FDL tuck or lower body lift? (photo)

Question

I am having my chest taken care of but need to choose to have either a lower body lift or the fleur de lis tummy tuck along with it. I don't care about scars, just want to look the "best" and get rid of the loose skin. If I do a lower body lift, will I still have a bunch of loose skin in my stomach? I know it will clean up my outer thighs and butt which is good, but will the stomach not look as good as with a FDL? 2 surgeons recommended LBL and 2 FDL. I can't decide and would like more opinions please

Warren Schutte, MD · Answer

You would benefit from a FDL abdominoplasty with lateral hip extension and also a lower back lift. I perform these surgeries at separate times, making patients wait a few months apart, depending on their healing from the first surgery.

Daniel Barrett, MD · Answer

Dear lavaroach,

it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Jeffrey M. Darrow, MD · Answer

A lower body lift simply refers to the circumferential incision around your body that corrects your abdomen, flanks, back and buttocks. This is a very powerful operation for the lower body. The key to remember, is that the further from your incision, the less effect there is on your tissues.  Therefore, after a lower body lift, where the incision is placed across your lower abdomen, the upper abdomen skin may not smooth and tighten as much as patients want. Therefore, for these people a FDL pattern can be combined with the LBL incision.  The FDL incision is right next to the upper abdominal skin and allows removal of loose upper abdominal skin.  The benefit is the tightest/smoothest abdominal skin and the trade off is a vertical midline abdominal incision line, instead of just the circumferential lower body incision. Discuss this option with your plastic surgeons.

Joel Patrick Maier, MD · Answer

Given the amount of laxity, you would benefit from all  options (fleur-de-lis and circumferential). This will maximize the tightness and lifting. I would not hesitate to proceed. Thank you for the inquiry!

Eric Swanson, MD · Answer

There is a saying that if you see 10 different plastic surgeons you will get 15 different opinions. There's a little truth to that! I'm not a fan of the fleur de lis because of the long scar in the midline. I would recommend a lower body lift. You have obviously lost a massive amount of weight. I prefer a near-circumferential lift, avoiding connecting the scars in the midline of the back. You also need a procedure for your breasts. I prefer to keep the nipples intact and do not do nipple grafting. The lower body lift also pulls up the mons pubis.

Ramiro Morales, Jr., MD · Answer

Thank you for your question and pictures. And congrats on the weight loss.  
I think they are both correct.  A full body lift will correct the circumferential horizontal skin excess, tighten up the gluteal area but I am fairly sure you will be left with vertical skin looseness and excess.  I think you need a combination of both which I gave done at the same time with some modifications to preserve blood supply and get the optimal results.  Be sure to consult with Board-Certified PS and I would ask the FDL surgeons if they would consider a combined FDL and FBL to address both the circumferential and vertical skin excesses.  Good luck on your surgery.  You should get great results.  If you obtained your weight loss through Bariatric surgery, be sure that they check your Nutrional status pre-op to ensure the best healing possible post op .

Gary M. Horndeski, MD · Answer

The fleur de lis was designed to take care of horizontal excess at the level above the umbilicus. At this level, you do have some excess but not that bad. I recommend doing the chest first using The Bellesoma Method. This technique will raise your breasts and lift the upper abdominal skin above the umbilicus and eliminate the need for the fleur de lis. Your back has excess skin as well. You will need 2 procedures: the 1st would be a circumferential chest lift using the breast lift technique and back lift and then 2nd would be the circumferential tummy tuck. I would not recommend a fleur de lis.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ronald J. Edelson, MD · Answer

You are a good candidate for a lower body lift. I would not recommend the fdl. The result is not worth the extra scar

Jose Leon, MD · Answer

Hello, thank you for your question and the pics, and congratulations on loosing the weight. So one is not necessarily a substitute of the other. If you look at your abdomen there seems to be a lot of excess skin towards the lateral part, which the FDL will pull towards the midline, but the body lift will help with all that receding skin you have on your lower pole of the buttocks and superior lateral part of the thigh. My choice would be to have the FDL and chest now, eventually continuing the scar towards the back in a different procedure

Camille Cash, MD · Answer

Congratulations on your weight loss!  From the photos it appears the circumferential body lift would address the skin laxity in both the front and back.  An exam is needed to know for sure but the photos don't demonstrate a clear necessity for the FDL to address excess skin at the central part of your abdomen.  I've included a video I hope you find helpful.

FDL tuck or lower body lift? (photo)

Answers (11)

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