Circumferential Hybrid Abdominoplasty Combining a Vertical Lipectomy with Belt Lipectomy
The circumferential hybrid abdominoplasty is a technique I developed for patients whose excess skin after significant weight loss runs in more than one direction and continues around the flanks and lower back. It combines a body lift (belt lipectomy) with a vertical excision on the front of the abdomen, so the full pattern is treated in a single operation. For a complete guide to the technique, read my comprehensive circumferential hybrid abdominoplasty article.
Is this the right operation for your skin pattern?
The direction of your skin excess determines the operation. Vertical excess, where skin hangs from top to bottom, is treated with the horizontal excision of a standard abdominoplasty (tummy tuck). Horizontal excess, where laxity runs side to side around the waist, needs a vertical excision. Most post weight loss patients have both, and the laxity continues past the hips into the flanks and lower back.
That combined pattern is what this operation treats. If your excess is confined to the front of the abdomen, a standard or Fleur de Lis abdominoplasty may be all you need. Whether this operation suits your pattern is assessed at consultation.
What the operation involves
- A circumferential incision around the lower torso, the same as a body lift (belt lipectomy), plus a vertical midline incision on the front of the abdomen
- I mark the incision plan with you in the anaesthetic bay before surgery
- Muscle repair if you have muscle separation (diastasis recti). This is not a given after weight loss and is assessed individually
- Repair of any hernia found on assessment, completed during the same operation
- A new belly button (umbilicus) is reconstructed
- General anaesthetic at Maitland Private Hospital
- Operating time of around 6 to 8 hours
- A hospital stay of 3 to 7 days
- 2 closed suction drains, 1 at each lateral hip. Some patients go home with drains still in place
Why come and see me
I am a Specialist Surgeon with 15+ years of experience, and my practice is focused on post weight loss and post pregnancy surgery. Patients who have lost a large amount of weight are a different patient population. The skin excess is more extensive, it runs in more than one direction, and it calls for different operations. Comprehensive skin removal is the core of my work, and the circumferential hybrid abdominoplasty is a technique I developed for this group. I also present at conferences and teach other surgeons my techniques.
The operation is only part of it. I prepare you for surgery with a detailed nutritional approach, because most post weight loss patients carry nutritional gaps that matter for healing. Your surgery takes place at Maitland Private Hospital, which has an ICU and 24 hour doctor cover. Afterwards you are followed closely by my nurse and by me, with intensive reviews over the first 2 weeks and then reviews at 4 weeks, 3 months, 6 months and 12 months. Many of my patients come from a long distance, and I liaise closely with your GP throughout.
Risks and recovery
This is major surgery. It runs for 6 to 8 hours under general anaesthetic, and complications can and do occur, including wound healing problems, seroma, infection, bleeding and blood clots. Recovery is measured in weeks, not days. You will need time off work, help at home in the first weeks, and you will be limited in what you can lift for 6 weeks. I go through the full picture with you at consultation, and I have written about both in detail: read my circumferential hybrid abdominoplasty recovery article and my circumferential hybrid abdominoplasty complications article before you decide anything.
Cost and Medicare
Where you meet the criteria, MBS item numbers may apply to this surgery, which affects your Medicare and health fund contribution, and you receive a full written itemised quote after your consultation. For a breakdown of what is involved, read my circumferential hybrid abdominoplasty cost article.
Your steps to surgery
1. Get your GP referral
A GP referral is required before any consultation.
2. Consultation with me
I assess your medical history, your nutritional status and your pattern of skin excess, and we work out whether this operation, a staged approach or a different procedure suits you.
3. Receive your written quote
A full itemised quote, including any applicable MBS item numbers, follows your consultation.
4. Prepare for surgery
Blood panel, correction of any nutritional gaps, and a preparation period before your surgery date.
5. Have your surgery
At Maitland Private Hospital, with a 3 to 7 day stay.
6. Recover with structured follow-up
Intensive reviews in the first 2 weeks, then reviews with me at 4 weeks, 3 months, 6 months and 12 months, with a formal handover to your GP.