Would I need a Fleur de Lis or could a regular tummy tuck take care of most of my loose skin? (Photos)

After losing 145 lbs., it is most likely that your breasts are drooping. The reason I mention the breasts is that there is a breast lift technique called The Bellesoma Method, which lifts the breasts and also the upper abdomen. By lifting the upper abdomen then there is less loose skin and you will not need a fleur de lis. I always do the breasts first because doing the abdomen first makes it harder to lift the breasts as high as possible. You will not need a fleur de lis as you do not have enough horizontal width. You will need a regular tummy tuck with a circumferential body lift. I would recommend doing the breast lift and tummy tuck at the same time and if needed then a posterior continuation for the circumferential body lift.

Best Wishes,

Gary Horndeski, M.D.

If the surgery is able to be achieved without doing the additional incision, that is always the best option to avoid more incisions, but if when pulling down the skin, there’s still loose skin in the upper abdomen then the FDL incision would be a great option to give you the best possible outcome. You also have the option of not having it done and later down the road if you are uncomfortable with the result, you can have it done or if you feel comfortable as is you don’t have to proceed with it.

Hello and thank you for your question. Congratulations on your weight loss! It is difficult to tell what would be the best procedure for you without a physical examination. With that much weight loss there is typically skin excess in both the horizontal and vertical dimensions. A standard tummy tuck will correct some vertical excess of the abdomen. Depending on your physical findings, a lower body lift is also a good option that results in improvement in lower back/gluteal and lateral thigh skin excess. That procedure also tends to correct more of the vertical skin redundancy of the abdomen by pulling laterally. However, a fleur-de-lis may be the only option if the vertical skin redundancy of the abdomen is excessive. Importantly, you should pursue your procedure only after you've reached a stable weight. You should also consult a plastic surgeon certified by the American Board of Plastic Surgery for best results. Good luck. I hope this helps.

Hi, I want to be clear about your question. In my experiences I can surely say that the fleur de lis looks like inevitable in your situation. You can think this like a trade, if you want to get flat abdomen, you should make your peace with the vertical scar. Otherwise you should know that you’ll leave with excess and bulging skin on your central abdomen.

Thank you for your inquiry. We would love to meet with you to discuss your concerns. Based on the photos sent, an abdominoplasty should be able to take care of most of your loose skin. Schedule a consultation with a Board-Certified Plastic Surgery to help you meet your goals.

Dear nickilove67,

it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Although everything is a trade off, I think it is often best to have a little bit of loose skin with a regular tummy tuck than to commit yourself to a very unaesthetic scar. This decision is best made at consultation with a plastic surgeon. Good luck.

It looks like the vertical scar would give you a nicer result. You may decide to do a traditional TT and then if not happy come back and add the vertical scar later. This at least gives you the opportunity to see if the vertical scar is worth it for you! Good Luck!

Hello and congratulations on your weight loss!You do have both vertical and horizontal skin laxity. A FDL would excise more skin and lead to a tighter result but you will have a vertical scar. If you want to avoid the vertical scar, you will still have a nice result with a standard abdominoplasty with a hip to hip incision.

Your photos seem to indicate transverse laxity sufficient enough to warrant a FDL tummy tuck. However, you don't burn any bridges having a conventional tummy tuck and seeing the results first. No harm except for having a second surgery, which isn't too uncommon for massive weight loss patients anyway.