Finding a surgeon: Standard TT vs FDL experience/photos? (Photos)

After a large weight loss, it is common to need a fleur de lis (FDL) tummy tuck to address skin laxity both vertically and horizontally. This is an extension of the standard tummy tuck technique, and surgeons who achieve excellent results with abdominoplasty usually carry those skills into FDL cases as well. What matters most is choosing someone with experience treating massive weight loss patients, since these procedures require more planning and judgment about scar placement.
It is absolutely appropriate to ask a surgeon’s office if they have FDL results you can review, even if they are not posted online. Many patients do not consent to public posting of photos, but surgeons often keep before and after examples available privately for consultations. Asking to see these is not considered rude — it shows that you are being thoughtful in your decision making.
I have also shared a detailed video where I explain the differences between standard and FDL tummy tucks, and how surgeons plan for the unique needs of massive weight loss patients.
— Güray Yesiladali, MD

Firstly should always do what feels best for you. It’s an important decision. You should have all the information possible in order for you to feel comfortable with moving forward.
As far as the FDL incision, it’s not mandatory, usually it’s only recommended when the surgeon is not able to remove all the excess skin pulling down and there’s additional skin left in the upper abdomen in those cases you can have it done and it would definitely improve if you are comfortable with it and it doesn’t bother you then you can proceed without having it done, or later down the road, you want to have it done you can have it done separately. You have many options but overall, if you decide to have it done, you should definitely be comfortable with the surgeon that you choose to make sure that they give you the best outcome.

There are several options of tummy tuck after massive weight loss. A “standard” abdominoplasty usually removed skin downward with scars ending at the hips. An extended tummy tuck may include remove the front abdominal and flank excess skin. A lower body lift extended the abdomen and lower back helping to lift the buttock and often decreases the waist.

While a fleur-de-lys you are removing excess skin downwards and centrally with an additional vertical scar. Fleur-de-lys helps narrow the waist. Often plastic surgeons perform FDL tummy tuck if there is already a vertical scar and that the patient heals well.

Thank you for your question and photos. You would do very well with a lipoabdominoplasty with a low pubic bone level incision. You already show good underlying muscle definition and this can be further enhanced with VASER Hi Def Lipo technique. You do not need an FDL! It would be a mistake if you'll take that route. See a board certified plastic surgeon experienced in advanced body sculpting techniques for an in person consultation/evaluation. Good luck.

Many surgeons who specializes in tummy tucks would probably only infrequently do a fleur-de-lis pattern. A standard or extended tummy tuck will often give the same or similar were better results without the ugly midline scar. In very few cases do you need to do this much horizontal excision. It seems to me from your photograph you may not need or want a fleur-de-lis pattern. Having a consultation with a plastic surgeon certainly sounds like a good idea and after a good examination could they explain the benefits of each type of surgery. Good luck.

Hi, I’m Dr.Eskalen from Istanbul/Turkey. FDL has a permanent and visible midline scar which is impossible to hide it. Your current form doesn’t need a FDL abdominoplasty. Only abdominoplasty is enough for you. I hope my message helps you.
Best regards,Dr.Eskalen.

The FDL (Fleur-de-Lis) tummy tuck is an excellent option for patients who have significant laxity and excess skin above the belly button, particularly after massive weight loss. I frequently and confidently perform this procedure for my post-bariatric patients who say, “I don’t care about the scar — I just want tightness.”
However, in women and younger patients who only have mild to moderate looseness above the belly button, I usually don’t recommend the FDL because the vertical scar may not be worth it aesthetically.
It’s important to know that the scar will initially appear red or brownish. If you're a non-smoker, protect the area from sun exposure, and have lighter skin, the scar is more likely to fade to a pale color over time — but even then, it will still be visible up close in a bikini or similar clothing.
To answer your questions:
A surgeon’s skill with standard tummy tucks doesn’t necessarily translate directly to FDL (Fleur-de-Lis) tummy tucks. While the procedure isn’t overly complex from a technical standpoint, it does have its own nuances — especially when it comes to scar placement and tension management.The reason you often don’t see FDL results posted is not because surgeons don’t perform the procedure, but because long vertical scars down the center of the abdomen aren’t considered aesthetically appealing on social media or promotional pages. In plastic surgery, success is often judged by how discreet the scars are — and FDL scars are, by nature, more visible.That said, it’s absolutely not rude to ask if the surgeon has FDL results they can share privately. It's a reasonable and appropriate question, especially if you’re considering the procedure. Most offices will understand and respect your interest in seeing real outcomes before you book a consultation.

Hello, frankly, nowadays fdl is a method used more for people who have lost a lot of weight. In these days when the perception of beauty is very much at the forefront, the vertical scar on the abdomen causes anxiety in most of the patients. Especially since extended tummy tuck stretches the abdominal skin in the anterolateral plane, it continues to be popular as a good option for many patients like you. Apart from this, there is not much difficulty in tummy tuck surgery with fdl in terms of technique. You can trust a surgeon whose tummy tuck results you like in this regard.
However, when I look at your situation, although it is difficult to examine without a physical examination, I believe that a good result can be obtained with extended tummy tuck without a vertical scar.

Congratulations on your impressive weight loss! You can ask your surgeon for photos specifically related to FDL approach. You may have more luck with photos if researching board certified plastic surgeons who have helped patients after major weight loss. I appeared on TLC's program Skin Tight which helped those who have lost significant weight restore their appearance. I've included a video I hope you find helpful.

Your number one most important variable is provider selection.
And the hands of the right surgeon you’ll have the best possible outcome.
And the hands of average surgeons the best you can help for our average results.
You should absolutely 100% insist that surgeons open up their portfolios and show you their entire collection of before and after pictures of previous patients who look like you for whatever operation they recommend.
If they have experience, then they should have a lot of pictures for you to look at.
If they don’t have pictures for you to look at then, they most likely haven’t done a lot of of these procedures or the results were so poor. They’re afraid to show you the outcomes.
My personal recommendation would be to avoid the vertical scar if at all possible because it doesn’t look good at all.
To me the correct procedure is a wraparound or extended tummy tuck going circumferentially.
Some of the horizontal skin laxity can be pulled towards the back, leaving you with enough horizontal skin tightening from an extended tummy tuck. The skin will not hang down all that much when you lean forward.
I would absolutely start with a wraparound tummy tuck, a.k.a. body lift.
If that’s insufficient, then you can always add a vertical component, but I would avoid this because it’s not a good look.
Find me the right plastic surgeon is not at all easy or straightforward.
My best recommendation is you schedule multiple in person consultations.
Bring pictures of your body to use as a reference during the consultation.
This is really important.
When the provider is showing you before and after pictures, make sure the patients in the pictures look like you do.
Don’t go by memory.
Have the pictures of yourself to use as a reference.
The patient should be about the same size, same degree of skin, laxity, etc. etc.
There’s no correct number of plastic surgeons to consult with to find the better provider.
The more consultations you schedule the more likely you are to find the right provider for your needs.
Exceptional results come from exceptional providers.
Average providers deliver average results.
In the hands of the right provider you should be able to have more before, and after pictures to look at then you have time for during the consultation.
Start looking online to understand what a quality tummy tuck should look like.
There are generally three variables to consider.
First, patient should have a natural looking belly button consistently.
The second is the design of the incision.
The incision should be set very low and follow anatomic contour naturally.
If the patient looks like they were recruited cut in half then that’s a poorly designed scar.
Don’t worry what the scar itself looks like because that is not related to the surgeons skill.
Scars take 12 to 18 months to fade out and sometimes pictures are taken earlier when the scars are not mature.
The third variable is the surgeon ability to not leave dog ears or skin laxity remnant at the end of the incision.
In your case, if you have a standard tummy tuck that doesn’t extend to the backside, you will definitely be left with dog ears.
The skin excision needs to go around the sides and finish up on the backside.
This requires turning the patient during surgery.
You should ask A specifically exactly how far the car will go and if the surgeon is going to turn you during surgery.
There’s only so far you can reach with the patient laying on their back and this is what limits the extent of a standard tummy tuck.
You definitely need an extended tummy tuck, and that would be my recommendation.
A standard tummy tuck with a vertical scar doesn’t give as good of a result and the scar is in my opinion Unacceptable if avoidable.
Make a list of five local plastic surgeons who seem to have a good track record for tummy, tuck surgery, and schedule in person consultations with each of them.
My best recommendation is to never have a virtual consultations.
Always meet the surgeon in person if possible.
Do not schedule surgery on the day of consultation.
Make sure you finish all your consultations before deciding to have surgery and making any financial deposit.
The biggest mistake I see patients make is having only one consultation and trying to decide who is the best plastic surgeon using their cell phone or computer.
Plastic surgeons who are good at self promotion may be good at that, but maybe not so good in the operating room.
Regardless, I want you to choose. I think you’ll appreciate having the outcome of a tummy tuck
Preferably a wrap around extended tummy tuck.
Good luck,
Mats Hagstrom MD