After massive weight loss there are many 'patterns' that are used to remove the excess skin and contour the abdomen. Frequently, a belt line dermolipectomy is used. With this procedure the excess skin in the waist abdomen and buttock is removed and tailored by a reduction scar line which goes all around the waist front to back. The benefit is a reduction and lift which includes buttock, the side of the thigh, abdomen, and to some extent the inner thigh. The pull or lift in this pattern can however straighten the waist. In order to narrow and contour the waist the skin must be removed in a vertical direction as well, not just on the horizontal line as in a more typical abdominoplasty. Hence, the fleur-de-lis, where the reduction occurs on the horizontal, but also on the vertical line, down the middle of the abdomen. The pattern become an inverted 'T'.
The better candidate is one who already has a vertical, or up and down, scar on the abdomen from prior surgery, often from a bypass procedure. Still, if the anticipated waist will be straight and shapeless, the extra incision and skin removal may be well worth the effort. Men probably will not be interested, though women who are more challenged by contoured or fitted clothing may appreciate the difference that the 'T' pattern has to offer. Certainly the procedure is worth looking into and may provide just what you are looking for.
Best of luck,