Should I get a 360 Tummy tuck or Fleur de Lis? (photos)

Most tummy tuck candidates have vertical excess (i.e. an abdominal roll). Some (often after massive weight loss), have transverse excess (i.e. upper abdominal midline excess). 
In much the same way a horizontal incision/excision can address the traditional lower abdominal roll, a vertical incision (or inverted T/Fleur de Lis) can address the transverse excess. There is a greater scar burden and candidates must decide for themselves if this improvement is worth it.
Anecdotally, most patients will do well with a standard transverse incision tummy tuck. The addition of a vertical scar is much less common and is most typically encountered in the massive weight loss population.
Based on your photos, you might benefit from a Fleur de lis/T abdominoplasty. However, there is no replacement for an in-person exam. The decision is simply a question of skin excess in the vertical and horizontal dimension.That being said, you may still need a posterior body lift. However, in my practice, these 2 procedures are staged both for healing and recovery concerns.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
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You do not need 360 or fleur de lis.  If you are not planning future pregnancies, I recommend abdominoplasty with mesh reinforcement.  The mesh creates a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight.  In terms of your breasts, I recommend a lift using The Bellesoma Method.  This will  reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained.  I recommend you do the breast lift first otherwise the tummy tuck can pull the breasts lower making it more difficult to lift the breasts as high as possible.Best Wishes,Gary Horndeski, M.D.

Thank you for your inquiry and photos, congratulations on your weight loss! It is a bit hard to determine with photos if you are candidate for FDL, an in person consultation would be best, usually FDL is recommended for massive weight loss patients who have had bariatric surgery preformed, this also depends on your back skin, if there is excessive skin on back the FDL helps pull the back skin since lipo does not always work if its skin. I suggest seeking board certified plastic surgeons with experience to discuss details. Best of luck!