Situations in which we defer or decline surgery
Active weight change
Weight should be stable for at least 6 months before surgery. Patients still actively losing or gaining weight will have results that distort as the body continues to change.
BMI above the safe range
BMI >35 for elective body contouring substantially raises complication rates. The right answer is usually to defer until further loss, not to proceed with elevated risk.
Current smoking
Wound healing complications are unacceptable in smokers. Cessation of at least 4 weeks pre-op and 4 weeks post-op is non-negotiable.
Uncontrolled chronic conditions
Uncontrolled diabetes (HbA1c >8%), uncontrolled hypertension, untreated obstructive sleep apnoea, or other significant unmanaged comorbidities should be addressed first.
Recent or planned pregnancy
Pregnancy after abdominoplasty stretches the repaired tissues. Patients planning future pregnancies are advised to defer mommy makeover or abdominoplasty until family is complete. The relevant marker is plan, not whether pregnancy is "possible" — many patients change plans, and the body contouring is harder to revise than to delay.
Unrealistic expectations
Patients seeking outcomes the procedure cannot deliver — perfect symmetry, scarless transformation, dramatic results from minor procedures — are likely to be disappointed regardless of how well the surgery goes. Pre-operative conversation should align expectation with reality; if it cannot, the right answer is not to proceed.
Concerning psychological context
Body contouring decisions made during major life upheaval (divorce, bereavement, job loss), during active eating disorder, or driven by external pressure rather than personal goal are unlikely to satisfy. We discuss these situations honestly and may recommend deferral.
Inadequate recovery support
For major procedures requiring 1–2 weeks of help at home, patients without that support should arrange it before scheduling — or defer the procedure. Returning home alone after lower body lift, mommy makeover, or extensive brachioplasty meaningfully raises complication rates.
What "not yet" looks like
"Not yet" is usually a path forward, not a refusal: lose another 10 kg first, stop smoking and return in 3 months, manage the diabetes first, complete childbearing first, build social support first. The procedures don't go anywhere — they will still be available when conditions are right.