Fleur de Lis or regular Tummy Tuck? Love to end up with a flat and especially thin waist. (photos)

Dear breastreductionsurgery,
based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Hello,
Thank you for reaching out with your question about choosing between a Fleur de Lis (FDL) tummy tuck and a regular horizontal tummy tuck. Based on your medical history and the photos you provided, I'm happy to offer some guidance.
Assessment of Your Needs:
From your description and the photos, it appears that the majority of the excess skin and fat is located below your belly button and extends to the top of your pubic region. Additionally, it seems you have some weakness or possibly diastasis recti (separation of the rectus abdominis muscles), which is common and typically addressed during a tummy tuck.
Choosing the Right Procedure:
Regular Tummy Tuck: Given that your primary concern is the lower abdominal area without significant excess skin above the belly button, a regular horizontal tummy tuck would likely meet your needs effectively. This procedure will allow for muscle plication (tightening of the abdominal muscles), removal of excess skin and fat below the belly button, and a pubic lift and reduction.
Fleur de Lis (FDL) Tummy Tuck: This type of tummy tuck is usually reserved for individuals who have substantial excess skin both vertically and horizontally across the abdomen. As you noted, the FDL tummy tuck results in a vertical scar that is more visible and can segment the abdomen in a way that some find less aesthetically pleasing. Based on your description, this doesn't seem necessary for your case.
Advantages of a Regular Tummy Tuck:
Less Visible Scarring: The scar from a regular tummy tuck can typically be hidden under underwear or a bikini, making it less conspicuous than the vertical scar from an FDL tummy tuck.
Comprehensive Results: A regular tummy tuck provides significant improvement in the lower abdomen, tightens the muscles effectively, and includes a pubic lift if needed, all while maintaining a more natural appearance of the belly button and overall abdominal contour.
Consultation with a Plastic Surgeon:
I recommend consulting with a board-certified plastic surgeon who specializes in body contouring. During your consultation, discuss your goals, concerns, and the specifics of each procedure. Your surgeon can provide personalized advice based on a thorough physical examination and discussion of your aesthetic goals.
Conclusion:
Based on your current situation and the location of the excess skin and fat, a regular horizontal tummy tuck seems to be the most suitable option. It will address your needs effectively without the additional complications and more visible scarring associated with an FDL tummy tuck.
Thank you for considering this important decision carefully, and I wish you the best of luck with your procedure.
Sincerely,
Dr. Katzen

Thank you for your question and photos. You do not need a Fleur de Lis with the large vertical mid-abdominal scar. A tummy-tuck combined with liposuction and a mons or pubic lift should result in an excellent outcome. Good luck.

Your concerns are understandable. The Fleur de Lis procedure, prevalent in plastic surgery during the 1990s and early 2000s, especially among weight loss patients, is now outdated. With advancements in techniques, excellent results can be attained without the prominent midline scar associated with Fleur de Lis, which may prove challenging to conceal. Instead, you may benefit from an extended tummy tuck, with incisions extended slightly farther to the sides to prevent dog ears (skin bunching). Simultaneously, liposuction of the flanks, and a pubic lift can be performed to enhance the overall outcome.

Dr. B.

360 Liposuction and 360 tummy tuck (muscle repair and pubic lifting include) will provide a very good result in your case.
Regarding your FDL query, it can be decided in a physical examination because the upper abdomen area needs to be examined to check the excess skin.
I understand your fear about the scar, but I haven't had such an issue with any of my patients, you won't be havint a stomach devided to two as the buttocks.

Hi there,
The FDL (Fleur de lis) is usually reserved for patients who have lost a lot of weight and have significant skin laxity in their upper abdomen. You do not appear this way in the photos.
All tummy tucks come with some version of liposuction to accentuate your curves better, so that is very common. A pubic lift almost happens naturally with the tummy tuck as the tension pulls this area up. Sometimes this area needs a lift or just liposuction so it doesn't pouch out in clothing.
For the best shape and thin waist I would recommend lipo 360 of your abdomen and regular tummy tuck
all the best

Hi,
This is an excellent question. You would most benefit from fleur de lis and 360 liposuction to really tighten your silhouette giving you an amazing shape. This is because you have skin excess in both vertical and horizontal manner. Certainly, a great shape still can be obtained without the need for vertical component but not as robust tight silhouette. Public lift (monsplasty) is commonly done at the same time so your entire abdomen and monsplasty have similar appearance without any puffiness or swelling.. I hope this helps. Thank you and good luck.

The fleur de lis tummy tuck is used when there is excess horizontal width, particularly above the umbilicus. You do not have that so you do not need the fleur de lis tummy tuck. If you are not planning future pregnancies, I recommend abdominoplasty with mesh reinforcement. The mesh creates a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight.

Best Wishes,

Gary Horndeski, M.D.

In my experience, a traditional/ regular tummy tuck should give you excellent results. (No need for ups and down or fleur de lis which may be required in massive weight loss cases).

Can combine liposuction waist and pubic areas.

An exam and consultation with a plastic surgeon is recommended to discuss your options and expectations.

Hi, thank you for sharing your question. You are a great candidate for a tummy tuck and I not believe you will need a FDL. Liposuction can be used during your procedure to optimize the results. You will have a flat abdomen with a thin waist.