Fleur de lis or extended tummy tuck? I’m 5’7” 153lbs and I’m 36 years old. (photos)

You will not be able to exercise the skin away. All patients after TT will have loose skin when bending over, but so will most models and bodybuilders. The Fleur de Lis TT is ideally suited for trimming away both vertical and horizontal excess of skin on the abdominal wall. A traditional TT addresses only the vertical excess.You will have to decide whether the vertical scar is worth the improvement in smoothness and contour. The FDL scar would not be hidden by bikinis or workout pants worn beneath the belly button.

Hi. Based on your pictures, I think you would likely be a good candidate for abdominoplasty and liposuction of the flanks. You could certainly consider a circumferential belt lipectomy, or a fleur-de-lis abdominoplasty. Basically, it comes down to what you and your surgeon feel like, based on your exam, would give you the best benefit with the least amount of risks or downsides and that includes the scar. Personally I think that the long vertical scar from the fleur-de-lis in your case is likely to be more detracting from your result than possibly having a little bit of laxity of the skin, to be able to avoid having that vertical scar. I will say though that with your last picture it does look like you have a pretty significant amount of skin laxity. But on your first picture most of the extra stretch in the radial or "hoop" type of direction is going to be what is removed with a tummy tuck. I would recommend consulting with a board certified plastic surgeon with good experience in this area to help walk you through the whole process.
Good luck and take care,
Dr. Howell.

It appears you have lost a lot of weight and so first of all I want to congratulate you on that. Now is your time to reward yourself. I often show patients the difference of a fleur-de-lis versus a standard extended abdominoplasty. Like you , many choose not to have the vertical scar. If however , they have chosen incorrectly and find that they still have a lot of loose skin , a vertical incision can always be done down the road. Be sure to discuss this with your surgeon ahead of time. Good luck

As others have stated, you do not need a fleur de lis tummy tuck. I would begin with a routine tummy tuck with possible lateral liposuction at the same time. After this, if you are still dissatisfied, you can consider extension such as circumferential lift. The technique I recommend is abdominoplasty with mesh reinforcement, if you are not planning future pregnancies. 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.

Thank you for sharing your excellent question and photographs. Based on your age and overall good frame, I would avoid an FDL and have a well-done full/extended tummy tuck performed. This will leave you with some loose skin when bent at the waist or when in “plank” position. If this bothers you once recovered, you can always add the vertical scar at a later point in time. “Tight” means a lot of different things to patients so i try to base it on the marginal benefit of tighter skin relative to the “cost” of greater scarring. Hope this helps.

You do not appear to have enough lax skin horizontally to require a Fleur de Lis and it’s long midline scar.

Further discussion with your/another plastic surgeon is recommended until you feel comfortable.

You are a very young woman with a beautiful body bone structure (frame) so I can only image achieving an awesome result.
You must’ve lost a lot of weight and as result you have developed a significant degree of saggy skin on your abdomen and ended with that little apron and that is pure excess of length. But when you bend over the saggy skin that hangs is pure excess of width and it will NOT improve with the Tummy Tuck, extended or short or Circumferential.
Your buttocks also appears to be saggy, so as an expert in the Body contouring After Weight Loss (AWL) surgeries, you are a perfect candidate for Lower Body lift and Fleur de Lis which in my hands include muscle repair to achieve a smaller waist, mons pubic lift and reduction if needed, lifting of the outer thigh, real buttocks lift, liposuction minor to lovehandle and use that precious fat to transfer to buttocks, just to add some shape.
Because you are an AWL patient, the approach for you, must be different, otherwise your results will be limited and incomplete.
Also have in mind you, as any of us, are only getting older and your tissues will only become saggier, so your abdominal skin and buttocks will be looking worst after aging. So in my approach, AWLS is the greatest opportunity to rejuvenate the body.
Be encouraged.
Dr. Cárdenas

You only need a standard tummy tuck and some lipo of your hips. You definitely don’t need a fdl tummy tuck. It’s ridiculous to even consider the fdl. As far as “extended” tummy tuck, that means different things to different people. You should clarify what it means and if there is a cost difference.

Hello and thank you for posting with such excellent photos. As confirmed by the last photo, a FDL is the only way to get rid of the excess skin up top. That said, it the vertical scar Is a hard sell.

Sometimes having that vertical scar is more of an issue then the extra skin. Most of my patients that are in your shoes, are ok with having some extra or loose skin, if it means avoiding a vertical scar.

If you decide for the ETT, the excess skin on your upper abdomen will not be as bad as it is now. There will be some improvement. If you feel some improvement is enough, then you should avoid the extra scar.

If you want all possible to excess skin gone, then the FLD is the way to go.

I believe the decision is up to you and it will depend on wether you prefer to live with a vertical scar that cannot be hidden under a bikini or underwear.... or if you prefer to live with some excess skin above your belly button and a scar that can be hidden under a bikini or underwear.

Best of luck!
Dr. Miguel Mota

This is a personal opinion because everyone’s definition of “too much loose skin” after surgery is slightly different.

I ask my patients a series of questions to help decide which procedure fits best...

1. Are you looking to be the smallest possible size in tight clothes? If so, then the vertical scar allows for more skin removal.

2. Would you be ok if your stomach was flat but there was a little extra skin when you planked/bent over? If so, you might be satisfied with the extended tummy tuck.

3. Could you (and would you) be open to the possibility of two separate surgeries? If that’s the case, then you can do the extended tummy tuck first and then evaluate at 6 months post op. If the skin is not tight enough, you could do Renuvion skin tightening (no additional scars) or add a vertical skin resection as a second stage so you are convinced the scar is worth it to you at that point. I don’t recommend adding the renuvion at the time of the extended tummy tuck due to a concern for increased complications.

I hope this helps!