Circumferential Abdominoplasty

A circumferential abdominoplasty, also called a body lift or belt lipectomy, removes loose skin and fat right around the waist rather than only across the front of the abdomen. The incision continues around the sides and the back, which allows the abdomen, hips, flanks, outer thighs and buttocks to be addressed together. It is used after major weight loss, when loose skin extends all the way around the body and a standard abdominoplasty at the front would leave the sides and back untreated.

At your consultation, Dr Ricketts examines the loose skin around your waist, assesses your abdominal muscles and your general health, and asks about your weight history and whether your weight is stable. This is a larger operation than a standard abdominoplasty, so she will explain honestly what it involves and how it fits into your overall plan.

The incision runs low around the whole circumference of the waist, so it can usually sit within underwear. Part of the operation is performed with you lying face down, to remove loose skin and lift the buttocks and outer thighs at the back, before you are turned to complete the abdominal part at the front, where the muscles can be repaired if they have separated. Because it treats the front, sides and back, it improves the contour of the whole lower trunk in a single stage, at the cost of a longer scar and a longer operation.

A circumferential abdominoplasty may suit you if you have loose, excess skin all the way around your waist after major weight loss, if your weight has been stable for a period of about six months, and if you are in reasonable general health. A stable weight and good nutrition are important, because they affect healing, and people who have lost a large amount of weight can have thinner skin that heals less predictably. Smoking increases the risk of healing problems, so stopping before and after surgery is necessary. Dr Ricketts will give you an honest assessment of what is achievable and how this fits into a staged plan.

At your consultation, Dr Ricketts examines the areas that concern you, assesses your skin and general health, and asks about your weight history. She then helps you plan whether a circumferential abdominoplasty is the right stage for you and in what order to address other areas, and she explains the scar, the recovery and the risks. Because body contouring after weight loss is usually staged, we plan the overall approach together, while being clear that it may be adjusted as you recover from each stage.

A circumferential abdominoplasty is performed under general anaesthetic and usually involves a hospital stay of two to three nights. On the day Dr Ricketts marks the areas beforehand with you standing, and the team looks after you from admission through to recovery, including measures to reduce the risk of blood clots. Drains are commonly used and would usually come out before you are discharged home. You will go home with garments, dressings and clear instructions.

You will wear compression garments and in the first one to two weeks expect discomfort, swelling and bruising, difficulty standing fully upright, and a need for some help at home. Because the scar runs around the whole waist, moving, sitting and lying down all take care in the early period.

Many people return to desk work at around three to four weeks, with longer for physical work. Gentle exercise such as walking can commence from two to three weeks, while intensive exercise and lifting are restricted for at least six weeks. Because body contouring after weight loss is usually staged, you generally recover for about three months between procedures, and the overall plan can take place over about a year. Scars fade gradually over a year or longer. Dr Ricketts will guide you at each step. Healing varies between individuals, and the outcomes one person experiences do not necessarily reflect what another will experience.

Dr Sophie Ricketts is a specialist plastic surgeon based in Richmond, Melbourne, with a focused practice in body contouring surgery, including circumferential abdominoplasty (body lift). She is a Fellow of the Royal Australasian College of Surgeons (FRACS) and a member of the Australian Society of Plastic Surgeons (ASPS) and the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), the peak professional bodies for plastic surgery in Australia. You can also find her on RealSelf. Each of these listings is maintained by independent organisations and provides patients with a straightforward way to check the qualifications, training, and scope of practice of the listed providers before booking a consultation.