Fleur de lis or extended tummy tuck: will I look okay with just an ETT? (photos)

Question

Slightly confused now after my last consult and wishing I’d asked more questions. Dr recommended ETT, lipo to flanks and full back. After asking if I would be flat. He answered by stating that if I wanted my waist to be smaller, I’d need a FDL. I didn’t want an FDL so asked if I’d still look good with just ETT. He said yes. Now I’m conflicted whether I’ll still look better with a ETT. I don’t expect to be tiny, I’m 5’5.5 and 195lbs. Will I look okay with just ETT? Or wasting my money?

George Bitar, MD · Answer

A fleur-de-lis abdominoplasty is considered when there is significant skin excess, and a horizontal scar would not be enough to address everything.  The tradeoff is a vertical scar with further cinching of the skin, which can provide better waist definition.  Generally, patients who have this much extra skin have lost a significant amount of weight from surgery.  Based on your photographs, you have excess skin and fat of the tummy and flanks.  You already have an hour glass figure, so further tightening would likely not add much, especially to outweigh adding another scar.  An extended tummy tuck and liposuction should give you a great result.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding whether you need a fleur de lis or an extended tummy tuck. Thank you for your pictures and your history. Based on your pictures, I strongly suggest the extended tummy tuck with liposuction of the flanks, superior iliac crest, and back. It is very important during the extended tummy tuck that muscle plication is done from the sternum to the pubic region. This will help to flatten the stomach. However, you do not need the other vertical component of fleur de lis to get a smaller abdomen. I think you will get an exceptional result with an extended tummy tuck. Thank you for your question regarding whether you need a fleur de lis or an extended tummy tuck. 
If you have any more questions regarding reconstructive surgery after massive weight loss, please contact my office. Reconstructive surgeries after massive weight loss include an abdominoplasty, tummy tuck, thigh lift, breast lift, mastopexy, arm lift, brachioplasty, torsoplasty, back lift, buttock augmentation, and buttock lift.  Since these reconstructive surgeries after massive weight loss,   are big procedures, please seek an experienced, board certified plastic surgeon with significant experience performing these types of lifts. Do your research.  Make sure they have performed at least 100 of each procedure you are considering for reconstructive surgery after massive weight loss.  Make sure they have the before and after pictures to prove it.  Carefully examine their before and after pictures and check their reviews on RealSelf.

James M. Economides, MD, FACS · Answer

You should be a good candidate for an extended tummy tuck that would give you a nice result without the need for the vertical scar of a FDL. I like to avoid the vertical scar as much as possible as you aren't able to conceal it in underwear or swimwear. I commonly design extended tummy tuck incisions to be able to contour your abdomen and waist with a nice result.

Irena Karanetz, MD · Answer

Hello and thank you for your question.
Based on your photos, you appear to be a good candidate for a full tummy tuck (possibly extended incision tummy tuck) which would allow to remove the excess skin below the belly button and to tighten the recuts (abs) muscle in order to achieve a flat abdominal contour. 
Liposuction of abdomen and flanks can help further improve abdominal contour and create more hourglass shape.
I would recommend to obtain an in person consultation with a Board-Certified Plastic Surgeon to further discuss your options and expectations.
I hope this helps.
Best,Dr. Karanetz
Dr. Irena KaranetzBreast Fellowship-TrainedBoard Certified Plastic Surgeon

Daniel Barrett, MD · Answer

Dear V78M,
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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ronald J. Edelson, MD · Answer

I have never done a fdl tummy tuck even in cases  far worse than you. Stick with the standard tummy tuck and some liposuction of your hips.

Connie Hiers, MD, FACS · Answer

Just based on your photos, the extended tummy tuck should do well for you. You do not have excessive upper abdominal skin.

Lourdes Rodriguez, MD · Answer

Hello, thank you for your question and pictures. 
After evaluating your case you seem to be a great candidate for a tummy tuck to remove the skin excess on the abdomen combined with 360 liposuctions to reshape your body, The BMI need to be under 33 for surgery. By combining these procedures, we can achieve good results.

Make sure to approach to a certified surgeon to help you clear all your doubts.

Best wishes!

Craig Fournier, MD · Answer

Hi and thank you for your question. The amount of skin laxity that you have on exam in the horizontal direction is the best way to determine if you need a FDL (or body lift). That being said, based on your photos, I suspect you would have a very nice result with an extended abdominoplasty and flank liposuction. Hope this helps!

Daniel Schmid, MD · Answer

The difference between the two will be in the tightness of the skin and better shape with FDL.  With a FDL you will have a more cinched waist at the cost of the vertical scar.  Either will improve your appearance overall but the decision on whether to do the vertical incision or not depends on your level of aversion to visible scarring on the abdomen.

Fleur de lis or extended tummy tuck: will I look okay with just an ETT? (photos)

Answers (16)

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