Is It Common for Belt Lipectomy with Fleur De Lys Abdominoplasty?

To truly answer this I would need to examine you.  The first consideration for you is whether you trust your surgeon.  If you do then they may be offering you good advice.  Many very experienced surgeons use this technique.

I would rarely suggest the Fleur-de-lis to my patients.  The time I would consider it is if vertical scar (laparotomy incision) is already present from other surgeries.  If that is not the case I would typically advise patients to have a circumferential body lift instead of the Fleur-de-lis.  My strong personal preference is slightly less tight contouring but a scar hidden in your bikini.  That being said if you may have too much excess skin your surgeon may be correct.  At the end of the day it is a personal choice that you must make:  tighter contour and visible scar or slightly looser but hidden scars.

Also, with significant weight loss people often have loose skin in the buttock, lateral thigh, and back.  This is corrected with the circumferential lift.Dr Rodger ShorttPlastic Surgeon Oakville

Thank you for your question regarding whether it is common for a belt lipectomy to be combined with a Fleur de Lis (FDL) abdominoplasty. Belt lipectomy with an FDL abdominoplasty is are common procedure for plastic surgeons with specialize in reconstructive surgery plastic surgery after massive weight loss. The belt lipectomy is also known as a lower body lift, a circumferential lower body lift, a 360-degree lower body lift, or a belt abdominoplasty. Most plastic surgeons don’t like the term belt lipectomy because “lipectomy” only describes the removal of fat. The 360 lower body lift is so much more than that. The 360 lower body lift eliminates excess skin and fat from the abdomen, hips, and buttocks. It also tightens the rectus abdominis muscles from the xiphoid process (sternum) to the pubic symphysis (mons or FUPA). During a belt lipectomy, the umbilicus, or belly button, is repositioned, and the pubic region is lifted and reduced. The lower body lift addresses the abdomen, hips, pubic region, and buttocks in a horizontal manner. That means during the 360 lower body lift, the lower body is vertically lifted up and down. With an FDL, there is a vertical component that addresses the upper abdomen, from the thyroid or sternum to the top of the pubic region. The FDL addresses the upper abdomen in a vertical fashion, pulling the sides of the abdomen horizontally together. Usually, fortunately, the vertical component is not needed. Additionally, the vertical component or FDL has a very high incidence of wound breakdown in the pubic region. Nonetheless, if you have excess skin and fat above your belly button, the FDL may be the best option for you. Another option would be a vertical abdominoplasty after your belt lipectomy. Thank you very interesting question regarding a comment for a belt lipectomy with the FDL abdominoplasty. Good luck. To get an accurate assessment of what exactly you need, schedule a free virtual consultation. Most plastic surgeons offer free virtual consultations. If you have any further questions regarding tummy tucks, abdominoplasties, or abdominal liposuction, please get in touch with an experienced plastic surgeon. Since the tummy tuck surgery is a big procedure, please seek an experienced, board-certified plastic surgeon with significant experience in performing tummy tucks. Do your research. If you cannot find an experienced tummy tuck plastic surgeon in your area, consider traveling to another state. Sincerely, Dr. Katzen, MD, MBA, FACS, FICS. ( Plastic Surgeon, President of the American Society of Bariatric Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

    I would get several opinions on the need for the vertical scar.  I think that I would ask the surgeon about the experience with performing all of those procedures together.  Kenneth Hughes, MD Los Angeles, CA

It sure is confusing, trying to figure out what's going to give the best result, what is safe, and which surgeon to use.  Is a fleur-de-lis tummy tuck common when doing a belt lipectomy?  Not really, but that doesn't mean that it's uncommon either.   Sometimes adding the vertical incision (and resulting scar) adds quite a bit to the result on the abdomen.  Try this:  with your left hand, pinch as much of the loose skin as you can between your belly button and your pubic area together.  While doing that, with your right hand pinch, in a side-to-side manner, as much skin together as you can just above your belly button.  If you're able to pinch quite a bit of skin together with your right hand while doing this maneuver, a fleur-de-lis might improve your result.  A fleur-de-lis does add some time to the surgery and probably increases the risk of problems healing the incision, but the benefit might be impressive.  That's why visiting with reputable surgeons is important.  You will certainly receive different opinions as to what is likely to create the best result.  Make sure to ask lots of questions during your visits.  Ultimately it's your choice.  The benefits versus the risks.  The fleur-de-lis can create some substantial improvements in the results, but they're a little more involved.  Common with a belt lipectomy?  Not exactly, but it may enhance the result tremendously in an appropriate patient.

The horizantal scar in the abdominoplasty is indicated whaen there is lots of excess skin horizantally. the verical scar removes excess skin in the vertical direction and gives more definition to the waist in those with excess skin verical.

Extending the tummy tuck to the back tighten the back and the buttoc is lifted.

Cobining these procedures is too much surgery and the risks of blood clots and healing problems can be increased. Recovery is more difficult and also you want the surgeon to take time to do the best that can be achievedand not hurry through the surgery.

I would not personally recommend that combination for one setting. Among other reasons, the fleur-de-lis will tighten the back to a large extent, and you may not require more back tightening. 

Without photos, I can't comment on the choice of procedures, but with the amount of weight loss you have had, it would not be a surprise if that were an excellent option. 

All the best. 

Your condition can only be evaluated with an exam. Many post weight loss do better with an extended TT even though there is more scar. You trade it for the enhanced result. Discuss this in your consultations.Thomas Narsete, M.D.

There can be too much planned for one day for safety, prevention of blood clots etc.  An anchor tummy tuck is plenty for one day and the vertical scar is better IF you have too much skin to get a nice result with just a horizontal scar.  I would personally NOT do anything to your back the same day.