A 360 tummy tuck, often referred to as a circumferential body lift or belt lipectomy, is a comprehensive body contouring procedure. This surgery addresses skin laxity and excess tissue around the entire torso, providing a balanced silhouette. Unlike traditional procedures, the 360 approach requires simultaneous treatment of the back and sides for optimal results.
Defining the Procedure and Its Scope
The “360” designation signifies that the surgery encompasses the full circumference of the body, unlike a traditional tummy tuck which focuses only on the front. This extensive procedure targets three primary regions: the anterior abdomen, the flanks (sides), and the lower back and buttock area. The goal is to remove excess skin and fat that drapes over the waistline.
The posterior element distinguishes the 360 tummy tuck from an extended tummy tuck, which typically only reaches the hip bones. By extending the incision around the entire waist, the surgeon removes a belt of skin and subcutaneous tissue from the back. This tightens the back and provides a lifting effect to the outer thighs and buttocks, resulting in a smoother lower body contour. This circumferential excision ensures the front contouring is not undermined by loose skin migrating from the back or sides.
Ideal Candidates and Patient Selection
This extensive surgery is most commonly indicated for individuals who have experienced massive weight loss, such as following bariatric surgery. After losing 100 pounds or more, the skin often loses elasticity and cannot retract, resulting in significant folds of loose, hanging tissue around the entire trunk. The 360 tummy tuck is designed to address this 360-degree skin redundancy that milder procedures cannot correct.
Ideal candidates must be in good overall health and have maintained a stable weight for several months. It is a contouring surgery, not a weight loss tool, so patients should be near their goal weight for the best aesthetic outcome. Candidates must be non-smokers, as tobacco use increases the risk of complications and impairs wound healing for such a large incision.
The Surgical Process Step-by-Step
The 360 tummy tuck is a complex operation requiring general anesthesia, typically lasting four to six hours. The procedure begins with the surgeon making a continuous, low-lying circumferential incision that circles the entire torso, placed just above the pubic area and extending around the flanks and lower back. This incision pattern is chosen so the resulting scar can be concealed by most underwear and swimwear.
The surgical team often begins with the patient in the prone (face-down) position, addressing the lower back and flanks first. Excess skin and fat are excised from the posterior area, and the remaining tissue is pulled taut to create a lift and contour the waistline. Once the back is completed, the patient is repositioned to the supine (face-up) position to address the anterior abdomen.
During the anterior portion, the surgeon removes excess skin and fat from the lower abdomen. They typically perform a rectus abdominis plication, which involves suturing the separated abdominal muscles back together to restore a firmer abdominal wall (diastasis recti correction). Liposuction is often incorporated to fine-tune the contours of the waist and hips. The skin is then redraped, trimmed, and the incision is closed, with the belly button repositioned to fit the newly contoured abdomen.
Post-Operative Care and Recovery Timeline
Due to the extensive nature of the surgery, the recovery period for a 360 tummy tuck is longer than a traditional abdominoplasty. Patients commonly spend one or more nights in the hospital for post-operative monitoring and pain management. Small surgical drains are placed under the skin to prevent fluid accumulation, typically remaining in place for one to two weeks.
Patients must wear a compression garment around the clock for several weeks to minimize swelling and support the newly contoured tissues. Initial mobility is restricted; patients are advised to walk with a slight bend in their torso for the first week to avoid tension on the incision line. Most individuals can return to light, sedentary work after two to three weeks. Strenuous exercise, heavy lifting, and activities that stress the core muscles must be avoided for approximately six to eight weeks. Full recovery, with final results becoming apparent as swelling resolves, can take six months to over a year.