A tummy tuck removes loose skin and fat from the front of the abdomen, with a scar running across from hip to hip. A body lift extends that same operation completely around the lower trunk, treating the flanks, lower back, buttocks and outer thighs as well.
This difference matters most after major weight loss, when loose skin rarely stops at the front.
Many people who have lost a lot of weight ask for a tummy tuck because it is the operation they have heard of. For some it is exactly right. For others it would tighten the front while leaving folds around the sides and back and sometimes make them look more obvious.
In this article Plastic Surgeon, Ms Helen McEvoy explains what each operation treats, the options in between, and how a surgeon decides, with you, which one you need.
This article is the second in a series of five about 360 Body Lift:
What is the difference between a tummy tuck and a body lift?
What is a 360 body lift?
Would I be suitable for a body lift after weight loss?
What is recovery like after a body lift?
What does a tummy tuck treat?
A tummy tuck, or abdominoplasty, removes the loose skin and fat between the belly button and the pubic area, and tightens the skin above it. In most cases the surgeon also repairs the abdominal muscles, which are often separated after pregnancy or significant weight gain, so the waist is firmer as well as flatter. The belly button is brought out through a new opening, and the scar sits low, usually below the underwear line from hip to hip.
It is an excellent operation when the excess skin sits mainly at the front, which is typical after pregnancy or moderate weight loss.
What doesn't a tummy tuck tackle?
A tummy tuck only treats the front. It does not deal with:
loose skin on the flanks, often called love handles
rolls of skin across the lower back
buttocks that have flattened and dropped
loose skin on the outer thighs
After major weight loss, the excess skin usually wraps around the body like a very loose belt. If only the front is tightened, the remaining skin can bunch at the ends of the scar into small folds known as dog ears, and the contrast between a flat front and loose sides and back can become more noticeable, not less.
What is a body lift?
A body lift, also called a lower body lift, 360 body lift, 360-degree body lift, belt lipectomy or sometimes a 360 tummy tuck, removes a band of loose skin from all the way around the lower trunk
It combines a tummy tuck at the front with a lift of the back, buttocks and outer thighs. This is achieved through a single, continuous scar that circles the body just above the buttocks at the back and low across the abdomen at the front.
The result is a tighter waist and a lift of the buttocks and outer thighs that a tummy tuck alone cannot achieve. Our article on what a 360 body lift involves explains the operation in more detail.
What lies in between?
There are two options between a standard tummy tuck and a full body lift.
An extended tummy tuck carries the scar further round onto the hips, so it can tighten the flanks as well as the front. It suits people whose loose skin wraps onto the sides but not across the back.
A fleur-de-lis tummy tuck (also spelled fleur-de-lys) in addition to the standard horizontal scar, a vertical one up the middle of the abdomen. It removes loose skin in both directions, which helps when the abdomen is loose from side to side as well as from top to bottom. This is common after very large weight loss, and a fleur-de-lis approach can also be combined with a body lift.
How do the operations compare?
Tummy Tuck compared with 360-Body Lift
The larger the operation, the higher the chance of minor wound problems and fluid collections under the skin (seroma). Most of these settle with simple treatment, but they are worth understanding before choosing a bigger operation.
How does a surgeon decide which I need?
The decision comes from examining you standing up, front, sides and back, and seeing where the loose skin sits. A useful test is whether the folds stop at your hips or carry on round the back to your spine.
The surgeon will also consider how much weight you have lost, whether the buttocks and outer thighs have dropped, the scars you are prepared to accept and how much recovery time you can manage.
Some patients choose a tummy tuck knowing it treats only part of the problem, because it suits their priorities, and that is a reasonable choice if it is an informed one. Where arms, thighs or breasts also need treatment, the surgery is usually planned in stages rather than all at once.
How do I find out which operation is right for me?
The answer depends on your body, not on the name of the operation you have read about. At The Cosmetic Doctors Company, surgical consultations are with Consultant Plastic Surgeon Ms Helen McEvoy, who will examine you, explain which option fits your shape, and be clear about the scars and recovery each one involves.
Your next step
If you are considering surgery, we recommend booking a consultation with Ms McEvoy. This will enable you to explore your options in a calm and professional environment. A consultation is where all good medical care starts. There will no obligation to proceed. The aim is to provide information and clarity, not pressure to have an operation.
To arrange a consultation with Ms McEvoy use the links below to telephone or email or fill out our contact form here.
References
Aly AS et al. Belt lipectomy for circumferential truncal excess: the University of Iowa experience.
Plast Reconstr Surg. 2003;111(1):398-413.
Song AY et al. A classification of contour deformities after bariatric weight loss: the Pittsburgh Rating Scale.
Plast Reconstr Surg. 2005;116(5):1535-1544.
Shermak MA. Body contouring.
Plast Reconstr Surg. 2012;129(6):963e-978e.
Mitchell RT, Rubin JP. The fleur-de-lis abdominoplasty.
Clin Plast Surg. 2014;41(4):673-680