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