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Should I Have a Fleur De Lis?

I'm about to have a full tummy tuck on the 21/03/08, so only a few days! My surgeon suggested the possibility of a fleur de lis to remove the fat pad above my belly button. I hate that part of my stomach but I don't want to have a large vertical scar. I'm having my surgery on the NHS so I'm not sure they can remove this by lipo. However, I have read that fat pads can be removed by hand. Is this possible? What would be best for me? I'm 21 & have recently lost around 46lbs. I've always had excess skin since I can remember being conscious of it. I was always over weight as a child & lost 3 stone when I was 15/16 but gained this again, until my recent weight loss.

Doctor Answers 6

Fleur de-lis tummy tuck

If you have severe laxity in the midline this may be a good option for you. I usually reserve this for massive weight loss patients.  Your skin looks significantly lax at such a young age.  Hard to say definitively without an exam.

Manhattan Plastic Surgeon
4.5 out of 5 stars 19 reviews

Fleur-de-lis Abdominoplasty

There are many different options when it comes to tummy tuck.

It is more likely that the fullness you see above the belly button is loose/redundant skin and not a "fat pad". Therefore any attempt to remove the fat pad is not likely to result in elimination of the fullness you see there. It won't matter if it is done with lipo or "by hand"; the skin will remain loose and hanging.

Express your concerns to your surgeon. Depending on how high your incision will be placed you could eliminate the upper umbilical redundant skin using a traditional abdominoplasty with/without a small vertical scar. This could obviate the need for the larger vertical scar seen with a fleur-de-lis.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 55 reviews

Should I Have a Fleur De Lis Tummy Tuck


The answer lies in the physical examination of your tissue. At your age and size I would not put a Fleur de Lis incision since the upper abdominal incision will not be as cosmetic as the horizontal incision.  At some point later you may need the additional excision with a vertical approach.


Paul Vitenas, Jr., MD
Houston Plastic Surgeon
5.0 out of 5 stars 57 reviews

Fleur de lis abdominoplasty

In considering a fleur de lis abdominoplasty, one of the most important factors is the age of the patient and the acceptance of a vertical scar.

Considering your age and the 46lbs weight loss, I would try to avoid this scar. I have done the fleur de lis for massive weight loss patients (120 pounds and more), and I tend to do it as a second procedure. On many occasions, this could be avoided.

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 16 reviews

Vertical scars on the abdomen don't look as good as horizontal ones

When doing an abdominoplasty, the lower abdominal horizontal scar usually heals quite well and is easily concealed. Occasionally in the masive weight loss patient a vertical scar is also necessary to optimize the result but at the expense of worse scar. Fro your photo it does not appear as though a vertical scar would be necessary. The tissue above your umbilicus is extra skin and not a "fat pad" and it will look flatter and tighter when it is unfurled and pulled down to reach the lower abdominal scar.

Usually, tummy tucks are performed when you are done having children so if you are anywhere near considering having a family, I would suggest you wait until afterward.

Fleur de lis tummy tuck - there are better options for you...

A Fleur de lis tummy tuck is a tummy tuck that has a vertical incision at the midline as well. In our practice, we often perform this procedure on patients who already have a scar in this area from a previous surgery. If you do not have a scar in this area, I would recommend to avoid placing a scar here as it would be prominent and noticeable. However, if you have had a previous surgery this midline incision is an excellent way to tighten the abdomen and to limit the extension of the lower abdominoplasty incision.

To learn more about tummy tucks, see photos, and help you decide which one is best for you, please visit us at the link below:

Pat Pazmino, MD
Miami Plastic Surgeon
4.5 out of 5 stars 66 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.