Do I Really Need the Feur-de-lis TT or Will I Have Almost the Same Results with a Regular Vertical Hip-to-hip Incision? (photo)

I have an extended abdominoplasty & medial thigh lift scheduled for Sep. I’m 28, 185lbs & 5’9. Loss of 140lbs(325-heavest). I've lost 100 or more twice before; this time I had lap-band, have completely changed my life style and maintained for 2 years. I don’t mind a vertical scar… as long as it is worth the trade off. Input, advice &/or suggestions is welcome. (I don’t have lipo on the list, but thinking about it)

Doctor Answers 14

Tummy tuck vs. Body Lift

You certainly need an extended abdominoplasty, not a vertical incision.  However, you also have some folds of skin on your back.  You may benefit from a circumferncial lift (whole body lift).  Of course, this can be done in 2 sessions.  Do the abdominoplasty first.  If you are dissatisfied with the back then you can do a posterior continuation to produce the whole body lift.  I would not do a vertical incision.

Best Wishes,

Gary M. Horndeski, M.D.


Texas Plastic Surgeon
5.0 out of 5 stars 163 reviews

A full tummy tuck is likely your best option. A fleur-de-llis is not mandatory.

Thank you for your question and the photos.

A full tummy tuck is likely your best option. A fleur-de-llis is not mandatory.

To be sure, see two or more board-certified plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery. I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 62 reviews

Nix The Fleur-De-Lis Tummy Tuck Approach

Based on your pictures, I don't see a significant benefit to the fleur-de-lis approach to your tummy tuck. You would get a good result with a standard horizontal excisional approach. I would, however, consider liposuction in the flanks so the side of your waistline will match better to your new flat abdomen. 

Avoid the Vertical Scar if Possible

I agree with many of the other answers listed below.   Certainly, a midline scar can be helpful in some patients, but it looks like from your photographs that you would probably get a nice result with a standard abdominoplasty with liposuction to help contour the hips and flanks.  Photographs are no substitute for a physical exam so it is hard to know how far to the side your scar will need to extend to give you the best result.  As you may know, some massive weight loss patients will need a circumferential surgery (body lift or belt lipectomy) to get optimal improvement.  If you can avoid the vertical scar I would because wound healing complications tend to increase with "T" shaped scar closures.  Good luck!

Skip The Vertical Scar, But Do The Lipo.

Although I frequently suggest the Fleur de Lis TT with the midline scar, from your photos you may not need it.  However, I would strongly recommend lipo of the abdomen and flanks at the time of your TT.  It can make an good result outstanding.  Best of luck.  lhc

Lee H. Colony, MD
Lansing Plastic Surgeon
5.0 out of 5 stars 15 reviews

Do I Really Need the Feur-de-lis TT or Will I Have Almost the Same Results with a Regular Vertical Hip-to-hip Incision? (photo)

Thanks for the posted photos. Very hard to be sure over the internet. So best to obtain a few second opinions in person. But my guess is a horizontal TT would or could be sufficient. Best of luck and follow up would be nice. 

Our vote, avoid the vertical scar

We have a fairly good experience with body contouring after weight loss, and we like the vertical or fleur-de-lise approach for some, but based on your photo we would favor the tummy tuck transverse pattern.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 34 reviews

Tummy Tuck Options

Thank you for the questions and good photos.  From what I can tell, an abdominoplasty without vertical skin removal and muscle repair would give you a great result.  Liposuction would be icing on the cake, but not critical. Without the vertical scar, you could potentially be back in a 2-piece swimsuit.  I have all my patients bring in their swimsuit the day of surgery so I can precisely place the scars in hidden places.  You may want to ask your surgeon if he does the same.  Hope it goes well!

Need a Vertical Scar Tummy Tuck?

Based on your pictures, I don't think you need a vertical scar also, but I would not fault a plastic surgeon for recommending it since it may give a little nicer contour to your trunk. 

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
5.0 out of 5 stars 28 reviews

Vertical scar

I also believe having the scar is not a good trade off. You might consider a belt tummy tuck or least having the surgeon go back as far as possible on the side. You mid torso has good contour and you do not have a lot of fullness in your upper abdomen.

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.