Eighty-four pound weight loss - do I need an FDL tummy tuck? (Photos)

Question

Age 46 non smoker lost 84 pounds. Have been advised FDL tummy tuck woule be best. Can anyone confirm this based off my photos many thanks

Daniel Barrett, MD · Answer

Dear Kind956103,

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

J. Timothy Katzen, MD, FACS · Answer

Hi Kind956103 in Dublin, IE, 
Thank you for your question regarding an eighty-four pound weight loss and do you need an FDL tummy tuck?  Congratulations on your 84 pound weight loss!  Great accomplishment.  Thank you for your history and your pictures.  First, we should analyze your pictures to determine what would be your best procedure. You have horizontal and vertical excess skin and fat of the upper, middle, and lower abdomen.  Most plastic surgeons would suggest a FDL to address all three zones of your abdomen.  The FDL tummy tuck or abdominoplasty is also called an inverted T abdominoplasty.  The FDL tummy tuck takes about 5 to 6 hours to complete.  Plan on a 2 to 3-week recovery.  Drains stay in place for about 2 to 3 weeks.  Sincerely, Dr. Katzen, MD, MBA, FACS, FICS, FASMBS (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.)

Ira H. Rex III, MD · Answer

The fleur-de-lis tummy tuck gets quite a bit of attention on Realself.  I personally think it leaves a terrible scar in the midline that I have a difficult time accepting.  Of course I can get my patients a little tighter this way, but I imagine it would keep them out of a bikini.  I think even looking at this in the mirror would be more dramatic than a little extra horizontal skin laxity.  You should check a lot of before and after photographs.  Almost all of my weight loss patients have a very nice results without a central scar.  Make sure you your homework!

Muge Sevindik, MD · Answer

Hello, thank you for your question. Yes, due to your excess skin in the midline, if we want to further narrow your abdominal volume and create a good waist shape, a fleur-de-lis abdominoplasty would be the best option.

Mehmet Ozdemir, MD · Answer

Hi and thank you for your question.
Based on your photos, you have excess skin both vertically and horizontally, which an FDL (fleur-de-lis) tummy tuck can address better than a standard tuck. The final decision depends on your goals, scar preference, and a thorough exam. A consultation is important to create a safe, personalized plan.I hope this helps.

Javier Parada, MD · Answer

Congratulations on your weight loss, that’s a major achievement. In patients with significant skin excess both vertically and horizontally, which is common after a large weight loss, a FDL tummy tuck is often the most effective option. This technique allows us to tighten the abdomen in both directions and achieve a smoother, more contoured result than a traditional tummy tuck alone.
Based on what you describe, you do appear to be an appropriate candidate for an FDL, but a final decision should always be made after an in-person or virtual consultation to fully assess your anatomy and goals.

Wayne I. Yamahata, MD · Answer

Although I can't confirm this without a physical examination, my impression is that you could achieve a good outcome with either an extended or circumferential tummy tuck. Either of these would avoid the vertical scar. You may want to discuss this further with your surgeon.

Gary M. Horndeski, MD · Answer

After an 84 lbs. weight loss, it is very possible that your breasts are sagging as well. There is a breast lift technique called The Bellesoma Method that will lift your breasts and also lift the upper abdomen and can eliminate the need for a fleur de lis. However, if you just want a tummy tuck then you may need a fleur de lis. A fleur de lis is used for horizontal excess and the traditional tummy tuck is used for vertical excess. You have both vertical and horizontal excess based on your photographs you have provided.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Paul M. Parker, MD, FACS · Answer

Congratulations on your impressive weight loss--you must feel like a different person. We see many patients like you today that have lost a significant amount of weight and have a lot of loose skin. Given your history and the pictures you have submitted, you appear to be a candidate for a FDL TT. My advice is to find a board certified plastic surgeon near you that does a lot of tummy tucks and have a consultation with them. They can review options with you for treatment and what you should look like afterwards. While a FDL TT removes loose skin in a side to side direction as well as an up and down direction, many of the patients I discuss it with are concerned about the presence of a vertical scar and would prefer to avoid it. It's really a matter of what's most important to the patient--optimal contour at the expense of more visible scarring or less scarring with somewhat less profound contour. This is something you can discuss in detail during your consultation. Hope this helps. Good luck!

Kadir Berat Oyur, MD · Answer

Hello, this is Dr. Berat.Based on massive weight loss, you appear to be a very good candidate for an FDL tummy tuck, as this technique is especially effective for removing excess skin both horizontally and vertically and achieving better waist contouring. It allows us to address the loose skin that a standard tummy tuck may not fully correct.

Eighty-four pound weight loss - do I need an FDL tummy tuck? (Photos)

Answers (14)

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