FDL or LBL for significant amount of loose skin on my hips and lower back along with my stomach? (Photos)

Question

I have a significant amount of loose skin on my hips and lower back along with my stomach, would that be addressed with an FDL tummy tuck or do I need a lower body lift?

Jeffrey M. Darrow, MD · Answer

A lower body lift will rejuvenate your abdomen, some of your inner thighs, your flanks, your back and lift your buttocks.  This circumferential procedure is a very powerful operation for rejuvenating the entire trunk.   A fleur-de-lis tummy tuck would only improve your anterior abdomen but would not appreciably improve your flanks, back and buttocks.  The vertical scar of a Fleur-de-lis is also aesthetically unattractive and difficult to camouflage in clothing.  An in person consultation and examination will help you understand your expected results.  Best wishes.

J. Timothy Katzen, MD, FACS · Answer

Hello, thank you for your question about FDL or LBL for significant amount of loose skin on my hips and lower back along with my stomach.  In your statement, you specifically mentioned that you have a “loose skin on your hips and lower back”. The fleur-de-lis (FDL) abdominoplasty does NOT take care of the hips or the lower back. The fleur-de-lis (FDL) tummy tuck only takes care of the abdomen. The fleur-de-lis (FDL) tummy tuck involves a horizontal and vertical incision on your abdomen. It takes care of the excess abdominal skin by pulling your abdominal skin down (the horizontal component) and pulling the abdomen together (the vertical component).  If your hips and your lower back bother you, (in addition to your abdomen), go with the 360 circumferential lower body lift. The 360 circumferential lower body lift addresses of the abdomen hips and back. During the 360 circumferential lower body lift, the buttocks are reduced/raised, the hips are reduced/raised, the abdomen is flattened, the rectus abdominis muscles are plicated/tightened, and the mons pubis is lifted and reduced. 
With both the Fleur-de-lis (FDL) and the 360 circumferential lower body lift are performed under general anesthesia. With either fleur-de-lis ( FDL) or the lower body lift, plan on giving yourself 3 to 4 week recovery.I specialize in reconstructive plastic surgery after weight loss.  If you have any more questions regarding the lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, or belt dermolipectomy please contact my office. Since the body lift is a big procedure, please seek an experienced, board certified plastic surgeon with significant experience performing the lower body lift. Do your research.  Make sure they have performed at least 100 circumferential lower body lift surgeries and have the before and after pictures to prove it.  Carefully examine their before and after pictures and check their reviews on RealSelf.   If you cannot find an experienced, lower body lift surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of  the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and ​member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

Daniel Barrett, MD · Answer

Dear Bright810099,
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

Kenneth Hughes, MD · Answer

The lower body lift is a surgery that involves removal of loose skin by way of an incision that goes around the waist and helps tighten the abdomen, sides, lower back, outer thighs, and butt. The lower body lift will create a flat abdomen along with an improved waist and an improved lower back. At the same time, the buttock can be lifted and the outer thighs can be improved.
You may also need a TT to take care of the skin and abdominal wall laxity in the front of the body. However, some patients may have loose skin on the back, buttocks, or lateral (outer) thighs as well. This is referred to as a posterior lower body lift. The TT and the posterior lower body lift performed at the same time is a lower body lift.

Camille Cash, MD · Answer

An exam is needed for specific recommendations, but from the submitted photos at least an FDL would be indicated.  This approach specifically addresses the skin laxity along your midline.  Without it you would likely have too much excess skin even after a tummy tuck.  I've included a video I hope you find helpful.

Michael S. Wong, MD · Answer

Dear Bright810099,
Thank you for your questions and photos. And congratulations on your weight loss! If you are not opposed to a vertical midline scar on your abdomen, this will address both your horizontal and vertical excess. Doing this alone will lead to a significant improvement. It will not, however, address the horizontal laxity in your buttock and your thighs. By completing the lower body lift, you will address these areas leading to a more complete lower body contouring.
Hope you find this helpful and wish you well.

Milan Doshi, MS, MCh · Answer

Dear Bright810099,
Thank you for your question and photographs. 
For the best-personalized advice photographic evaluation is not enough. An in-person consultation is a must. 
Belt lipectomy will give you a good result.
There are two ways to address extra lower abdominal and back skin.
Belt lipectomy back will give you a good curvy figure but the scar will be at a Higher level while lower body lift will address extra thigh skin also, and the scar will be at a lower level but the waistline will not be as defined as belt lipectomy. 
Please consult with your plastic surgeon or board-certified plastic surgeon near you and discuss in detail. 
Best of luck, Dr Milan Doshi Mumbai, India

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