28 Different Abdominoplasty Techniques Explained


Dr Bernard Beldholm

  1. Mini Tummy Tuck Aka Lower Abdominoplasty
  2. Standard Tummy Tuck With Umbilicus Repositioning
  3. Standard Tummy Tuck With Floating Umbilicus
  4. Extended Tummy Tuck
  5. Body Lift
  6. Belt Lipectomy
  7. Reverse Tummy Tuck
  8. Fleur De-lis Tummy Tuck
  9. Traditional Tummy Tuck
  10. Avelar Abdominoplasty
  11. Illouz Suction Abdominoplasty
  12. Lipoabdominoplasty (LABP) And Lipo-suction Assisted Abdominoplasty
  13. Vaser-assisted Tummy Tuck
  14. 4D Vaser Assisted Tummy Tuck
  15. Panniculectomy And Apronectomy
  16. High Superior Tension Lipoabdominoplasty (HSTA)
  17. Lipectomy
  18. Abdominoplasty With “scarpa Fascia” Preservation
  19. Abdominoplasty With Tension Sutures
  20. Periumbilical Perforator-sparing Abdominoplasty
  21. Abdominoplasty With Plication of the Rectus Abdominis
  22. Corset Trunkplasty
  23. Endoscopic Tummy Tuck
  24. Floating Abdominoplasty

If you are struggling to understand which type of tummy tuck is right for you, then you have come to the right place. This is the most comprehensive list of different tummy tuck techniques you will find anywhere online. In this guide, you will learn about more than 20 kinds of tummy tuck procedures that can transform that undesirable flap of excess skin on your belly to a smooth, trim tummy with a beautiful silhouette. Everything you need to know before you schedule your consultation is right here.

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Mother with loose skin

Mother with Loose Skin

Life after baby isn’t always smooth sailing. No, it’s not just trying to eat healthy when you have a craving for dessert, nor is it the late nights soothing a fussy infant. For some women, it’s sagging belly skin. Perhaps months have passed, and your skin still hasn’t quite bounced back. It starts to dawn on you that much like baby, the changes pregnancy caused to your stomach may be permanent.

Post weight loss patients

The same thing goes for those who have lost weight. You have accomplished an incredible goal, and should feel proud. Unfortunately, the leftover skin hanging around your midsection haunts you like a remnant from the past. You don’t want to be that person anymore. And you want that telltale pooch of skin on your belly to go away for good. No one could blame you.

Abdominoplasty has been around for a long time

Tummy Tucks Around Long Time

Tummy tucks have been around for approximately 120 years. In that time, they have come a long way. The very first abdominoplasty was performed back in 1899 in Maryland. Modern procedures have taken the place of what are now considered suboptimal methods of removing the flap of excess sagging skin around your belly.

Compared to modern abdominoplasty, some of the older methods were downright crude. The oldest tummy tuck procedures removed the belly button entirely. As recently as 2016, one woman made headlines when she woke up without a belly button after undergoing a tummy tuck and hernia repair surgery. She claimed her surgeon did not make her aware of the surgical procedure he planned to use.

Now, the likelihood of something like this happening to you today is uncommon. But it can be helpful to familiarize yourself with some of the techniques below so that you and your doctor are on the same page with what you can expect after surgery.

Today, we have advanced methods that offer far superior results than ever before. There are many tummy tuck techniques to choose from. So, which kind of tummy tuck is right for you? By the time you finish reading our tummy tuck guide, you will have a better sense of which options to discuss with your doctor.

Mini tummy tuck AKA lower abdominoplasty

mini tummy tuck is a very popular choice for women today who are looking to get rid of the “pooch” that is common on the lower abdomen. If you are unhappy with the skin below your belly button only, your surgeon might recommend this technique for you. This technique is also ideal for removing that small flap of skin that remains after giving birth by C-section

Also known as a lower abdominoplasty, a mini tummy tuck is far less invasive than many other tummy tuck procedures. This is a less extensive tummy tuck technique that is designed to remove a small amount of hanging skin that is common after pregnancy or modest weight loss, for example.

The surgeon will make a single incision just above the pubic bone and trim away the excess skin. This method leaves a thin, horizontal scar that is merely a few inches long.

The mini tummy tuck cost is less than other procedures because it is less invasive. Other benefits are a quick recovery time and minimal scarring compared to other methods. Complications are also reduced compared to more extensive abdominoplasties.

There are limitations to how much skin can be removed using this method. Patients who have achieved substantial weight loss will require a much longer incision than this procedure requires.

Download our short guide: “Preparing for your Abdominoplasty Surgery Checklist”

Preparing for your Tummy Tuck Surgery

Standard tummy tuck with umbilicus repositioning

A standard tummy tuck addresses excess skin on both the upper and lower abdomen. It also involves repositioning the navel. By freeing the navel, the entire abdominal wall is exposed. This allows the surgeon to remove skin all the way up the rib cage without interruption.

This technique dates back to 1967, and is not one that Dr. Beldholm would recommend since there are less-invasive techniques that deliver better results today with a lower incidence of negative side effects. The standard tummy tuck with repositioning of the belly button is known to have a high risk of seroma, which makes it less than ideal compared to other methods. A seroma is an undesirable side effect of surgery in which a collection of clear fluid (known as serum) gathers under the skin at the site where skin has been removed. A standard tummy tuck also requires drains.

Standard tummy tuck with floating umbilicus

This kind of tummy tuck is similar to a standard tummy tuck with umbilicus repositioning because both target extra skin on both the upper and lower abdominal wall. Unlike some other tummy tuck procedures, the surgeon does not cut a circle around the belly button.

So, how does a floating umbilicus differ from umbilical repositioning? With this method, a cut is made below the belly button and then the surgeon pulls the skin (navel and all) down toward the pubic bone to close the incision.

This is not a preferred technique for the vast majority of patients because only a very small amount of skin can be removed successfully. The reason for this is that as the belly button is pulled down along with the skin to close the incision, the navel will be positioned too low if a lot of skin is removed. This gives a result that just looks “off”. It is not the most practical or aesthetically pleasing choice. Of all the types of tummy tuck procedures, this is one that Dr. Beldholm does not recommend for most patients.

Extended tummy tuck

Just like the last two tummy tuck techniques we discussed, the extended tummy tuck address both upper and lower abdominal skin. The extended tummy tuck is exactly what it sounds like. In this method, the surgeon will extend the incision further around the waist than they would for a standard tummy tuck, making it an option for those seeking to remove a lot of excess skin around the belly and sides.

Typically, we see this in patients who have lost a substantial amount of weight thanks to gastric bypass surgery. Skin after major weight loss is typically very lax and stretched out both above and bellow the belly button. It also may result in a buildup of fatty deposits around the waist. The extended tummy tuck gets the job done rather nicely.

While the overwhelming majority of patients are thrilled with their new slimmer appearance, it is worth noting that a longer incision is required, which naturally results in a longer scar.

It is important that you choose an experienced surgeon who makes well-planned incisions that will heal and fade attractively. Most patients feel the scar is well worth their new slimmer figure.

Body Lift

This tummy tuck is designed for lifting the thighs and butt in addition to removing excess belly skin. With this comprehensive body surgery method, the surgeon will shape and tone a large area of the body by addressing the underlying tissue that supports the skin and fat in multiple areas.

For patients with poor tissue elasticity or a dimpled skin texture, a body lift may be the right choice. A body lift can lift your buttocks, slim your upper and lower abdominal area (even extending to the lower back in patients who need it), and tighten the thighs, leaving you with a dramatically improved figure.

Keep in mind a body lift only addresses excess skin. It does not remove fat deposits as liposuction does. However, this technique can be paired with liposuction for even better results.

Belt lipectomy

This technique is also known as an abdominal lipectomy. It is a procedure most commonly used for patients who have experienced substantial weight loss after bariatric surgery.

Lipectomy simply means cutting away fat. A belt lipectomy is similar to a body lift, except that it eliminates both fatty tissue and sagging skin below your belly button, rather than simply removing only excess skin. A belt lipectomy may include your lower abdomen, hips, thighs and buttocks. The tissue is simply cut around the waist, like a belt.

This surgery is ideal for removing extra skin folds. A belt lipectomy results in a flatter, smoother tummy and lower body.

This procedure is not recommended for patients who are still fluctuating with their weight. Once your weight is stable, that is the time for a belt lipectomy. It is the final stage of your weight loss journey to get rid of that last bit of excess skin and fat that remains once you have reached your goal weight.

Belt lipectomies tend to be more costly than other types of tummy tucks, but the results can be truly fantastic.

Reverse Tummy Tuck

A reverse tummy tuck is also known as an upper abdominoplasty. If you have undergone liposuction in the past and noticed that it did not improve the appearance of your upper abdomen as you had hoped, a reverse tummy tuck may be the next course of action.

This procedure involves cutting away excess tissue above the belly button only. If you have a pooch of excess sagging skin below your belly button, then this is not the right procedure for you. This technique improves the upper abdominal contours with an incision that follows the lower part of the breast and sternum.

A reverse tummy tuck is favorable because of the location of the incision. Well-placed scars can usually be hidden quite easily, even in a two-piece bathing suit. Your doctor may suggest pairing this surgery with a liposuction procedure for the smoothest results possible and a nice, tight appearance of the upper belly.

Fleur de-lis tummy tuck

Named after the shape of a water lily, the fleur de-lis surgery has an incision in the middle of the abdomen that leaves both vertical and horizontal scars. The downside is that vertical scars are much more difficult to conceal.

Scar visibility is a major consideration when it comes to any cosmetic surgery. Exposed scars not only look less attractive, but they are more difficult to shield from the sun in the summer. This can have negative effects on the quality of the scar such as permanent darkened pigmentation and decreased collagen and elastin production.

So, who can benefit from a fleur de-lis tummy tuck? Patients who want a substantial amount of tissue removed are the most likely candidates. The tradeoff of the scars is well worth it for those who need major body sculpting. Scar revision options such as lasers and injections may also be used superficially to diminish the look of scars after surgery.

Traditional tummy tuck

Female Chest Muscles

The traditional or standard tummy tuck removes excess skin and repairs muscle separation.

Avelar Abdominoplasty

Avelar abdominoplasty is a combination of liposuction with minimal cutting to remove excess skin and fat for the tummy tuck portion of the procedure. This method gained popularity in the 1990s thanks to a Brazilian surgeon named Dr. Juarez M. Avelar.

It was among the earliest to introduce liposuction as part of tummy tuck surgery, so it is an important technique to know about. Avelar abdominoplasty was important for setting the groundwork for liposuction in tummy tucks, and it is still sometimes used today in rare instances. However, it is uncommon to find patients that are suitable for avelar abdominoplasty since it has a limited incision and thus, limited results.

This method has limitations since the skin is not undermined, or raised. One of the biggest drawbacks is that the patient is left with an extremely high scar that is difficult to hide. Naturally, this is not a desirable cosmetic result. We can do better today.

Illouz suction abdominoplasty

This is another 1990s method that was one of the first to use liposuction as part of the tummy tuck procedure. Similar to the avelar abdominoplasty discussed above, surgeons were very cautious since it had always (wrongly) been considered dangerous to perform liposuction and tummy tuck simultaneously.

Again, this is a limited technique that gives suboptimal results because it cuts away only a minimal amount of skin and fat without undermining in order to preserve blood flow. Undermining simply means elevating the skin and fatty tissue off the abdominal wall. By not undermining, there is only so much a surgeon can do to improve the appearance of your belly. Back then, doctors believed this was necessary for patient safety.

Lipo-abdominoplasty  (Liposuction assisted abdominoplasty)

This two-part procedure combines liposuction with abdominoplasty, yielding better results and smoother skin than a tummy tuck alone. This idea was first introduced by Cardoso de Castro back in 1987. This groundbreaking technique is the first to introduce liposuction to the surgery, however there are more effective methods that refined on his concept that are available today.

Liposuction is performed first to create space on the inside. It gets rid of fat so that when the surgeon pulls down the tissue, it results in smoother-looking skin. Next, an incision is made along the abdominal crease. The flank is then tightened, ideally keeping an acceptable distance between the navel and mons pubis for the most natural look.

A highly-trained surgeon can make all the difference in planning the site of scars to minimize their visibility. The more the skin sags, the more difficult it is to plan, so be sure to seek a very experienced doctor for your surgery.

VASER-assisted tummy tuck

VASER Procedure

Vaser stands for Vibration Amplification of Sound Energy at Resonance. Dr. Beldholm uses ultrasonic liposuction, inserting a probe which melts away the fat and then sucks it away. After the fat deposits are removed, the tummy tuck is performed. Patients are left with smooth result.

This is one of the new tummy tuck techniques that Dr Beldholm preferred today. Aside from creating a super smooth finish on the skin, adding liposuction to tummy tucks have been shown to reduce the length of incisions and scars. In surgery, anything we can do to reduce scar size is vital to giving patients a satisfactory outcome.

A tummy tuck and lipo allows you to heal quicker and hide scars more easily. For these reasons, adding Vaser liposuction to your tummy tuck is a very popular choice today.

4D VASER assisted tummy tuck

Waste not, want not. This method is just like the Vaser-assisted tummy tuck method, except that the fat that is removed is used to enhance other body parts, such as the breasts or buttocks, for women who desire more fullness in these areas.

This advanced technique firms your belly while reshaping other areas of your body using your very own fat. Patients love using their natural fat to achieve an aesthetically pleasing result all over. Many women report that using their own fat to augment their breasts and buttocks feels like a more “natural” choice than having implants.

There are limitations to this procedure, however. If you desire to add a lot of volume to other areas of your body, you are going to need to have an adequate amount of fat removed. Of course, maintaining harmony of your body is top priority, so your surgeon will assess your body in detail to determine exactly how much fat should be relocated.

Panniculectomy and apronectomy

A panniculectomy removes the pannus, which is excess skin located on the lower part of the abdomen. Unlike a tummy tuck, this method does nothing to tighten the abdominal muscles. Instead, it involves simply cutting out the tissue.

It is a much more straightforward procedure than the tummy tuck, and results are limited because of this. For weight loss patients, removing low hanging skin can create a more smooth, attractive abdominal contour. A panniculectomy is not a replacement for weight loss, however.

As with most surgical procedures on the belly, patients will be advised to reach a stable weight prior to having it done. This method does not address stretch marks, although some may be removed from the area of skin that is excised. Another benefit of panniculectomy is the cost.

High superior tension lipo-abdominoplasty (HSTA)

Did you know that fashion trends greatly influence the types of tummy tuck scars surgeons choose? Bikini styles change from time to time, and cosmetic surgery must keep up with the latest fashions in order to produce the most aesthetically pleasing and well-hidden scars.

Pioneered in 1995 by Lockwood, the high superior tension lipoabdominoplasty prevailed thanks to the ultra high-waist French-cut bikinis that were in vogue at the time. Surgeons developed this technique because it allowed skin tissue to be stretched out to the side much easier, which was great for this style of swimsuit. This method leaves a scar that is quite high up on the midsection, which is generally not desirable today since swimwear styles are lower cut these days.

Extensive liposuction is also performed, along with high-tension sutures. HSTA was created to prevent seroma formation since it preserves lymphatic vessels. Undermining is limited, which limits aesthetic results, but it does reduce trauma and preserves abdominal nerves. Since the introduction of HSTA, there have been dozens of refinements to the procedure.


This means cutting out fat, plain and simple. It could be anywhere: the thighs, arms or tummy, for example. For patients who are obese, this is a way to remove excess fatty tissue surgically. Nothing more, nothing less.

Most patients will benefit from a multi-step approach that addresses more than just fat alone. The reason is that obesity stretches the skin, creating very lax, damaged tissue that does not “snap back” like younger, firmer skin does.

What does lax tissue look like? Try the skin elasticity test. Pinch the skin on the back side of your hand with your thumb and index finger for about five seconds. When you let go, take note of how long it takes for the skin to return to its original position. The longer it takes, the less elasticity the skin has.

Being overweight stretches the skin, and simply cutting away the fat does nothing to improve skin quality. Lipectomy has limited results for those seeking to improve their appearance, but it can be useful for the right candidate.

Abdominoplasty with “Scarpa Fascia” preservation

Developed to improve on the safety and recovery speed of traditional abdominoplasty, this method preserves the lymph vessels and vascular structures within the skin. Doing so greatly lowers the risk of seroma.

The scarpa fascia refers to the deep layer underneath the skin of the abdomen known as the stratum membranosum, which is where a collection of lymph are located. This method has a faster recovery rate and less complications than a conventional abdominoplasty since the surgical area is smaller. This results in shorter hospitals stays and reduces the volume of fluid that needs to be drained.

This safe, repeatable procedure gives consistently good results and is recommended over abdominoplasties that trim away the scarpa fascia.

Abdominoplasty with tension sutures

This type of tummy tuck cuts the patient on the inside and then uses the tension from stitches on the flap of skin to pull it down as the incision is closed. Essentially, it is nearly the same as a standard tummy tuck with stitches.

The point of the tension sutures is to reduce the risk of seroma, or fluid collection. Using sutures to anchor the abdominal flap not only helps prevent seroma, it can also prevent a complication known as distal flap necrosis, or death of the tissue.

It is considered safer than older forms of abdominoplasty. The other advantages of this method are that this is a drainless tummy tuck, and patients are even encouraged to walk upright right away.

Periumbilical perforator-sparing abdominoplasty

Introduced as a way to make liposuction during tummy tuck surgery safer, periumbilical perforator-sparing abdominoplasty is one method to do exactly that.

There are a lot of blood vessels surrounding the belly button that feed the skin. Perforators come through the rectus abdominis muscle, and this technique preserves them for better healing.

The perforators tend to be low, so when the surgeon stretches the tissue, the perforators can limit how smooth the result may be. However, the latest lipoabdominoplasty techniques likewise maintain adequate blood flow, so this technique is not used as often as it once was.

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Abdominoplasty with plication of the rectus abdominis

Tummy Pregrancy opt

That is quite a mouthful, isn’t it? The word plication means to fold, and your rectus abdominis is your abdominal muscles. Now that we have got that out of the way, this method refers to pulling the two large abdominal muscles together as part of a standard tummy tuck if you have separation between the muscles.

Patients who have experienced weight loss after pregnancy or overcoming obesity often have a weakened abdominal wall, which can lead to separation. With this tummy tuck method, the surgeon tightens stretched and weakened abdominal muscles by folding the excess pleated and suturing it in place.

Not all weight loss patients or pregnant women have muscle separation. It is possible to go through pregnancy or lose weight without muscle damage, so just because you have given birth or lost weight does not mean you will need to repair the muscle. However, for those who have stretched or separated the stomach muscles, your surgeon can use plication to repair them.

Corset trunkplasty

This is a relatively new body contouring surgery used for post-bariatric patients and people with substantial weight loss. To perform this procedure, the surgeon makes a cut in the middle of the abdomen, then pulls the tissue in to give the waist a slimmer silhouette, similar to how a corset gives women an hourglass figure.

The drawback is the placement of the cut in the center of the belly. It is not a desirable location for a scar since it cannot be hidden by a bikini or underwear like you can with other kinds of tummy tucks.

While corset trunkplasty is considered a safe, new procedure, Dr. Beldholm advises against it for most patients due to the scars. Minor complications such as a small amount of wound separation and mild tissue death may also occur.

Endoscopic tummy tuck

An endoscopic tummy tuck is a variation of the mini tummy tuck. No skin is removed at all with this method. Popular about five to ten years ago, the endoscopic tummy tuck repairs muscle separation without having to do a large cut on the lower part of the abdomen. This results in minimal scarring and a shorter recovery time for most patients.

The surgeon uses an endoscope light device to make several small incisions along the pubic bone or in and around the belly button. It is a minimally invasive tummy tuck technique with far less visible scarring, plus less bruising and swelling than other kinds of tummy tucks.

The downside is that if the patient has muscle separated by 10cm, for example, they will be left with a rather large piece of skin in the middle when the muscles are joined together. Because of this, it has limited uses for patients who have anything more than a tiny separation.

Unfortunately, patients seeking substantial changes to their body would have an overall poor cosmetic result if they were to use this technique. Dr. Beldholm is unlikely to recommend it for most of his patients for this reason. It would be a poor surgical choice for anyone with a lot of excess skin. It is also not advisable for patients with very lax or mature skin with decreased elasticity.

Floating abdominoplasty

Last but not least, we have the floating abdominoplasty, also known as the FAB technique. With the word “fab” in the name, you might expect this to be one of the best tummy tuck methods available. But unfortunately that is not the case.

Dr. Beldholm advises against this method for the vast majority of patients, except perhaps for those seeking to tighten a modest amount of skin, ideally only a few centimeters of tissue at most. Generally speaking, most women need to have more skin removed than that after pregnancy. For patients who have accomplished substantial weight loss through dieting or surgery, you can forget about this technique. It will not work well at all in those instances.

The reason is that a floating abdominoplasty avoids cuts around the belly button. Instead, the stalk of the belly button is cut on the inside. Then, as the skin tissue is pulled down to close the incision, the surgeon will reattach the belly button.

So what exactly is the problem? If the surgeon were to remove more than a few centimeters of skin, they would have to pull the skin down quite far, and the belly button along with it. It would look silly to have your belly button positioned too far down toward the pubic bone, which would lend a very unnatural-looking result.

Typically, patients are seeking to remove more skin and fat than what this technique is able to accomplish. The floating abdominoplasty may be fab for some, but it is not for everyone.

What makes a good tummy tuck technique

As you can see, there are many different types of tummy tucks. Abdominoplasty has come quite a long way in the last century. What makes a good tummy tuck technique? The goal is to consider each patient case by case when deciding which procedure to choose. We want to achieve the best possible results with the lowest risk of complications.

The most successful abdominoplasty methods ensure natural placement of the belly button, well-planned scars that are ideally hidden when possible, and beautiful results for each and every patient.

Reference articles and resources

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