BMI guidelines for Tummy tuck and BBL

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. The BMI is a number that compares your weight to your height. High BMI’s create higher surgical risks.

Patients with a BMI less than 35 are typically good candidates for the Tummy Tuck and BBL. However, every surgeon has a different guideline for what is the acceptable BMI for an elective surgery.

If your BMI is greater than 35, you have an increased risk of surgical complications.

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.

BMI and surgical risks

Body mass index formulas.

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.

BMISurgical Risk Level (Cosmetic Surgery)
25 – 29low risk
30 – 35relatively low risk if otherwise healthy
35 – 40potentially 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 good 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.

Patient with BMI less than 35 are generally good candidates for the BBL and Tummy Tuck

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

A tile saying: "According to my doctor's bmi chart, I am six inches too short!".

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!

Semaglutide and Tirzepatide injection to help you lose weight

Most recently, the option for weight loss injections has been introduced to many Plastic Surgery practices to assist high BMI patients in losing weight. In my own practice, we offer Semaglutide and Tirzepatide injections.

Patients are having great success with these medications. However, most patients do gain weight once the injections are stopped. For this reason it is important to permanently change diet and exercise routines to keep weight off.

Lower BMI will give you tighter and better Tummy Tuck results

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.

BMI calculation – enter your height and weight

BMI calculator

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.

Please feel free to ask me any questions about BMI and co-morbid conditions below.

(originally published June 17, 2017)

Wondering if a Tummy tuck or Brazilian butt lift is right for you?

Contact Us to schedule your in-office or virtual consultation. Or just give us a call at 410-494-8100! Note: Virtual consults can also be used to get second opinions.

By Dr. Ricardo L. Rodriguez MD Board Certified Plastic Surgeon Cosmeticsurg Baltimore, Maryland Ricardo L. Rodriguez on American Society of Plastic Surgeons.

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18 thoughts on “BMI guidelines for Tummy tuck and BBL”

  • Rosemary Kennedy says:

    I would be waiting to hear from Leeza.Thanks for answering my questions. I feel very confident now.
    • Dr. Ricardo L. Rodriguez says:

      Did Leeza ever get back to you? We had a web redesign and all our comments have been unavailable until now.
  • Rosemary Kennedy says:

    I want to have a bbl and tt at the same time my bmi is 30 I have high blood pressure it is controlled by medication.I just turned 57 and i want to have these surgerys tell me should i have one at time or is it ok to have both. If so what would be the best Anesthesia a IV Sedation or Local for the bbl and General for the tummy tuck with a exparel to help with the pain and healing process can this be done. Please tell me what would best. Thanks in Advance
    • Dr. Ricardo L Rodriguez says:

      BMI of 30 is great, and if your blood pressure is under control you should be fine. Of course, we would need a medical clearance from your personal physician. We don't use Exparel, which is very expensive and lasts only for 3 days. We use a Marcaine (same drug as Exparel but shorter actin) in a slow infusing pain pump that goes directly into the tissues to provide local anesthesia. As for safety, the safest thing is IV sedation when you have an anesthesiologist who is good at IV sedation. We have been doing this over 10 years. We have been doing TT & BBL together for over 13 years. Let us know if you would like a virtual consult so I can answer all your questions. I will tell Leeza leeza@cosmeticsurg.net to contact you.
    • Dr. Ricardo L Rodriguez says:

      Depends. What is your BMI now? You can calculate your BMI from height and weight measurements online, just google BMI calculator. Secondly, you will need a clearance from your endocrinologist. Let us know!
    • Dr. Ricardo L Rodriguez says:

      I am in Baltimore, but most of our patients are from out of town. We can still do a virtual consultation over Skype or FaceTime and I can give you advice on what to look for.
    • Dr. Ricardo L Rodriguez says:

      Vanessa: Sorry did not reply earlier (2/22/18) as it happens, that is my birthday! Yes you have a perfect BMI. Successful fat grafting is not about volume of fat injected, but about getting a good waist to hip ratio. Secondly, once the fat cells have been redistributed, further weight gains are directed to the desired areas. Contact Kelly at kelly@cosmeticsurg.net or Leeza at leeza@cosmeticsurg.net Thanks for your interest!
  • Nakesha says:

    I had a hernia surgery in 2003 and so i have a mesh covering my abdominal muscles. I have had no complications. Would I be able to get a mommy makeover? What would be the stipulations and/or complications?
    • Dr. Ricardo L Rodriguez says:

      Nakesha: That should not be a problem. We usually oversow the mesh tighten the muscles. We do not try to remove it. Contact Kelly at kelly@cosmeticsurg.net for more information. We would love to help you.
  • BRENDA says:

    I am 57 years old and I have had many hernia surgeries over the years between 1990-2002 In 1990 I had a major c-section because my baby was dead but they brought to back to life after 5 minutes of CPR. In the process of my surgery they cut muscles in the stomach and the center split from side to side the dr. Just left the skin hanging on me later 2 months after my baby birth I went back to the Dr. I found a big ball in the stomach another hernia so they did surgery Sept 10th 1990 and ever since every two years kept having hernias until 2002 found a dr. He had to anchor it to my pelvic bones so the stomach won't split it is thinner than tissue paper. All said my question is can I loose weight? I Have tried and I am wondering if it is because of the netting to hold me together. Could I have a cosmetic surgery even though the netting is under the skin? I have even consulted coolscupling but they won't to it because off the netting to much pressure. I am depressed carrying all this at. I have never been over at always was thin all my life until baby 3 came now I have skin issues, weight issues,diabetic, Do you think you could help me with a tummy tuck to remove all the excess fat from baby. I am not fat all over just around the stomach every where else I am thin. Please help me desperately need help!!
    • Dr. Ricardo L Rodriguez says:

      Brenda: Your case is complicated and has a lot of factors to take into consideration. If ou want meaningful answers rather than generic advice you should contact kelly at kelly@cosmeticsurg.net to arrange for a virtual consult. I will look at your pictures and do a Skype or FaceTime session to evaluate you and make specific recommendations. The generic advice is this: Get a consult with a plastic surgeon in your city and try to get an idea of what the surgical options are.
  • Noor says:

    thank you Doctor for this explication but when I calculate my BMI I found that is equal to 40 so my question is that I found in the net this link http://www.cosmetic-tour.com/en/operations/body-surgery-tunisia/tummy-tuck-tunisia/ that tells that they can accept me to the surgery can you please help me deciding whether I follow their curriculum or should I make another choice ? please help me doctor
    • Dr. Ricardo L Rodriguez says:

      Noor: The fact that will accept you for surgery does not mean that you will escape the chance of a complication. The relationship between high BMI and surgical risk is real. You are much better off losing weight first to get to a reasonable BMI then getting the surgery. Do not risk your health, you only have one body and one life to live.