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5 Causes Of Weight Gain After A Tummy Tuck

Following a tummy tuck, it’s not uncommon for some patients to gain weight afterwards. In this post, we’ll outline five main underlying reasons.

But before we discuss weight gain after a tummy tuck, it’s important to discuss weight before surgery.

A tummy tuck, in and of itself, is not a weight loss operation. While it takes away skin and fat, it really works best when a patient is already close to the weight they are comfortable with. That doesn’t always mean rail thin, but it means realistic and healthy.

This is because there are two components to a tummy tuck. One is the removal of skin and fat in the lower abdomen, the other is the tightening of the wall of the abdomen. The removal of skin and fat is rather straightforward. It’s that bulge that you can grab in the lower abdomen with your hands that we’re pretty much able to throw away.

The abdominal wall is a different story. When you tighten the abdominal muscles to bring them together, which is commonly done to repair muscle separation after pregnancy – you are pushing the intestines back into the place that they used to be. If those intestines are surrounded by a large amount of fat, visceral fat, they will just push back and stretch the abdominal wall again.

Generally, following a tummy tuck, slender people will stay flatter because they have less visceral fat, medium-weight people will stretch a medium amount because they have more, and, in many cases, I won’t tighten patients who have tense or full bellies, because they will just be unhappy and stretch back completely. These tissues are alive. They respond to the abdominal stress and they find a new normal resting point.

But let’s presume you’re a patient at a good weight with a reasonable amount of visceral fat. Unfortunately, it’s still possible to gain weight even after the surgery. Let’s take a look at how.

Reason 1: Fluid Retention

Fear not, this cause of weight gain will solve itself over time.

During surgery, intravenous fluids are given. And, because of the surgery and inflammation, a lot of that fluid is stored in the body. It leads to a feeling of bloating, along with some swelling of the hands, feet and above the incision.

Fortunately, your body and your kidneys are smarter than your doctor and that fluid will start to mobilize within about 10 days and go away. This is totally normal and to be expected.

Reason 2: Weight Loss Drugs & Fad Diets

More and more commonly, patients are turning to either fad diets or weight loss drugs to reduce their weight prior to surgery.

Some of these choices are unsustainable changes to the patient’s normal lifestyle. Furthermore, they cannot be continued through surgery and many of them cannot be continued long-term either. As a result, there’s often a rebound effect where people gain weight when they come off of these diets or drugs.

Instead, we suggest trying to lose weight the good old-fashioned way: diet, exercise, and behavior modification. And if you do use weight loss drugs before surgery, make sure your weight is stable prior to surgery because you need good nutrition to heal. After surgery, if you must use them again then be sure to let your doctor know and organise extra checkups.

Reason 3: Lack Of Exercise

Any type of surgery slows you down and limits your ability to exercise, which means burning fewer calories.

So, almost inevitably, there is some weight gain as the balance between “calories in” to “calories out” leans towards weight gain.

That said, you really need to give yourself the time to recover from a tummy tuck. In particular, the first three weeks are critical. If every instruction is followed and everything goes well in the first three weeks, you will actually be able to start exercising sooner and get back to your pre-op weight.

I have many patients who want to do too much too soon and actually slow themselves down by not giving their bodies a chance to heal. So, while lack of exercise post-op may lead to some weight gain in the short term, in the long term it will actually get you back to the gym more quickly.

Reason 4: Diet Changes

You’ve dieted, you’ve exercised, you’ve done everything right, and now you’ve had a tummy tuck to remove the loose skin. You’re feeling flatter than you’ve ever felt since before childbearing.

Some patients will see this as an opportunity to ditch a healthy diet and eat whatever they like. Unfortunately, it is not.

Maintaining your healthy diet both before and after surgery is the key to maintaining your new figure. Remember, visceral fat and external fat can always be increased, so you’ve got to work hard to keep it off and avoid a need for further surgery.

Reason 5: Inevitable Aging

It becomes harder to maintain our weight as we get older because our hormones change as we age.

So, think of the tummy tuck not just as a single operation but as a change in lifestyle. Exercise does not have to be overly vigorous – a good long walk will burn just as many calories as a short but intensive workout.

As you age, focus on exercise that is most realistic for you and will not set you back with injuries.


We always try to give our patients realistic expectations. We cannot make a heavy patient a thin patient, but we can often make them far more streamlined.

These honest and important distinctions are the key to making people happy, but you can certainly stack the deck in your favor by being at a good weight beforehand and then doing your best to maintain that weight afterwards.

Please get in touch if you’d like to discuss a tummy tuck. We offer free consultations and cover Maryland, Washington DC and north Virginia.

November 14, 2023 8:05 am
Categories: Blog

Written by Dr. Adam Tattelbaum

Dr. Adam Tattelbaum is a highly skilled and compassionate plastic surgeon with over two decades of experience.

Double-certified by the American Board of Plastic Surgery and the American Board of Surgery, Dr. Tattelbaum believes in providing personalized patient care and customizes his treatment plans to suit the individual.

Dr. Tattelbaum's candid and realistic approach has earned him recognition, not only with his patients but in the Top Doctor lists of the Washingtonian and Bethesda magazines. He is also a member of the American Society for Aesthetic Plastic Surgery, a mark of distinction in the field of cosmetic surgery.

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