Jamie is a 44 year old woman fed up with her body. She started a diet and exercise program and lost 60 pounds. At 197 lbs, her BMI was still 32 but she was anxious to rid herself of the excess skin. She intended to lose 30 more pounds, but found it increasingly hard to lose weight and her loose skin made it embarrassing to go to the gym.
After a thorough consultation, she required several procedures. Each was done 6-8 weeks apart, including abdominoplasty and mastopexy at the first stage. Brachioplasty at the second stage and thigh lift and posterior lower body lift on the third. She meanwhile lost the additional weight- both through surgery and continued diet and exercise.
While I generally like to wait until my patients are below BMI of 30, decisions have to be individualized and exceptions can be made.