Abdominoplasty is not a single operation, but rather a range of procedures tailored to the amount and distribution of excess skin, abdominal wall changes and body contour concerns.

Dr Alex Cameron performs several types of abdominoplasty, including:

• circumferential abdominoplasty
• standard abdominoplasty
• extended abdominoplasty
• male abdominoplasty.

Circumferential abdominoplasty is generally the most comprehensive form of abdominoplasty surgery and is designed to address excess skin and tissue around the full circumference of the trunk.

Several different terms are commonly used to describe this type of surgery, including:

• circumferential abdominoplasty
• 360 abdominoplasty
• body lift
• belt lipectomy.

While these procedures are similar, the exact scar placement and surgical emphasis can vary depending on the areas being treated.

For example, a body lift often places greater emphasis on lifting the buttocks and outer thighs, while a belt lipectomy may focus more on removing excess tissue higher around the lower back.

During consultation, Dr Cameron will assess your anatomy and discuss the most appropriate approach for your body shape and goals.

Most patients undergoing a circumferential abdominoplasty have lost a significant amount of weight, often greater than 20–50 kilograms.

After major weight loss, excess skin commonly develops around the entire trunk in what is sometimes described as an “inverted cone” pattern. Because this excess skin extends around the full circumference of the body, it is often difficult to adequately address with a standard tummy tuck alone.

Circumferential abdominoplasty may be appropriate for patients with:

• loose abdominal skin
• flank and lower back skin excess
• buttock flattening or descent
• upper thigh laxity
• abdominal muscle separation
• recurrent skin irritation or rashes
• difficulty with movement or exercise
• difficulty with clothing fit
• significant body contour changes following weight loss.

Some patients who have lost smaller amounts of weight may still prefer a circumferential approach if they wish to improve contour through the flanks, buttocks or lateral thighs in addition to the abdomen.

Repair of rectus diastasis during surgery may also improve abdominal wall support and core stability. Many patients describe feeling more supported during exercise and daily movement following recovery.

Good candidates for surgery are generally medically well, weight stable and able to safely recover from a major operation.

Factors that can affect suitability include:

• smoking
• obesity
• unstable weight
• poor nutritional status
• poorly controlled medical conditions
• previous abdominal surgery
• future pregnancy plans.

If these factors are relevant to you, the Morphē team will work with you before surgery to help optimise your preparation and recovery. This may include support from our dietitians, endocrinologist, obesity physicians, physiotherapists or psychologist where appropriate.

Preparation for a circumferential abdominoplasty focuses on improving healing, reducing complications and supporting long-term function and contour.

At Morphē, preparation may include:

• nutritional optimisation
• smoking cessation support
• weight stability assessment
• physiotherapy input
• optimisation of underlying medical conditions
• psychological support where required.

Because circumferential abdominoplasty is a major body contouring procedure, preparation often also includes physiotherapy-based “prehab” to help optimise mobility and core function before surgery.

During your consultation, Dr Alex Cameron will assess:

• the distribution of excess skin
• abdominal wall laxity
• rectus muscle separation
• flank and back contour
• buttock volume and position
• skin quality
• previous scars
• overall body balance.

The goal is not simply to remove excess skin, but to improve contour and restore balance across the entire trunk.

Circumferential abdominoplasty is performed under general anaesthetic and usually takes approximately five hours. The procedure is performed in stages during the same operation.

Most patients stay in hospital for three to five nights following surgery. An overnight stay in HDU or ICU is commonly used to help support early recovery and pain management.

Surgery usually begins with the patient lying face down so the lower back, buttocks and posterior trunk can be addressed first. Excess skin is removed from the lower back and buttock region, while preserving deeper gluteal fat to help maintain buttock contour and shape.

The patient is then carefully repositioned onto their back so the abdominal component of the operation can be completed.

The abdominal skin and underlying fat are elevated from the abdominal wall while preserving the belly button on its blood supply. The abdominal muscles are repaired where required using internal sutures to correct rectus diastasis and improve abdominal wall support.

Excess abdominal skin is then removed, the abdomen reshaped, and the belly button repositioned.

Depending on your anatomy and goals, surgery may also include:

• liposuction
• contouring of the mons pubis
• flank contouring
• indirect improvement in upper thigh contour through lifting of the lateral thigh tissues
• repair of small hernias where appropriate.

The procedure is carefully planned to improve contour around the full circumference of the trunk while balancing scar placement, tissue support and long-term stability.

Drains are usually required temporarily following surgery to reduce fluid accumulation during healing. These are commonly removed before discharge from hospital, although some patients may occasionally go home with drains in place for a short period.

A negative pressure dressing system such as Prevena is commonly used to support wound healing and reduce tension on the incisions during early recovery. Compression garments are usually worn continuously for approximately six weeks following surgery.

Dr Cameron performs circumferential abdominoplasty procedures at Burnside Hospital or St Andrew’s Hospital.

Circumferential abdominoplasty is the most effective body contouring procedure for improving excess skin around the entire lower trunk.

Most patients notice:

• a flatter abdominal contour
• improved waist definition
• smoother contour through the flanks and lower back
• lifting and reshaping of the buttocks. While the procedure can improve buttock position and contour, it does not create significant buttock volume in the way fat grafting procedures can.
• improved waist-to-hip ratio
• reduced skin overhang
• better clothing fit
• improved comfort with movement and exercise.

Repair of rectus diastasis may also improve core support and abdominal wall stability.

Patients following major weight loss may still have reduced skin elasticity and tissue support, which can influence scar quality and long-term contour stability.

While circumferential abdominoplasty can create substantial improvement, future weight changes, pregnancy and natural ageing can still affect the body over time.

Recovery following a circumferential abdominoplasty is significant, and patients should prepare for a gradual recovery process over several weeks.

Most patients experience tightness, swelling and discomfort during the first one to two weeks after surgery. The first few days are generally the most uncomfortable period due to the extent of surgery and abdominal wall repair.

Pain management begins in hospital and usually includes a combination of simple analgesics such as paracetamol and anti-inflammatory medication together with stronger prescription pain relief where required.

Walking and mobilisation are encouraged early after surgery, and patients work closely with physiotherapists during their hospital stay to support recovery and reduce the risk of complications.

Patients are usually slightly bent forward initially while the abdomen heals.

Swelling is expected and can take 6-12 months to fully settle. Temporary firmness, asymmetry or loss of contour definition during healing is common and gradually improves over time.

Circumferential abdominoplasty scars are permanent but are positioned to be concealed beneath most underwear or swimwear where possible. Scar quality varies between individuals, however most scars soften and fade significantly over twelve months.

We will guide you through scar care, which may include silicone therapy, scar massage, taping, sun protection and occasionally laser treatment.

Follow-up appointments are scheduled throughout your recovery, and Dr Cameron is happy to review you at any stage if you have concerns.

As a general guide, most patients are able to return to regular activity as follows:

• Walking and gentle mobilisation: encouraged early
• Desk-based work: usually 4–6 weeks
• Light exercise: around 4 weeks
• Gym and core exercise: around 6–8 weeks
• Swimming: around 6 weeks
• Heavy lifting or physical work: around 6–8 weeks
• Driving: usually 2–4 weeks, provided you are comfortable moving and not taking sedating pain medication.

All surgery carries some degree of risk. These risks are reduced through careful preparation, surgical planning, post-operative care, and the experience and judgement of Dr Cameron and the Morphē team.

General risks associated with body contouring surgery will be discussed with you before your procedure.

Risks specific to circumferential abdominoplasty may include:

• Seroma. A seroma is a collection of fluid beneath the skin and is more common after major weight loss surgery. Drains, compression garments, Prevena dressings and careful surgical technique all help reduce this risk. If a seroma occurs, it may require drainage in the clinic.
• Wound healing issues. Small areas of delayed healing are relatively common, particularly around the belly button or areas of increased tension such as the lower back incision. Significant wound healing problems are uncommon with appropriate preparation and aftercare.
• Scarring. Circumferential abdominoplasty scars are permanent but are positioned to be concealed beneath underwear or swimwear where possible. Scar quality varies between individuals.

Risks specific to circumferential abdominoplasty may include: (cont.)

• Swelling. Swelling is expected following surgery and gradually improves over six to twelve months. Compression garments and lymphatic massage help support this process.
• Altered sensation. Temporary numbness around the abdomen, scars and upper thighs is common and usually improves over several months. Some permanent altered sensation may persist.
• Asymmetry or contour irregularity. Minor asymmetry is common and often improves as swelling settles. Some patients may gradually develop mild recurrent looseness over time due to skin quality and tissue stretch.
• Venous thromboembolism. Circumferential abdominoplasty carries an increased risk of blood clots such as deep vein thrombosis or pulmonary embolism. Careful perioperative management and early mobilisation are important in reducing this risk.
• Need for revision surgery. Further surgery is occasionally required to improve contour, scarring or residual skin excess.