Combination lower body lift and FDL? (photos)

Question

I’m planning a circumferential lower body lift to address skin laxity from massive weight loss, but I have both horizontal and vertical laxity in my abdomen. Can FDL be combined with the body lift to get the best results? I would really like to avoid a revision if the body lift leaves vertical laxity in my skin closer to the rib cage.

J. Timothy Katzen, MD, FACS · Answer

Hello FreshStart0311,
Thank you for your question about the possibility of combining a lower body lift with a Fleur de Lis (FDL) procedure, and for providing your pictures and history.
Let's clarify what each procedure involves:
A 360 Circumferential Lower Body Lift includes a tummy tuck, rectus abdominis muscle plication, pubic lift and reduction, hip lift and reduction, and a buttock lift.
The Fleur de Lis (FDL) involves both horizontal and vertical tummy tucks, removing excess skin and fat from the abdomen in both directions, along with pubic reduction and rectus abdominis muscle plication.
The primary distinction between the FDL and the 360 circumferential lower body lift is the vertical removal of abdominal skin and fat in the FDL, whereas the lower body lift includes a posterior lift.
Therefore, it is indeed possible to combine a 360 circumferential lower body lift with an FDL. Essentially, the surgery you are considering is a 360 circumferential lower body lift with an additional vertical incision extending from the mons pubis to the xiphoid process.
Most plastic surgeons would recommend a 360 circumferential lower body lift for addressing issues with the pubic region, rectus muscle diastasis (particularly below the bellybutton), and excess skin and fat around the abdomen, hips, and buttocks. However, experienced board-certified plastic surgeons specializing in 360 circumferential lower body lifts generally observe that there is not a significant amount of vertical excess skin and fat in cases like yours. The vertical excess is often due to rectus muscle distention rather than loose skin, leading many to conclude that a vertical tummy tuck component may not be necessary.
I hope this clarifies whether a combination of a 360 circumferential lower body lift and an FDL is advisable in your case.
Sincerely,
Dr. Katzen

Luis Suarez, MD · Answer

Yes, the best option in this case would be a 360 tummy tuck known as circular tummy tuck, to remove all the skin from both lower abdomen and lower back. If this kid is able to be removed successfully, just with that you can avoid the FDL incision. However, if you still have residual skin in the upper abdomen, that would be a suggestion to help remove that skin. If it’s done, it does help improve and cinch the waist.

Thomas Trevisani, MD · Answer

Congrats on your weight loss! 
In person exam is essential. Short answer-yes, FDL can be combined with other body lift procedures at the same time - provided it is performed in a safe, accredited facility with overnight stay

Rodolfo Castillo, MD · Answer

According to what we see in your photos, to achieve the best outcome, it is necessary to remove excess skin both in the abdomen and in the hips and buttocks. This result is achieved through a circular fleur-de-lis abdominoplasty and can be performed in a single stage.
Best, Dr Rodolfo Castillo.

Daniel Barrett, MD · Answer

Dear FreshStart0311,
I understand your concern. It is best however that you consult with a board certified plastic surgeon to determine whether you can have several aesthetic surgeries in one session, as this would depend on various factors including but not limited to your general health condition, the type of anesthesia that will be used, and the type of surgeries that will be performed among others.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Murat Diyarbakirlioglu, MD, FEBOPRAS · Answer

FDL and 360 body lifting is one of the most common surgeries after massive weight loss and you are a very good candidate for 360 body lifting and FDL.

Peter D. Geldner, MD · Answer

While an in-person evaluation is the best way to make a good determination of your best surgical option, I would say that a FDL is your best option. Though the scar can be bothersome, it would give you the best contour.

Gerald Minniti, MD, FACS · Answer

You can't get much leaner than you! Wow and congratulations. The combination of a lower body lift with a vertical abdominal excision (FDL) is most appropriate for you and will leave you looking great. Although it is a big operation, because you're so lean, you will have much less swelling, less bruising, less pain, and a lower risk of all complications.

Camille Cash, MD · Answer

Congratulations on your weight loss!  Yes, you can combine a FDL incision along with your lower body lift in order to get the maximum reduction in excess skin.  Be sure to see an experienced board certified plastic surgeon for a consultation.  I've included a video on plastic surgery after major weight loss that I hope you find helpful.

Combination lower body lift and FDL? (photos)

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