A 360 body lift is an operation that removes a band of loose skin and fat from all the way around the lower trunk, through one continuous scar that circles the body.
It tightens the abdomen and waist at the front, the flanks at the sides, and lifts the buttocks and outer thighs at the back. You may also see it called a lower body lift, circumferential body lift, belt lipectomy, 360 tummy tuck or a 360-degree body lift.
These names all describe essentially the same operation.
It is mainly performed after major weight loss, whether through diet, bariatric surgery or weight loss injections such as Ozempic or Mounjaro. Particularly when loose skin wraps around the body rather than sitting only at the front. In this article Plastic Surgeon Helen McEvoy explains what the operation involves, what it can and cannot achieve, and the main risks.
This is the third in a series of five articles 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 areas does a 360 body lift treat?
A 360 body lift treats the lower trunk as one unit: the tummy, the waist, flanks, the lower back, the buttocks and the outer thighs. Because the skin is tightened all the way round, pulling at the front and back works together, which gives a better-defined waist than treating the front alone. Lifting the skin of the lower back also raises the buttocks and smooths the outer thighs, which often drop and flatten after major weight loss.
How is the operation performed?
The operation is carried out under general anaesthetic and usually takes 4+ hours. Before surgery, the surgeon marks you while you stand, because loose skin hangs differently when you lie down.
During surgery, the procedure at the front is essentially a tummy tuck. The abdominal muscles can be tightened if they have separated, and the belly button is brought out through a new opening. After repositioning you, your surgeon removes a wedge of skin and fat from across the lower back and hips.
Rather than relying on the skin alone to hold the lift, an important part of the technique is anchoring the deeper fibrous tissue layers under the skin, known as the superficial fascial system. This takes tension off the scar, helps it stay low and flat, and makes the result last longer. Additional liposuction may be used to smooth the hips or thighs.
Can a body lift improve the buttocks?
Yes, in two ways. The lift itself raises buttocks that have dropped and tightens the skin over them. Lifting alone, however, can leave the buttocks looking flatter, because major weight loss often removes much of their volume. To counter this, the surgeon can use some of the tissue that would otherwise be discarded from the lower back, folding it into the buttocks to add projection. This is known as autologous gluteal augmentation, or auto-augmentation. It uses your own tissue rather than implants or fat transfer and is decided case by case depending on how much tissue is available and the shape you want.
Where does the scar sit?
The scar runs all the way around the body. At the front it sits low, like a tummy tuck scar, below the underwear or bikini line. Over the hips it rises slightly, and at the back it crosses just above the buttocks, where it can usually be hidden by most underwear and swimwear. The surgeon will plan its position with you before surgery, taking account of the clothes you usually wear. The scar is long, and this is the main trade-off of this operation. It may be red and raised for the first few months, then gradually flattens and fades over 12 to 18 months, although it will always be visible.
What a body lift cannot do?
A lower body lift treats the lower trunk only. It does not deal with
rolls of skin on the upper back or around the bra line,
loose skin on the inner thighs,
hanging skin on the upper arms,
deflated breasts.
Each of these needs its own operation, such as a thigh lift, arm lift or breast uplift, and these are usually done as separate stages several months apart rather than all at once, to keep each operation safer. A body lift is also not a way to lose weight. It removes loose skin and some fat but works best once your weight has been stable for several months at or near your goal.
What are the main risks?
A 360 body lift is a major operation, and complications are more common than after a standard tummy tuck. Most are minor and settle with simple treatment, but you should understand them before deciding. The most common are:
Seroma: a collection of fluid under the skin, usually drained in clinic with a needle.
Wound healing problems: small areas where the wound opens, most often at the hips or where scars meet, which usually heal with dressings.
Changes to the scar: stretching, thickening or slight movement of its position over time. Your surgeon will advise how to manage your scars to achieve the best result.
Altered sensation: numbness of the skin around the abdomen and lower back, which usually improves over months.
Less common but more serious risks include infection, bleeding, and blood clots in the legs or lungs. The risk of clots is reduced with compression stockings, early walking and, in most cases, blood-thinning tablets or injections.
Your risk of complications is lower if you do not smoke, your weight is stable and your nutrition is good, which is why these form part of the assessment for surgery.
How do I find out if a 360 body lift is right for me?
The right operation depends on where your loose skin sits and what matters most to you. At The Cosmetic Doctors Company, surgical consultations are with Consultant Plastic Surgeon Ms Helen McEvoy, who will examine you, explain whether a 360 body lift or a smaller operation would suit you, and talk through the scar, risks and recovery in detail.
References
Lockwood T. Lower body lift with superficial fascial system suspension.
Plast Reconstr Surg. 1993;92(6):1112-1122
Centeno RF. Autologous gluteal augmentation with circumferential body lift in the massive weight loss and aesthetic patient.
Clin Plast Surg. 2006;33(3):479-496
Carloni R, et al. Circumferential contouring of the lower trunk: indications, operative techniques, and outcomes. A systematic review.
Aesthetic Plast Surg. 2016;40(5):652-668