Would I get good results from a regular tummy tuck or is a fleur de lis necessary? (Photo)

Question

I had one surgeon recommend a fleur de lis tummy tuck, but would I be happy enough with a regular tummy tuck? He also recommended a vertical incision to the mons area. Not sure about it

Drew Davis, MD · Answer

A fleur-de-lis tummy tuck is typically recommended for patients with substantial skin laxity both vertically and horizontally, often after major weight loss. It allows tightening in two directions but adds a vertical midline scar.
If your primary concern is lower abdominal skin laxity without significant side-to-side excess, a traditional full tummy tuck is often sufficient. Many patients can achieve excellent contour improvement without the additional vertical incision.
The decision depends on how much horizontal looseness is present when the skin is lifted and how much central redundancy remains after standard tightening. An in-person exam allows us to assess skin pinch, tissue mobility and overall contour goals to determine whether the added scar of a fleur-de-lis is truly necessary.

Daniel Careaga, MD · Answer

From the side photo &mdash; especially with a shirt on &mdash; it’s honestly very difficult to determine which approach would be best. Proper evaluation really requires in-person examination, including skin quality, distribution of excess tissue, and abdominal wall laxity.
That said, I can explain the general differences.
A standard (horizontal) tummy tuck removes excess skin primarily in the vertical direction &mdash; meaning it tightens the abdomen from top to bottom. This works very well for many patients, particularly those whose looseness is mostly in that vertical dimension.
A fleur-de-lis tummy tuck adds a vertical incision in addition to the horizontal one. This allows removal of excess skin not only vertically but also side-to-side (horizontal laxity). Patients who have had massive weight loss often have significant skin redundancy in both directions, and they tend to benefit the most from a fleur-de-lis approach.
However &mdash; and this is important &mdash; the fleur-de-lis does come with a visible vertical scar. There are patients who technically could gain some additional contour improvement from a fleur-de-lis, but in my opinion, the incremental improvement is sometimes not worth the tradeoff of the vertical scar. That balance is very individual.
Different surgeons will have different thresholds based on:
Their aesthetic philosophy
Their experience with post-weight-loss body contouring
How they weigh scar burden versus contour improvement
Ultimately, it comes down to:
How much horizontal laxity you truly have
How important scar placement is to you
Whether the additional tightening justifies the vertical scar in your specific case
A detailed in-person consultation and honest discussion about scar tradeoffs versus contour gains is the best way to decide.

Paul M. Parker, MD, FACS · Answer

It's hard to tell from your picture which procedure you would be suited for. We do a lot of tummy tucks in our practice and it is the unusual patient who elects to have a fleur de lis tummy tuck because of the vertical scar--they really prefer to have one low, horizontal scar which I can hide beneath revealing clothing. In addition, a vertical scar in the mons area would be highly unusual in our practice.

Kadir Berat Oyur, MD · Answer

Hi and thank you for your question.
From your photo, you are a good candidate for a tummy tuck to remove the excess skin on your abdomen. However, we would need clearer, full-torso photos from the front while standing to determine if a fleur-de-lis tummy tuck is necessary.
Hope this helps!

Mehmet Ozdemir, MD · Answer

Hi and thank you for your question.
Based on your photo, you are suitable for a tummy tuck due to the excess skin on your abdomen. However, we cannot determine if a fleur-de-lis tummy tuck is necessary without clearer photos of your entire torso, including a full front view while standing upright.
Hope this helps!

Gary M. Horndeski, MD · Answer

Your photograph is inadequate.  I would need photographs of the front and side views of the upper and lower abdomen to give an accurate answer.

Best Wishes,

Gary Horndeski, M.D.

Camille Cash, MD · Answer

An examination or additional photos are needed to determine the best recommendation for you.  Fleur de lis incisions are helpful when a patient has significant skin laxity along the midline.  Instead of just being able to remove skin vertically, it allows the surgeon to remove skin horizontally as well to give the best overall contour.  We see it most frequently in patients who have lost significant amounts of weight.  I've included a video I hope you find helpful.

Mats Hagstrom, MD (license on probation) · Answer

Your picture is insufficient to make a quality assessment.
We need to see your entire abdomen.
We also need to know your history in regards to pregnancies and weight loss.
I’m not a fan of adding a vertical scar a.k.a. fleur-de-lis Tammy Tuck pattern. If someone has access skin, it’s better to do an extended or wraparound tummy tuck.
I suggest your first good body pictures of yourself and bring those with you to use as a reference during any in person consultation.
Next ask providers to open up their portfolio and show you their entire collection of before and after pictures of previous patients who had similar body characteristics and
 Don’t go by memory, but instead have pictures of yourself to use as reference.
I would recommend consulting with several providers before selecting a surgeon.
The more consultations you have the more likely you are to find a better provider for your needs.
If a tummy talk Isn’t done well then it’s unlikely you’re going to be able to revise it to improve the outcome.
You get one shot of doing this procedure correctly.
Do not assume that someone was born certified in plastic surgery with some good reviews has mastered this procedure without getting confirmation by seeing lots and lots of before and after pictures and
 Ask the provider how many of these procedures they’ve done on people who have similar body characteristics
That should tell you how many before and after pictures they should have it their disposal.
When in doubt slow down and scheduled more consultations
Best,
Mats Hagstrom MD

Would I get good results from a regular tummy tuck or is a fleur de lis necessary? (Photo)

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