Hello, and thank you for your question regarding whether a fleur-de-lis (FDL) tummy tuck can be combined with a lower body lift. Congratulations on your impressive 125-pound weight loss! A fleur-de-lis (FDL) abdominoplasty can absolutely be combined with a lower body lift. The FDL tummy tuck involves both a horizontal incision (like a traditional tummy tuck) and a vertical incision from the sternum down to the pubic region. This removes excess skin from the central abdomen, creating a more dramatic waist reduction. Some plastic surgeons refer to this technique as an inverted-T tummy tuck due to the shape of the incisions. A lower body lift is a more comprehensive procedure designed to tighten and lift the abdomen, hips, outer thighs, and buttocks. The incision runs circumferentially around the waist, removing excess lower abdominal, flank, and back skin, which the FDL alone does not address. Combining both procedures offers the best of both worlds—a tight, defined waistline and complete lower body contouring. For the most "snatched" waistline, many experienced, board-certified plastic surgeons recommend combining the FDL with a lower body lift. This approach removes excess skin from both the front and back while also narrowing the waist more effectively than a lower body lift alone. Regarding your breast augmentation, if you wish to maintain your 38DDD cup size, most plastic surgeons would recommend an implant size of approximately 600cc, depending on your breast tissue and the amount removed during a full anchor mastopexy (breast lift). Silicone (gummy bear) implants are an excellent choice for a natural, long-lasting result. For the most natural shape, most plastic surgeons would recommend placing the implant in a dual-plane position, meaning the implant is partially under and partially over the pectoralis major muscle. This technique provides a natural slope while supporting the implant to reduce sagging over time. I hope this helps answer your question regarding whether an FDL tummy tuck can be combined with a lower body lift, as well as your concerns about breast implants and maintaining cup size. Best of luck on your transformation! Sincerely, Dr. Katzen