What should I do instead of fleur-de-lis tummy tuck after 40kg weight loss? (Photo)

Hello; definitely for FDL Abdominoplasty; I do not think; it is necessary. With Lipoabdominoplasty; you reach for very good results; even without a vertical incision; it is possible. At the first stage, with Vaserlipo from the waist and back areas; I recommend for removing the fat. Thus, as the fat in the waist field will decrease; after Lipoabdominoplasty, the waist cavity will emerge in a better case. 15-20 days after the first surgery, I advise for Lipoabdominoplasty or surgeries; it can also be done in reverse order. However, I advise for waiting at least for 2 months; after Lipoabdominoplasty process. In Lipoabdominoplasty, fat is removed from both the upper abdomen and since the abdominal diameter is reduced by abdominal muscle application; maximum thinning will be achieved. With Tummy Tuck; performing for Vaserlipo at the same time also; does not cause for any problem; as long as, becoming master with the related technique.

I would suggest the extended tuck instead and avoid the vertical incision. I think you would do very well with this. You will need the tuck for the lower part for sure because no skin tightening device will be sufficient to tighten that amount of loose skin.

According to your photos, it does not appear that you need FDL. You can achieve a good result with the extended tummy tuck: I do not perform FDL surgery on any patient unless there is excessive body sagging.
Best Wishes
Erman Ak M.D.