Will I need a fleur de lis tummy tuck or is a circumferential enough? (Photos)

First, congratulations on your weight loss, that is a great accomplishment!  It would seem that you are asking if you need a fluer-de-lis tummy tuck (FDL TT) or a circumferential lower body lift (LBL).  The answer to this question requires an understanding of the vectors of tissue laxity.  It is important to understand that the vertical component is used to treat the excess skin in the horizontal direction rather than the vertical vector this is treated by a traditional tummy tuck.  Very commonly, people who have lost massive amounts of weight have both a vertical and horizontal skin laxity, but in my experience this is *almost* always fixed by a lower body lift without the vertical component (such as a FDL-TT).   Often times, for people who are unwilling, financial unable, or unconcerned about their posterior skin excess, I will offer a FDL as a way of treating the skin laxity in the lateral areas of the abdomen near the flanks.  The most important questions for you to answer are 1) how important is it for you to avoid a vertical scar, 2) if you really wish to avoid the vertical scar, are you willing to undergo a lower body lift, and 3) how much does the tissue laxity of your lateral thighs and buttocks region bother you (these areas are better treated with a LBL.  As you can see the answer is not entirely simple and while your pics are very helpful, nothing is going to replace an in person exam and a discussion with your surgeon about your goals and desire to avoid potential scars.  Best of luck, and again, congratulations!

Thank you for your question and pictures I would recommend an extended tummy tuck, I believe you can achieve your goal, always see a board certified PS.