Is a fleur de lis my only option? (photo)

Dear glitter40,Thank you for your question. I am not as absolute as some of the people who have responded, I do use Fleur de Lys techniques on massive weight loss patients...otherwise the result does not end up looking goof. In your case, however, you should be fine with a standard tummy tuck and flank liposuction. Consult with another board certified plastic surgeon and get a second opinion after an in person exam. Any responses you get on this forum are preliminary and incomplete assessments as we don't have the benefit of examining you.Good luck,Nirmal R. Nathan, M.D.

·      Certified, American Board of Plastic Surgery

·      Member, American Society of Plastic Surgeons

·      RealSelf Top Doctor

thanks for the question and sharing the photographs. You will benefit from an abdominoplasty procedure. A fleur de lys procedure gives good result in massive weight loss cased but gives midline scar. You can get good results with a standard abdominoplasty with muscle tightening and liposuction of the flanks. this will save you a midline scar which majority of the patients do not like at all. 

Congrats on your three kids! 
Fleur-de-lys tummy tuck is NOT necessary!!! You are an excellent
candidate for a standard/extended abdominoplasty to correct your abdominal
wall! The rectus muscle (midline) and oblique muscles (lateral) will also be
tightened at the same time. This will remove all of your skin and fat from your
umbilicus to the pubic area . . . it will tighten your core and improve your
“sway” back!  Liposculpture of
flanks/back-bra line and thighs can be done at the same time. You will have an
excellent cosmetic and functional result. 
Good luck!  

It appears that you will do well with routine TT with possible additional liposuction to sculpt you 360 degrees. Most who have the fleur de lis have had significant weight loss often 50-100 plus pounds.Good luck and see a few board certified plastic surgeons in your area>

In thirty years of practice I have never done a fleur de lys tummy tuck.   You’re not even close to needing one. A standard tummy tuck will work just fine. Get another opinion.

Hello and thank you for your question. Based on these photo, I
believe you are a good candidate for lipo-abdominoplasty (standard tummy tuck with added liposuction). I don't believe you would need the fleur-de-lis type. During this procedure, extra skin in the lower half of your abdomen including the stretch marks will
be removed. In addition, typically the fascial laxity/separation of recti
muscles will be taken care of by muscle plication, giving you a flat
abdomen. The added liposuction of your hips/flanks will help with creating a
natural and aesthetic waistline. Incision can be placed very low to be
hidden under bikini. With proper surgical technique, belly button can be
designed to  be a true 'innie'. Recovery from tummy tuck is 1-2
weeks. Strenuous activity and lifting heavy weights should be avoided 6 weeks
to 3 months post op. I would seek consultation with a board-certified
plastic surgeon for a full evaluation and advice. Best,
Pejman Aflaki, M.D.                                            
Johns
Hopkins-trained double board-certified plastic surgeon

You will have to decide whether the vertical scar running from the breastbone downward below the navel in addition to the horizontal scar from the TT is worth the improvement in smoothness and contour.  The TT scar can be concealed under bikinis, but the FDL may take additional effort to conceal. From your photos it appears that lipo and a TT with plication would give you good results. Recommend that you consult with another board certified PS who performs hundreds of lipo and TT procedures each year with great results and hundreds of before and after photos along with patient reviews on his/her website.

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.  Tummy tucks do not repair the muscle but repair the fascia.  The fascia will shorten the muscle, which will increase its strength.  Best Wishes,Gary Horndeski, M.D.

Hello and thank you for your question.  You do not need a fleur de lis vertical incision. Based on your photographs, skin laxity, and history of three children, you are a great candidate for a tummy tuck with liposuction.  This can be done through a low and short incision, all completely below the bikini line.  The belly button can be designed to look natural and have no scars on the exterior.   Your muscles can also be plicated resulting in a flat abdomen.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.  

Best wishes and good luck.


Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon
 

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 traditional 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.
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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