How can I tell what would be removed during a tummy tuck with 360 lipo?

Question

I'm researching tummy tucks and wondering how I can tell what would be removed during the procedure with lipo. Also, I carry all my weight in my abdomen and can pinch inches, so how would it impact the BMI requirement for me?

Daniel Barrett, MD · Answer

Dear Makemeovedr,

generally speaking, you want to reach your goal weight before you consider a tummy tuck, otherwise your results will be suboptimal if you continue to lose weight after the surgery. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

J. Timothy Katzen, MD, FACS · Answer

Hello, and thank you for your question regarding what is removed during a tummy tuck with 360-degree liposuction. I appreciate your research, as it’s important to understand what this procedure entails.

A tummy tuck (abdominoplasty) with 360-degree liposuction combines skin and fat removal from the abdomen with comprehensive liposuction around the waist, flanks, back, and sometimes hips to create a more sculpted, contoured waistline. Here's how you can determine what would be removed:

What Gets Removed During a Tummy Tuck?
Excess Lower Abdominal Skin and Fat – Any loose, stretched-out skin below the belly button is typically removed. You can get an idea of how much by bending forward slightly and pinching the extra skin.
Abdominal Muscle Tightening – If you have diastasis recti (a separation of the abdominal muscles, common after weight gain or pregnancy), your surgeon will suture the muscles back together, helping flatten and strengthen the core.
Repositioning of the Belly Button – Because the skin is pulled downward, the belly button is repositioned to a natural location.
Lifting the Mons Pubis – In many cases, a tummy tuck also slightly lifts and tightens the pubic area for a smoother contour.
What Gets Removed with 360 Lipo?
Liposuction removes stubborn fat deposits around the entire midsection to enhance the contour. With 360-degree liposuction, areas treated typically include:

Flanks (love handles)
Lower back
Upper back (bra roll area, if needed)
Hips (depending on your anatomy and goals)
The key to 360 lipo is that it sculpts the entire waistline, creating a smoother, more balanced appearance from all angles. However, liposuction does not remove excess skin, which is why combining it with a tummy tuck is beneficial if you have loose skin.

How This Impacts BMI Requirements
Since you mentioned carrying most of your weight in your abdomen, it’s important to understand how BMI affects candidacy. Most board-certified plastic surgeons prefer a BMI of 30 or below for optimal safety. However, many experienced surgeons will perform a tummy tuck with a BMI up to 34–35, depending on your overall health.

Here’s how your BMI might change after surgery:

Liposuction removes fat, not weight – You might see a slight decrease on the scale, but it’s more about contouring than weight loss.
A tummy tuck removes skin and fat – Depending on how much excess tissue is removed, some patients lose 5 to 10 pounds from the excised skin and fat.
Your BMI will drop after surgery – If you are slightly above the preferred BMI range, surgery itself may lower your BMI by 1–2 points.
Next Steps
To get a better idea of what will be removed in your case, I recommend:

Pinching your lower abdominal skin – Anything you can pinch below the belly button is likely to be removed.
Standing in front of a mirror and grabbing your waist and back fat – These are the areas that would be treated with liposuction.
Consulting with a board-certified plastic surgeon – They can mark your body and show you exactly where skin and fat would be removed, giving you a clearer picture of what to expect.
Good luck, and I hope this helps answer your question regarding what is removed in a tummy tuck with 360 liposuction!

Sincerely,
Dr. Katzen

Moises Salama, MD · Answer

Thanks for your question. For a tummy tuck, the excess skin and fat below the navel is what is removed. The BMI requirement depends on your height and weight prior to surgery. At my practice, the BMI requirement for a tummy tuck is under 33. Hope this helps. Always consult with a board certified plastic surgeon. Take care, Dr. Salama, board certified plastic surgeon

Chet Mays, MD · Answer

Thank you for your inquiry!  To answer this question with accuracy, we would need to see you in person or as a virtual appointment.  We would love to meet with you to discuss your options.  Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals.

Ira H. Rex III, MD · Answer

I would have a better idea how to give you a very safe I had photographs.  During an examination, I  explain to my patient in detail what they can expect as far as the effects of liposuction and how much fullness of the abdomen can be improved.  There are not any official BMI requirements and a plastic surgeon could make a good decision regarding the operation balanced against your expectations of results.

Jose Perez-Gurri, MD, FACS · Answer

Hi, thanks for your question. Many women wonder the same. A full tummy tuck will remove the skin and fat from the belly button down to your pubic region. The umbilical stalk (belly button) is preserved a new opening on the skin is made to bring the stalk out. Lipo 360 will improve your waist line and under bra rolls. There are limits as too how much may be removed depending on the state you live in. Here in Florida, if liposuction is performed in conjunction with another procedure the amount of actual fat (SNF) removed is limited to 1,000 cc. Good luck, Dr. PG

Gary M. Horndeski, MD · Answer

At the time of abdominoplasty, the skin and fat from approximately 1 inch above your umbilicus and approximately 1 inch above your pubic bone is excised in a diamond-shaped pattern and removed totally. The maximum amount that can be taken out with Lipo 360 is 5 liters, which corresponds to 10 lbs. These would be your limitations.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Connie Hiers, MD, FACS · Answer

photos would have been very helpful. However, the areas that can be pinched are the areas that can be treated with liposuction. Actual weight loss with liposuction is low so it may not change your BMI much. Liposuction is not weight-loss surgery.

James Knoetgen, III, MD · Answer

A tummy tuck with 360 liposuction is a combination procedure that addresses excess skin, fat, and muscle laxity in the abdominal and waist areas. Here’s how to determine what would typically be removed:
Tummy Tuck (Abdominoplasty)
1.	Excess Skin:
o	Skin from the lower abdomen (usually from just above the belly button to the pubic area) is removed.
o	The remaining skin is pulled down and tightened.
o	A new belly button may be created if needed.
2.	Stretched or Weakened Muscles:
o	If you have muscle separation (diastasis recti), the surgeon will stitch the abdominal muscles together for a flatter, firmer core.
3.	Some Fat Removal:
o	Fat in the lower abdomen is typically excised with the skin.
o	This alone may not contour the waist and flanks, which is where 360 lipo comes in.
360 Lipo (Circumferential Liposuction)
1.	Fat Removal Around the Entire Midsection:
o	Liposuction is performed on the abdomen, waist, flanks, and lower back for a sculpted look.
o	It can extend to the bra roll area and hips, depending on your needs.
2.	Not for Skin Tightening:
o	Unlike a tummy tuck, lipo doesn’t remove loose skin. That’s why combining it with a tummy tuck is beneficial.
What You Can Expect to Be Removed
✅ Loose, excess skin from the lower abdomen
✅ Fat around the waist, flanks, and back
✅ Stretched muscles (if muscle repair is performed)
What Won’t Be Removed:
❌ Excess skin on the back or thighs (unless combined with another procedure)
❌ Internal visceral fat (fat surrounding organs, which can only be reduced with weight loss)

Camille Cash, MD · Answer

A tummy tuck will essentially remove excess subcutaneous fat and skin in an elliptical shape from the belly button to the pubic bone.  The liposuction can address subcutaneous fat of the hips and flanks as well as the back.  Visceral fat (the fat behind the muscle wall which surrounds the organs) is not impacted by a tummy tuck nor liposuction.  BMI is a calculation of height and weight and doesn't take into consideration other body composition factors.  The best way to see if you're a candidate is to schedule a consultation with a board certified plastic surgeon near you.  I've included a video on tummy tuck scars that I hope you find helpful.

How can I tell what would be removed during a tummy tuck with 360 lipo?

Answers (10)

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