Can I get a positive result without a fleur de lis tummy tuck? (photos)

During my consultation, I was told that my upper abdominal area may not be totally flat after surgery unless I went with a fleur de lis surgery. At my heaviest, I was 5'4" 230#. I'm currently 150#. I really don't want the vertical scar, but I also don't want to be disappointed with the results. Surgery is scheduled in 6 weeks, working on getting rid of these last 10 pounds.

Doctor Answers 11

Tummy tuck

Thank you for your question and photographs.

It is important when looking for a plastic surgeon for a tummy tuck that you find one who is board certified to obtain the best results possible. From the photos you have posted and your weightloss history, you look like a candidate for a traditional tummy tuck to correct the loose skin and tighten the abdominal wall along with some liposuction for the pouch above your belly button. When I perform a tummy tuck, I tighten the diastasis rectus muscle which brings in the waist. I think you would be happy with the results from a traditional tummy tuck with the incision below the bikini line. If you are worried about the scar associated with a full tummy tuck, there are topical scar creams as well as laser treatments that can diminish the look of the scar and make it finer and less noticeable. I hope this helps!

James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science

Pittsburgh Plastic Surgeon
4.9 out of 5 stars 64 reviews

100% do NOT need a fleur-de-lis

You will do incredible with a standard tummy tuck and perhaps some liposuction to really knock the ball out of the park.  Hope this helps!-JGH


Hi Lynn,I think it would be wise for you to seek a second opinion.From your photos you look like you would do well with either an extended tummy tuck or possibly a circumferential tummy tuck but certainly not a Fleur De Lis. There are very few indications for a Fleur De Lis in my practice and I see a lot of massive weight loss patients. In fact the only time I would use it is if there is a pre existing midline scar.
The midline scar is impossible to hide in bathers or underwear and it is often a poor quality scar.Best wishes

Tummy tuck

Any body contouring after large weight loss usually requires more than one surgery for best results. A standard tummy tuck can always be followed by Vaser ultrasound liposuction (+/- smart lipo, Thermi tight) months later which will tighten skin and avoid a vertical scar.An exam and consultation with a plastic surgeon who performs these procedures is recommended to confirm you are a candidate as well as discuss your options and expectations.

Tummy tuck

Hello and thank you for your question. Based on your photograph, you are a great candidate for a tummy tuck with liposuction.  Unless I am missing something here that I cannot see in this photograph, you do not need a fleur de lis midline vertical incision.  I think you should have a great result with a single low incision, all completely below the bikini line.  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.  The most important aspect is to find a surgeon you are comfortable with. Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 67 reviews

Looks promising

The pictures you show are not great but I do think you can do a an extended tummy tuck or body lift and get a great result. See a few board certified plastic surgeons who do this kind of work and look at their before and after pictures. Good Luck!

Gregory T. Lynam, MD
Richmond Plastic Surgeon
4.9 out of 5 stars 53 reviews

Can I get a positive result without a fleur de lis tummy tuck?

Thank you for your question.  Congratulations on your significant weight loss.I understand your concern over the midline incision.   The incision is primarily to remove excess skin above the belly button that may be only improved and not fully corrected with a standard tummy tuck.   Some of the decision to add the midline incision depends upon your skin tone and elasticity of your skin.  The biggest part of the decision however, are your goals and expectations.   Not everyone needs it.   It is difficult to say if you would need the incision by your photos.   I would recommend seeing another board certified plastic surgeon who has experience in weight post-weight loss surgery to get another opinion.I hope this helps.

Fleur de Lis Not Always Necessary

The decision to accept the vertical scar from a Fleur de Lis Abdominoplasty is not an easy one.  I completely understand your hesitation.  Your surgeon is concerned that laxity could remain in the upper abdomen if the vertical incision is not created.  I have also given many patients very strong encouragement to accept a Fleur de Lis in the past because it is sometimes clear to me that they will not be happy with their shape without it.  You don't appear to be one of those people, but it's very hard to tell.  Photographs alone don't always show the whole story.  Honestly, you need another consultation with someone who takes care of weight loss patients before you go through with this plan.  You need to know for yourself that this is the right decision for you.I'm going to post a link to a video I made a few years ago with regard to this topic.  I think it is worth you seeing.Good Luck!

Thomas P. Sterry, MD
New York Plastic Surgeon
5.0 out of 5 stars 17 reviews

Best procedures for you, some advice:

Thanks for the question. After having analyzed all the information and photos provided to us, I recommend you perform a Breast Lift to treat the sagging breast skin getting a good projection, and also Implants, therefore today we have much modern and safety silicone implants such as the "Cohesive Gel - Silicone Breast Implants" with textured cover ("gummy bear implants") They are quite safe and aesthetically best as they give a firmer consistency, better projection and natural appearance.

Also, with the Tummy Tuck, I would like to perform waist and lateral liposuction to give you a better body contour.Kind regards

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 147 reviews

Can I get a positive result without a fleur de lis tummy tuck? (photos)

The plastic surgeon who recommended a fleur-de-lis obviously knew what he was talking about and it shows his experience.  Nothing short of a fleur-de-lis can get you a flat tummy.  Best of luck.

Ruben B. Abrams, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 17 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.