Fleur de lis TT - what advice would you give me? (Photo)

Question

So i'm considering getting a mommy makeover and i came across fleur de liis tt and i got intrigued. I already have a previous scar running down my stomach that i wouldn't mind the surgeon going that route since its already ugly anyway. As i research, i see it is recommended to people who have lose a signicant amount of wait. I haven't lost too much and im not heavy eiither. What advive would you give me? Picturess attached

Rajaie Hazboun, MD, MBA · Answer

Thank you for posting your question here!I will start by stating that my answer is based on the limited information and pictures provided , for a customized plan please consult with your plastic surgeon in person.
Fleur de lis is usually utilized when a patient has excess skin both in the vertical and horizontal dimensions which is more common in massive weight loss patients. That being said in certain individuals with old vertical scars an exception can be made especially when the scar might not have healed in an aesthetic manner as it will likely benefit from a revision. If your scar is bothering you then that might be a good option for you ! I hope this helps ! best of luck!

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding the Fleur de Lis tummy tuck, and congratulations on exploring options to enhance your abdominal contour! Based on your photos and history, you appear to be an excellent candidate for this procedure. The Fleur de Lis tummy tuck combines a traditional horizontal tummy tuck with a vertical component, resulting in an inverted T-shaped scar. This approach is ideal for individuals with significant excess skin both horizontally and vertically, allowing for a more comprehensive tightening of the abdomen.

In your case, given the pre-existing scar running down your abdomen, a Fleur de Lis could be a great choice to revise that scar while achieving a more defined waistline. Although the Fleur de Lis technique is often recommended for individuals who have lost a substantial amount of weight, it can be equally beneficial in cases like yours, where scar revision and contouring are desired.

Due to your prior surgeries, it’s wise to discuss with your plastic surgeon whether an abdominal CT might be beneficial to rule out any hernias or weakened fascia. This will ensure that your surgery can proceed safely, especially if your skin or muscle layers are thinner than average from previous procedures. Overall, the Fleur de Lis tummy tuck can provide transformative results, especially with your aesthetic goals in mind.

Sincerely,
Dr. Katzen

Arif Eroglu, MD · Answer

HelloThe Fleur De Lis (FDL) technique for tummy tuck is generally used for individuals who have both horizontal and vertical excess skin due to significant weight loss. However, you already have a vertical scar along the midline of your upper abdomen. Due to the existing scar on your upper abdomen, a standard tummy tuck cannot be performed. It significantly increases the risk of necrosis in the upper abdominal skin. Therefore, the FDL tummy tuck would be suitable for you.

Carmina Cardenas, MD · Answer

You already have a very obvious scar in the middle of your abdomen which have caused also your belly button to be distorted. So you will be a great candidate for a Tummy Tuck Fleur de Lis, through this incision it is possible to remove completely your old scar, reconstruct your bb into a beautiful and feminine one, do a muscle repair to create a flatter abdomen and smaller waist line and remove the excess of skin. 
I have done it many times because it is the same principle applied to after weight loss patients. 
Be encouraged!
Dr. Cardenas

Ira H. Rex III, MD · Answer

This is a very interesting case.  I think you have an excellent idea to consider with a plastic surgeon.  I would need to do an exam and have an important conversation about your expectations and what that surgery could achieve.  You would get a very nice scar revision!  I think this would be an exciting case for a plastic surgeon who is very experienced with tummy tucks.  Good luck.

Gary M. Horndeski, MD · Answer

Unfortunately, you have not provided photographs of your breasts or if you are considering a mommy makeover. The breast procedure is usually done first because it will lift the upper abdominal skin higher and decrease the need for as much abdominal dissection and will eliminate the need for a fleur de lis. However, in your case, since you already have the vertical scar there, you would benefit from a scar revision. I recommend doing a breast lift and tummy tuck at the same time. The breast lift technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. At the same time, the tummy tuck can be done. 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.

Best Wishes,

Gary Horndeski, M.D.

Ramiro Morales, Jr., MD · Answer

Thank you for your question and pictures.   While under normal circumstances, I would not have recommended a Fleur de Lis TT in you, since you already have a vertical scar, I would take advantage of that and remove the scar as part of the Fleur de lis pattern.  The benefits can be a better vertical scar hopefully as well as possibly a narrower waist.  Be sure to see a Board-Certified PS for your consultation.

Shlomo Widder, MD · Answer

Dear Georgian,
     Thanks for posting your pictures. From observing your pictures you appear to have abdominal skin and muscles laxity as well as vertical midline scar from the chest bone to the mid lower abdomen from previous surgery. It appears that your belly button was removed. Fleur de lis tummy tuck is rarely indicated and in fact I have performed tummy tuck surgery on well over 1500 patients and never used that technique. However, due to your vertical scar, you will have de facto Fleur de lis procedure if you decide to have tummy tuck surgery. In summary, you will end up with 2 scars, one vertical and one horizontal from hip to hip.
     Always, consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most important , check the before and after pictures in the photo gallery to make sure that they are numerous, consistent and attractive with flat stomach, nice scars, low horizontal scar, narrower waists and improved body postures.
          Best of luck,
                                 Dr Widder
                      widderplasticsurgery.com

Eric Swanson, MD · Answer

Yes, you need that vertical scar revised. It can be done in combination with a tummy tuck, which is a fleur-de-lis. What was your original surgery? A preoperative ultrasound scan would be useful to make sure you don't have a hidden hernia or defect in the abdominal wall (much better to know about that before surgery). Be sure to see an experienced plastic surgeon because your surgery is a little challenging.

Harry T. Haramis, MD, FACS · Answer

In my experience, yes, fleur de lis is a great option in patients with severe excess skin after very large weight loss. This allows removal of skin up and down as well as horizontally to narrow waist.

You do not appear to need a fleur de lis but since you have the vertical scar, can modify a T tummy tuck to give best results.

An exam and consultation with a plastic surgeon who performs these procedures is recommended to confirm you are a candidate as well as discuss your options and expectations.

Fleur de lis TT - what advice would you give me? (Photo)

Answers (16)

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