360 Tummy Tuck (Circumferential Abdominoplasty)

After a large weight loss, loose skin rarely stops at the front of the abdomen. It folds over the hips, hangs at the flanks, rolls across the lower back and pulls the buttocks and outer thighs down with it. A standard tummy tuck tightens the front only — and in these patients it can make the contrast with a loose back more obvious. The operation designed for skin that wraps around the body is the 360 tummy tuck, also called a circumferential abdominoplasty or belt lipectomy.

Dr. Paulo Michels performs the 360 tummy tuck, the extended tummy tuck and the lower body lift at Elyzee Hospital in Abu Dhabi, for patients who have lost weight after bariatric surgery, with GLP-1 medicines or through diet and training.

What is a 360 tummy tuck?

A 360 tummy tuck removes a belt of excess skin and fat around the entire lower trunk — front, both flanks and lower back — in one operation. At the front it does everything a standard tummy tuck does: the loose lower abdominal skin is removed, separated abdominal muscles are repaired and the belly button is repositioned. The excision then continues over the hips and across the lower back, so the scar meets itself as a belt.

The phrase is used in two ways. Some clinics call a tummy tuck combined with liposuction around the waist and back a “360 tummy tuck” — in that operation skin is removed only at the front. At this practice that combination is described as a lipoabdominoplasty with 360 liposuction on the tummy tuck page. This page is about the circumferential operation, in which the skin itself is removed all the way around.

Extended tummy tuck, belt lipectomy or lower body lift?

The names overlap. What separates them is how far around the body the excision goes, and whether the buttocks and thighs are deliberately lifted.

Procedure	How far the incision goes	What it treats	Best for
Standard (full) tummy tuck	Low across the front, hip to hip	Loose lower abdominal skin, muscle separation, belly button	Laxity limited to the front, often after pregnancy
Extended tummy tuck	Across the front and further round onto the flanks	Front plus the side rolls over the hips	Loose skin that reaches the flanks but not the back
360 tummy tuck / circumferential abdominoplasty / belt lipectomy	All the way around, including the lower back	Front, flanks and lower back in one belt	Excess skin that wraps round to the back
Lower body lift	All the way around, planned to lift below the scar as well	Everything above, plus lifting of the buttocks and outer thighs	Circumferential laxity with sagging buttocks and outer thighs

For laxity above the belly button with a firm lower abdomen, a reverse tummy tuck is the relevant operation. When the excess is also wide from side to side across the front, a vertical component can be added — see the Fleur-de-Lis tummy tuck.

Who is a 360 tummy tuck for?

The typical patient has lost a large amount of weight and is left with skin that no longer shrinks back:

• After massive weight loss — through diet and exercise, with loose skin that hangs at the front and continues around the sides and back
• After bariatric surgery — gastric sleeve or bypass patients whose weight has settled
• After GLP-1 weight loss — semaglutide (Ozempic, Wegovy) or tirzepatide (Mounjaro), where fast weight loss leaves deflated skin around the whole trunk
• An overhang that wraps to the back — a lower abdominal apron with rolls over the hips and a lower-back fold, often with chafing or rashes in the UAE heat

A simple self-check: stand in front of a mirror and turn sideways and to the back. If the loose roll you can pinch at the front continues past your hips, a front-only tummy tuck is unlikely to be enough. The full background is in loose skin after weight loss and in the article body lift or tummy tuck after weight loss.

Why does weight stability matter?

A 360 tummy tuck is a contouring operation, not a weight-loss operation. Surgery is planned once your weight has been stable for several months. Operating while weight is still falling allows new laxity to appear afterwards; weight regain stretches the result.

If you take a GLP-1 medicine, it is usually paused about two weeks before surgery, as directed by the anaesthesia team — never stop it on your own. After bariatric surgery, nutrition is checked before surgery, because protein, iron and vitamin levels influence how well an incision of this length heals.

How is a 360 tummy tuck performed?

The operation is performed under general anaesthesia at Elyzee Hospital and is longer than a standard tummy tuck.

1. Marking — with you standing, the line of the scar is drawn around the body, planned to sit within underwear or swimwear, and the amount of skin to remove is estimated at front, sides and back.
2. The back and flanks — usually treated first with you lying face down: the lower-back excess is removed and, where planned, the buttocks are lifted or reshaped with your own tissue.
3. Turning — you are carefully repositioned onto your back during the operation, with the anaesthesia team protecting pressure points throughout.
4. The front — the abdominal skin is lifted, the separated muscles are repaired, the excess is removed and the belly button is brought out in its new position.
5. Liposuction and closure — liposuction refines the flanks, waist or upper abdomen where needed, and the long incision is closed in layers to support a fine scar.

The exact sequence and positions depend on your plan and are explained before surgery.

Can the buttocks be lifted or reshaped at the same time?

Yes. In a lower body lift the excision at the back lies just above the buttocks, so closing it lifts the upper buttocks and smooths the outer thighs.

Many patients after weight loss have buttocks that are not only low but flat. Here the tissue of the lower back that would otherwise be thrown away can be kept, de-epithelialised and turned down into the buttocks as a flap — a gluteal auto-augmentation using your own tissue, with no implant. Fat grafting is an alternative when there is enough fat. The options are compared in sagging buttocks after weight loss; for patients who simply want more projection, see the Brazilian butt lift (BBL) and buttock augmentation.

Is liposuction part of the operation?

Often. Liposuction is used to refine the waist, flanks, back or upper abdomen and to blend the transitions so the result looks continuous from every angle. After massive weight loss there is usually more skin than fat, so the excision does most of the work; the liposuction is a refinement.

Can breast, arm and thigh surgery be done too?

After massive weight loss, the trunk is rarely the only area affected. The breasts may have deflated, the upper arms may hang and the inner thighs may be loose. These are usually treated in stages rather than all at once, because combining too many areas lengthens the anaesthetic and the recovery. A typical plan treats the trunk first and, after recovery, the breasts — for example with an auto-augmentation breast lift — the arms or the inner thighs. The order follows what bothers you most and what is safest. The overall approach is described on the body contouring and body lift page.

Pain and recovery

Recovery after a 360 tummy tuck is longer than after a standard tummy tuck, because both the front and the back are healing.

• Pain control — ultrasound-guided nerve blocks are placed by the anaesthesiologist, which considerably reduce early pain and the need for strong painkillers
• Hospital stay — a stay for monitoring after surgery; you walk from the first day
• Walking and clot prevention — long body-contouring operations carry a higher risk of blood clots, so your risk is assessed before surgery and prevention measures are chosen accordingly: leg compression during surgery, early and frequent walking, and blood-thinning medication when the anaesthesia team considers it appropriate
• Weeks 1–2 — rest at home; Manual Lymphatic Drainage (MLD) starts to reduce swelling; you are shown how to lie and get up to protect the front and back incisions
• Weeks 2–3 or more — most patients return to desk work
• Around week 6 — compression garment off
• Weeks 6–8 — gym and heavier lifting once cleared
• Months 6–12 — the scar matures and fades

Drains are used in most circumferential operations for some days; progressive tension sutures reduce the space where fluid collects and, in limited cases, allow a drainless recovery. In the UAE climate, stay in air-conditioned spaces while wearing the garment and keep the scars out of direct sun for the first year.

Patients from Dubai

Many of Dr. Michels’ body-contouring patients live in Dubai. All consultations and surgery take place at Elyzee Hospital in Abu Dhabi — you can book by WhatsApp or phone on +971 50 106 7981, or through the contact form. The pre-operative tests, surgery and follow-up visits are grouped where possible to keep the number of journeys down; the emirate you live in changes the logistics, never the clinical plan. See also tummy tuck for patients in Dubai.

What does your investment include?

360 tummy tuck fees are quoted individually after consultation, because the plan — extended tummy tuck, belt lipectomy or lower body lift, with or without buttock auto-augmentation or liposuction — determines the operating time and hospital stay. The quote is all-inclusive:

• Surgeon’s fee and pre-operative planning
• Specialist anaesthesiologist, including ultrasound-guided nerve blocks
• Hospital stay and operating theatre at Elyzee Hospital
• Post-operative compression garments
• Discharge medication
• Follow-up appointments and ongoing clinical support