Tummy Tuck Types Explained: Mini, Full, Extended, Fleur-de-Lis and 360

By Dr. Rushapol Sdawat, MD — Thai Board-certified Plastic and Reconstructive Surgeon, Medical Licence No. 17689
Last reviewed: 28 AUG 2026

You have probably been quoted for "a tummy tuck" by at least one clinic that never told you which one. That is not a small omission. The phrase covers at least five distinct operations, with different scars, different recovery, different risk, and different prices — and the most common cause of disappointment I see in consultations is not surgical failure. It is a patient who was sold the smaller operation when their anatomy needed the larger one, or who chose the smaller operation because the scar sounded better, without anyone explaining what it could not fix.

So this article does what a quote cannot: it walks through each variant, tells you exactly where the scar sits, and tells you honestly who each one suits — including the version most people asking for it do not actually qualify for.

I am a Thai Board-certified plastic and reconstructive surgeon, and I have been doing this work for around 26 years. What follows is how I explain it across the desk.

Why "tummy tuck" is not one operation

Every abdominoplasty variant does some combination of three things: removes redundant skin and fat, repairs the stretched midline of the abdominal wall, and repositions the umbilicus. The variants differ in how much skin is removed, in which direction the excess runs, and therefore where the scar has to go.

That last point is the one to hold onto. The scar is not a design choice. Skin can only be removed by cutting it out, and the scar sits wherever the excess was. A surgeon who promises a big correction with a tiny scar is describing an operation that does not exist.

The mini abdominoplasty: the most requested and least suitable

A mini abdominoplasty removes a modest ellipse of skin below the umbilicus through a scar similar in length to a caesarean scar, sometimes slightly longer. The umbilicus is not moved. The muscle repair, if done at all, is limited to below the navel.

It suits a genuinely narrow group: people with good skin tone above the navel, little or no rectus diastasis — the separation of the vertical abdominal muscles — and a small pocket of loose skin confined strictly to the lower abdomen. In practice that often means someone young, close to their ideal weight, after one pregnancy or modest weight loss.

Here is the honest part, and it matters more than anything else on this page: most people who ask me for a mini abdominoplasty are not candidates for one. They ask for it because the scar is shorter and the recovery quicker, which is entirely rational. But if your laxity extends above the navel, a mini simply leaves it there — and now it sits above a tightened lower abdomen, where it is more visible, not less. A large share of revision enquiries I receive from patients operated on elsewhere are mis-selected minis. The operation was performed competently. It was the wrong operation.

The full abdominoplasty: what "full" actually includes

The full (standard) abdominoplasty is the workhorse. The skin and fat layer is lifted from the pubic line up to the ribs, the rectus diastasis is repaired with a line of plication sutures running from the breastbone to the pubis, the excess skin is removed, and the umbilicus — which stays attached to its stalk throughout — is brought out through a new opening in the redrawn skin. That step is called umbilical transposition, and it is one of the reasons a full abdominoplasty cannot be shrunk into a mini: if you remove enough skin to correct upper-abdominal laxity, the old umbilical opening ends up somewhere it should not be.

The scar runs from hip to hip, low enough to sit inside underwear or swimwear. There is also a scar around the umbilicus. At Intrarat Hospital my published price is A$7,000 / ฿160,000 (indicative, converted at approximately 23 THB/AUD, confirmed at booking), inclusive of hospital, anaesthesia, first-night ICU monitoring and accommodation. A mini is priced on assessment — [CONFIRM: current mini abdominoplasty price from /price].

What diastasis repair actually fixes — and what it is not

Patients often say "my muscles are torn" or "my core is weak". Neither is quite right. In pregnancy or significant weight gain, the linea alba — the band of connective tissue joining the two vertical rectus abdominis muscles down your midline — stretches sideways. The muscles themselves are usually normal. They have simply been pushed apart by a widened, thinned sheet of connective tissue that does not recoil, because connective tissue is not muscle and cannot be exercised back.

That is why no amount of core training closes a significant diastasis, and why the repair is a suture repair of the connective tissue, not a muscle operation. It is also why the repair changes the shape of the abdomen — the bulge you see when you sit up is the abdominal contents pushing through the slack midline — and why it is protected during recovery: sutured connective tissue takes weeks to regain strength.

The extended abdominoplasty: when the problem does not stop at your hips

If you pinch your loose skin at the front and follow it sideways, it may not stop. Many patients — especially after weight loss — carry a roll that continues past the hip bones onto the flanks. A full abdominoplasty ends its scar at the hips, so it ends its correction there too, and the flank roll remains, now sitting beside a flat abdomen.

The extended abdominoplasty carries the excision and the scar around past the hip bones toward the back, chasing the excess to where it actually finishes. Longer scar, longer operation, larger raw surface — and the right operation for that anatomy. My price is A$8,300 / ฿190,000 (indicative, confirmed at booking).

The fleur-de-lis: a vertical scar, deliberately

Everything above removes skin in one direction: vertically, pulling the abdomen down and tightening it top to bottom. But after massive weight loss, many abdomens are loose in both directions — there is excess running side to side as well. No horizontal-scar operation can correct horizontal excess.

The fleur-de-lis abdominoplasty adds a vertical wedge of excision up the midline, leaving an inverted-T scar: the usual hip-to-hip line plus a vertical line up the centre of the abdomen. Named for the shape of the excision pattern, it is an explicit trade — you accept a visible vertical scar in exchange for a degree of tightening no other pattern can deliver. For the right patient, usually post-massive-weight-loss with a wide, apron-like laxity, the trade is worth it. For anyone else it is over-surgery. The junction point of the T is also the most failure-prone point of the wound, which belongs in the risk conversation, not the footnotes.

The 360: circumferential abdominoplasty, belt lipectomy and the lower body lift

When the excess runs all the way around — abdomen, flanks, back rolls, and a descended buttock and outer thigh — the excision goes all the way around too. The scar circles the body like a belt.

Terminology here is loose, and clinics exploit that, so let me be precise:

• Circumferential abdominoplasty / belt lipectomy: removes the ring of excess trunk tissue. The emphasis is resection of the roll.

• Lower body lift: the same circumferential excision, but the posterior part is designed as a lift — the buttock and outer thigh tissue below the scar is elevated and re-suspended, sometimes preserving deep tissue to restore buttock volume.

• The difference is the buttock component. If your buttock and outer thigh have descended and deflated, a belt lipectomy alone removes the roll but does not address them; a lower body lift does.

My circumferential body lift is A$14,800 / ฿340,000 (indicative, confirmed at booking). It is a major undertaking with the highest complication profile of anything on this page, and I have written about it separately at length rather than compress it here.

Panniculectomy: the operation that is not a tummy tuck

A panniculectomy removes the overhanging apron of skin and fat (the pannus) and nothing else — no muscle repair, no umbilical transposition, no contouring above the navel. It is fundamentally a functional operation, done for recurrent skin infections, rashes and hygiene problems under the fold, sometimes in patients still too heavy for an aesthetic abdominoplasty. It relieves the apron; it does not aim to produce a flat, shaped abdomen. In Australia, post-pregnancy abdominoplasty has a Medicare item number (MBS 30175) under strict criteria — but Medicare does not cover any procedure performed overseas, so that pathway exists only at home.

How the variants compare — and the risks they all share

VariantWhat it addressesScarUmbilicus moved?Diastasis repairTypical candidateMiniSkin below navel onlyShort suprapubic lineNoLimited or noneNarrow group; good tone above navelFullWhole front of abdomenHip to hip, plus umbilicalYesFull-lengthPost-pregnancy, moderate weight changeExtendedAbdomen plus flank rollsPast the hip bonesYesFull-lengthLaxity continuing onto flanksFleur-de-lisVertical and horizontal excessInverted T (adds vertical scar)YesFull-lengthMassive weight loss, wide laxityCircumferential / lower body liftFull trunk ring ± buttock liftComplete beltYesFull-lengthMassive weight loss, circumferential excessPanniculectomyOverhanging apron onlyLow transverseNoNoFunctional relief, not contouring

The bigger the operation, the higher each of these risks, but none of them is ever zero: haematoma, seroma (fluid collection under the flap, the most common of all), infection, wound-edge separation, skin necrosis — particularly at the midline of a full abdominoplasty and the T-junction of a fleur-de-lis — altered or numb skin sensation, venous thromboembolism, asymmetry, scars that stretch or thicken, and a result you are technically fine with but emotionally disappointed by. Abdominoplasty carries one of the higher VTE risks in aesthetic surgery, which is why I use mechanical prophylaxis and early mobilisation, and why flying home early is not negotiable — ASAPS advises patients not to fly for six to eight weeks after surgery of this kind. No protocol removes these risks; a careful protocol manages them.

When to seek care

Whether you are in a Bangkok recovery apartment, in transit, or back home in Australia:

Emergency — go to hospital now: sudden breathlessness, chest pain, or coughing blood (possible pulmonary embolism); a calf that becomes painful, hot or swollen (possible DVT); rapid abdominal swelling with severe pain or light-headedness (possible haematoma); fever with spreading redness and feeling systemically unwell.

Same-day review — contact your surgical team today: wound edges opening; fluid collecting under the skin as a mobile swelling; darkening, dusky or blackening skin near the incision or umbilicus; increasing rather than decreasing pain after the first week; foul-smelling discharge.

If you are my patient, you have my team's direct line before you leave hospital. If you are back in Australia, present to your GP or an emergency department — do not wait to "check with Thailand first" when the symptom is on the emergency list.

The question that actually chooses your operation

Not "which tummy tuck do I want?" but "where does my excess actually finish, and in which directions does it run?" Answer that honestly — with a surgeon willing to examine you and say the less convenient thing — and the variant chooses itself. The mis-selected mini is cheaper and easier to sell. It is also the revision I see most. Choose the operation your tissue needs, or wait until you are ready for it.

Dr. Rushapol Sdawat (known to international patients as Dr. Dominic) is a Thai Board-certified plastic and reconstructive surgeon practising at Intrarat Hospital, Bangkok, Medical Licence No. 17689. He holds Thai Board certification in General Surgery (Phramongkutklao Hospital) and in Plastic and Reconstructive Surgery (Ramathibodi Hospital, Mahidol University), has been a member of ISAPS since 2008 and is an international member of the American Society of Plastic Surgeons. Dr. Rushapol holds Thai specialist certification; he is not registered with Ahpra and does not hold Australian or New Zealand specialist registration. His registration can be verified on the Medical Council of Thailand register at checkmd.tmc.or.th.

This article is provided for general information and education. It is not medical advice and cannot substitute for individual assessment by a qualified practitioner who knows your history. Surgery carries risk, including risk of serious complications and of outcomes that do not meet expectations. Results vary between patients.