Is there such thing as a mini fleur de lis tummy tuck?

Question

I'm thinking of having a fleur de lis tummy tuck bit the tall vertical scar really puts me off. I've seen patients who have only had the scar go up to the navel and no further. Does this work?

Kenneth Hughes, MD · Answer

A mini TT involves removal of a small amount of skin and fat below the belly button that addresses only the lower portion of the abdomen. This procedure applies to very few patients and is appropriate only for patients who have loose skin at the inferior aspect, or bottom, of the abdomen. If patients have loose skin above the belly button or a muscle laxity, a short scar or full TT would be more appropriate. A physical exam would be necessary to determine what procedure is most appropriate for you to achieve the results you are seeking. You do have to decide whether the vertical and horizontal scar of a fleur de lis TT is worth having the procedure.

Benjamin Baker, BMBS MBA FRCS(Plast) · Answer

Thanks for your question. What you have seen relates to a variation in scar pattern that enables patients undergoing full abdominoplasty, with a tight abdominal closure, to keep the horizontal component of the scar low and hidden beneath underwear (the additional short vertical component allows repositioning of the umbilicus if the upper incision cannot be made above it). It also enables the surgeon to address skin laxity around the umbilicus in patients who would otherwise be candidates for a mini tummy tuck. I would recommend consulting a plastic surgeon with a specialist interest in body contouring.

Daniel Barrett, MD · Answer

Dear stonebuster1,
it is hard to tell for sure without an examination or at least tummy tuck. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. 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

Pejman Aflaki, MD · Answer

Hello and thank you for your question. Please post your question and submit photos if you can. I have not heard of a vertical scar limited only to below the belly button. Fleu-de-lis abdominoplasty aims at removing the excess skin in vertical dimension, and typically has a long vertical scar.  I would seek consultation with a board-certified plastic surgeon
for a full evaluation and advice. Best,
Pejman Aflaki, M.D.                                             
Johns
Hopkins-trained double board-certified plastic surgeon

Ronald J. Edelson, MD · Answer

I think most mini tummy tucks turn out to be disappointing. The fdl tummy tuck is almost never indicated. Combining the two operations neither of which is a good one I can’t imagine being worthwhile.

Shlomo Widder, MD · Answer

Dear Stone buster,   Posting a front and side view pictures of your stomach would have been helpful. I have been in practice for over 32 years and performed tummy tuck surgery on well over 1000 patients. I have never performed a Fleur de lis tummy tuck, be it mini or maxi, because  I never found it necessary and the standard tummy tuck is more than sufficient to give you a flat stomach with nice belly button, narrower waists, and improved body posture. The vertical scar from the Fleur de lis technique is unsightly and increases significantly the risk of wound complications.   Always, consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery, to make sure that they are numerous, consistent and attractive with the above mentioned features and low scar.                    Best of luck,                                      Dr Widder

Nelson Castillo, MD · Answer

Thank you for sharing your question.  Typically the vertical incisions that run from navel to horizontal scar are the result of the patient not having sufficient skin laxity to be able to remove enough skin with a regular tummy tuck, or the patient may have already had a scar present and some additional cinching of the lower abdomen can be done.  This would not impact any horizontal skin laxity of the upper abdomen, however.  Seek out a series of ASPS board certified surgeons to get the best treatment advice based on your starting position and aesthetic desires.

Camille Cash, MD · Answer

The incision pattern for a tummy tuck depends on the patient's needs.  A fleur de lis incision is needed when there is too much skin laxity on the upper abdomen to be addressed through the lower incisions.  If you have significant laxity here then a lower vertical incision will not correct it.  I encourage you to visit with a board certified plastic surgeon near you for a consultation.  Here you will learn about the various approaches and what is recommended for you based on an examination and discussion of your goals.

Connie Hiers, MD, FACS · Answer

Most patients with the vertical scar going up to their navel already had this scar from previous surgeries like emergency C sections. However, the lower vertical component could be added if needed. Usually, it is not needed.

Arian Mowlavi, MD, FACS (license on probation) · Answer

It is difficult to answer your question without any pictures or a consultation. That being said, the extent of the scar often depends on the patient. You may want to consider a normal tummy tuck procedure, which will place the scar below the bikini line to reduce visibility. A Skype or FaceTime consultation with a tummy tuck specialist can help you get an accurate recommendation and pricing. 
Respectfully, 
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee