Hello, thank you for your questions regarding what to do with your abdomen and buttock regarding an 80-pound weight loss and whether you need a 360 circumferential lower body lift, with or without a fleur-de-lis (FDL) pattern incision. Basically, in my opinion, it boils down to what you want and your end goals. If the excess skin of your buttock bothers you and you want your hips reduced, then, I would suggest a 360 circumferential lower body lift. If you undergo a 360 circumferential lower body lift, I do not think you need the vertical component of the FDL component. If the excess skin on your buttock does not bother you and your hips do not necessarily bother you, I would propose an extended tummy tuck, again without the FDL component or vertical incision. During that same procedure, I would suggest liposuction of the love handles and autologous fat transfer to the buttock or a Brazilian Buttock lift (BBL). Yes, a tummy tuck and BBL can be performed at the same time. Either way, whether you go with an extended tummy tuck or a 360 lower body lift, in my opinion, there is no reason to do a vertical incision. Please see my website for countless examples. In my opinion, for you, I have eliminated the need for a vertical incision. Basically, the question that you need to answer is whether you are concerned enough about the excess skin and fat of your hips and the excess skin of your buttock to warrant a 360 circumferential lower body lift. Thank you for your great question regarding whether you need a lower body lift with a fleur-de-lis (FDL) after an 80-pound weight loss. I specialize in reconstructive plastic surgery after weight loss. If you have any more questions regarding the lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, or belt dermolipectomy please contact my office. Since the body lift is a big procedure, please seek an experienced, board certified plastic surgeon with significant experience performing the lower body lift. Do your research. Make sure they have performed at least 100 circumferential lower body lift surgeries and have the before and after pictures to prove it. Carefully examine their before and after pictures and check their reviews on RealSelf. If you cannot find an experienced, lower body lift surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)