Fleur Di Lis Abdominoplasty? (photo)

Hello, I'm 5"4 and weigh 77 kilo and am scheduled for a Fleur Di Lis tummy tuck with breast reduction and lift in two weeks. I'm two yrs post op from vertical sleeve gastrectomy and have lost over 40 kilo. My question is, is liposuction required with this kind of tummy tuck? I have spoken with my plastic surgeon here in Australia and he informs me that it is not necessary with this particular tummy tuck. I'm just not sure after looking at loads of before and after photo's on the net. Thanks.

Doctor Answers 12

Liposuction with abdominoplasty

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A fleur de lis abdominoplasty is a tummy tuck that not only has the standard bikini line incision but also a vertical midline incision.  The advantage to this procedure is that it not only tightens your abdomen in the vertical direction but also in the horizontal direction.  For patients like yourself who have lost a lot of weight and who already have a vertical midline scar, this can be the perfect operation. 



Your question about combining liposuction with your abdominoplasty is really one of surgeon preference.  I personally always combine liposuction of the love handles with all of my abdominoplasties but I know many surgeons that never do it. If you are comfortable with your surgeon and his/her before and after pictures, I would trust their judgement on this.  Good luck.

Liposuction with Fleur de Lis Tummy Tuck

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The Fleur De Lis approach is great when a patient already has a vertical scar. It works very well to remove most of all the skin in the center, which is where most patients carry most of their weight. You probably will not need any additional liposuction. Judicious liposuction can be added to the flanks but sometimes it is safest to do this at another time. Trust your surgeon if you like his/her results. Good luck.

Fleur Di Lis Abdominoplasty?

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The real question is the liposuction could add additional risks to a very long operation. Not that it is not required. Best to re discuss with your surgeon to fully understand the risk/benefit ratios. 

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Liposuction with tummy tuck

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Certainly some liposuction with the tummy tuck will give you an improved results.  I always include this with the tummy tuck procedure and do not charge extra as most surgeons do.  It is simple and does not require that much time.

Fleur di lis tummy tuck question

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Liposuction is a nice tool and may be helpful for your surgery. It is not a needed to perform your surgery. I am sure your doctor has it available should he or she think it is appropriate to use. Good Luck!

Gregory T. Lynam, MD
Richmond Plastic Surgeon
4.9 out of 5 stars 62 reviews

Lipoosuction “Necessary” with Tummy Tuck?

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Congratulations on your significant weight loss and good luck with your upcoming procedure. Liposuction surgery is never “necessary” as part of a tummy tuck procedure.  Often, it is a useful tool for some patients undergoing tummy tuck surgery. It can be especially helpful in the “flank" areas  or for treatment of the suprapubic area.

 For more specific advice,  don't hesitate to address this question ( again) with your plastic surgeon.

 Best wishes.

Liposuction with Tummy Tuck

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Based on your pictures, you could have some liposuction in your flank area. However, this is best determined by your plastic surgeon. If you are unsure, an in person second opinion may be better.

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 76 reviews

Fleur de Lis

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The abdominal wall contour can undergo significant changes when women have undergone significant weight loss.  Under these circumstances, it’s not unusual for women to develop loose excess skin, weakened muscles, fat accumulation and stretch marks. It’s important to realize that no two patients are ever exactly alike and for this reason it’s important to individualize care.

                Although it’s hard to make a specific recommendation without a physical examination, your history and pictures suggest that you have excess skin in both the vertical and transverse dimensions.  In addition there’s probably laxity of the underlying muscles as well.

                Under these circumstances, the Fleur de Lis abdominoplasty is an excellent surgical option.  This procedure removes excess tissue in both the vertical and transverse dimensions.  Unfortunately patients are left with a vertical and transverse scar at the conclusion of the procedure.  This procedure is occasionally combined with liposuction of the flanks. 

                The need for supplemental liposuction when patients undergo Fleur De Lis abdominoplasty is based on the patient’s anatomic starting point and aesthetic goals. Not every patient needs liposuction and this decision often needs to be made in the operating room when patients undergo this procedure.

                If you’re concerned about this issue, further discussion with your surgeon is appropriate. Your surgeon should be able to address your concerns and alleviate your anxiety.

Fleur De Lis Tummy Tuck with Liposuction

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   Fleur de lis tummy tuck can be combined with liposuction.  However, whether the liposuction would add anything would be determined by the amount of fat on your flanks.

Fleur de lis vs circumferential with a fleur de lis

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Thank you for the question and the photos.  The more excess skin that you have the longer the incisions need to be to achieve optimal results.  Since you have laxity in the vertical as well as the horizontal dimensions as well circumferentially around your waist you would likely be best served by a circumferential lower body lift (tummy tuck in the front, thigh lift on the sides, and buttock lift in the back) as well as a fleur de lis.  The fleur de lis part will improve the horizontal laxity of your abdomen.  This will all result in an incision around your waist all the way around as well as a vertical incision from pubic bone to xyphoid (area in the middle bewteen your rib cage edges).  Liposuction of the flank mat be performed as well but I suspect this would be of secondary importance compared to the removal of tissue in the manner discussed above.

All the best,

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.