An incision is made at the bikini line from hip to hip just above the pubic area; another circular incision made around the navel frees the umbilicus from the abdominal skin. The skin and fat of the abdomen is elevated off the muscle wall. If the muscular wall is lax, its fascial covering can be tightened with sutures (plication). This is often the case in mothers where previous pregnancies have weakened the abdominal muscles or separated the rectus muscles (diastasis or divarication). The abdominal skin is pulled downwards and excess tissue is resected. A new opening is made for the umbilicus and the skin is closed in layers.  

When there is less excess lower abdominal tissue with or without poor muscular tone, a mini abdominoplasty is indicated.  

A shorter incision is made at the bikini line. The skin and fat of the abdomen is elevated off the muscle fascia. Instead of a skin incision around the navel, the umbilicus is floated by cutting its stalk above the muscle fascia, thereby allowing the umbilicus to follow when the abdominal skin is pulled downwards. The lax muscle fascia is tightened with sutures to improve its tone and create a waist (plication). The abdominal skin is pulled downwards and excess tissue is discarded. The skin is then closed in layers.