Extended TT with or without an FDL? (Photos)

Hello,For better or worse there are lots of options for abdominal contouring. Typically, if a patient with your amount of skin is not concerned about scars and wants the best contour, I offer either FDL or a corset trunk plasty (an extension of the FDL). If you want the least amount of scars and are okay with having some excess skin on the upper abdomen (as opposed to a scar), then a standard tummy tuck with extension around the sides and back (a "belt lipectomy" or "lower body lift") would be the better option. So, it can be confusing because there are several options based on your desires. I'll attach a free e-book I wrote about these options that can hopefully help it make sense. All the best in your decision!Dr. BlaggAustin, TX

You most definitely have a circumferential excess of lose skin...I can see the roll extending around to your backside which is very common after you have lost 90 or more pounds. For that reason, I feel the LBL is a must.
You will have a lot nicer waist contour and less excess when you bend forward of you also do the vertical incision or FDL.  You need to decide if that extra scar and possible slower healing is worth the improved shape.

Judging from your pics, you have the appearance of someone who has undergone massive weight loss with gastric bypass surgery.  Usually in this scenario there is significantly more loose redundant abdominal skin to have to deal with than our typical tummy tuck patient.  Most traditional tummy tuck patients have redundant skin along vertical axis, and hence the traditional tummy tuck with the low transverse abdominal scar (bikini line) is sufficient to eliminate this excess with just that scar.  Massive weight loss patients usually also have excess loose skin along the horizontal axis as well, which cannot be addressed adequately with just the transverse scar.  Hence the vertical mid- line abdominal scar can be utilized to remove skin along the horizontal axis (to tighten the skin more circumferentialy arond the waistline to give you tighter skin and accentuate your hourglass figure).  The FDL scar is a lot more visible and there is greater risks for wound healing issues and numbness so that is the downside but it might be worth it if you desire maximal skin tightening and contouring of your waistline.  I would ask to see your surgeons' before and after pics of their traditional vs. FDL tummy tucks to see how the results differ and how the patients looked like before surgery that would require the FDL component.  Best wishes.

Thanks for sharing your experience.I see horizontal and vertical excess of skin in your tummy photos. I would say that adding an FDL to your tummy tuck would be highly beneficial. Speak with your plastic surgeon about the risks before making a decision. See my video link below.

Thank you for sharing your question.  Though we can not see your gluteal region it does appear that you would benefit from a belt lipectomy (360 degree skin removal) with a tummy tuck.  The vertical incision of an FDL can only be determined based on the amount of skin excess you demonstrate in a horizontal dimension.  Hope this helps.