI?

Research studies show that a tummy tuck or abdominoplasty with or without liposuction is safe for overweight and obese patients. It is a result-driven procedure, allowing non-obese and obese patients to achieve the same aesthetic results. However, postoperative care is the most significant factor determining the outcome for obese and non-obese patients. 

If you are overweight or obese, you may qualify for this procedure. However, if you are close to the ideal weight, you will see improved results. People with BMI over 30 must lose weight before undergoing the procedure because this is in their best interest. 

Patients overweight or obese with health issues should avoid this elective surgery. However, if you are overweight and have good health status, you can undergo this procedure and achieve your cosmetic goals. 

People who want to achieve the best outcomes should be within 20 or 30 pounds of their goal weight, generally healthy, and free from health conditions that can increase the risk of complications. Likewise, if you show commitment to living a healthy and active life, you can achieve your goals. 

Benefits of an overweight tummy tuck 

Many women and men, especially those who are overweight, find that tummy tuck surgery is a fantastic alternative. It raises your standard of living and makes your abdomen look better.

So, these are the primary reasons people undergo tummy tuck surgery. It dramatically changes your abdomen’s appearance by sculpting your body figure, allowing you to achieve your desired appearance. 

In line with or matching to your weight and body type, your postoperative abdomen will be flatter, firmer, and more contoured. Because to its potential to significantly reduce weight and boost confidence, the surgery is especially beneficial for women who want to enhance their appearance after giving child.

Several people have put on more weight as a result of the Covid-19 pandemic’s reduced physical activity and lack of exercise. Many health problems, such as diabetes, hypertension, and cardiovascular illnesses, are brought on by weight increase.

On the other hand, a tummy tuck procedure tightens your core muscles and supports your spinal structures by reducing strains on your body. It also plays a critical role in improving your posture. 

Having good posture allows obese people to sit and stand properly, exude confidence, and improve their appearance. Improved posture also relieves back pain, discomfort, and neuropathic issues. 

BMI requirements for Tummy Tucks on Plus Sized People 

Plus-sized or overweight people have different BMI requirements because it depends on various factors. However, the general rule of thumb is that patients should have a BMI between 35 and 40. 

If you have a BMI of more than 40, you are not a suitable candidate for tummy tuck surgery. In addition to the BMI, you must have optimal physical and emotional health. Make sure you perform medical diagnostic tests to determine whether you can undergo this elective surgery. 

High BMI tummy tuck Recovery 

According to certain research, patients with high BMI are more likely to experience difficulties following a stomach tuck treatment, especially if they disobey their surgeon’s advice during the recovery phase. For instance, obese people who undergo a stomach tuck may develop fat necrosis.

Some patients also experience tummy tuck muscle repair failure. Remember that your immune system plays a critical role in surgery’s success, wound healing, scar formation, and recovery. 

Because overweight patients have a weakened immune system, it may take longer than usual for wounds to heal. Therefore, surgeons recommend avoiding strenuous activity during the recovery period. 

Likewise, you must consume a healthy diet rich in veggies and fruits to streamline the entire process and reduce the risk of complications, including infections, fluid accumulation, fat necrosis, and muscle damage. 

The Cost of Tummy Tucks for Plus Size Patients

The cost of tummy tucks for overweight and obese patients varies because every patient has their own BMI, health status, genetic makeup, cosmetic requirements, and recovery potential. 

Remember, a tummy tuck procedure for overweight and obese patients is more complex than ideal candidates. It requires specialized skills and more operative time. The average cost of a tummy tuck for overweight people is between $16,500 and $23,500. 

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