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

Hello,Traditional and circumferential tummy tucks tighten skin in (mostly) the vertical vector; skin is taken from above (abdomen, waist and back) and pulled downward, and skin from below (pubic, thigh, and buttock) and pulled upward. FDL can be combined with the previously mentioned maneuvers to tighten in the horizontal (circumferential) direction.  To see whether you need a FDL component to your tummy tuck, grab skin from either side of your belly button and pull it to the center over the belly button. Keep grabbing skin farther apart until you can no longer make them meet in the middle. If that distance is greater than 4 to 6 inches, you will likely not be happy with a FDL component. Go visit a few ABPS certified/ASAPS member surgeons who specialize in body contouring. Best of luck!

Thank you for your question and photos. Based on these limited view photos, you do not need a FDL. you would do best with an abdominoplasty in conjunction with a lower body lift. With 150lbs weight loss, I expect a lot of looseness of the lower back and buttock areas as well. See a board certified plastic surgeon for an in person consultation/evaluation. Good luck.

Dear Chloewithac,it is hard to tell for sure without an examination but base on you photo, it looks like you might benefit from extended tummy tuck. 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

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.

The Fleur de lis technique for tummy tuck allows stronger tightening of your skin by removing extra tissue through an additional vertical scar on your abdomen. It is a very helpful technique for those that have a high level of laxity.  A circumferential abdominoplasty places a scar all the way around your waist, and helps lift and tighten the hips and buttock area at the same time. If your laxity all around your trunk, with more than 100 lb of weight loss, it is the way to go. Judging from your photos, you would do very well with a circumferential. It's usually the more extreme cases where folks need a circumferential with a fleur de lis. In person consultation with an American Board of Plastic Surgery certified/ASAPS member surgeon is the way to get the answers you need for sure.

Fleur 're lys would offer the opportunity to tighten in two dimensions. However the trade off is additional scarring. A belt lumpectomy maybe an option if you have lumbar excess. 

You can avoid a FDL tummy tuck and get a good result.  In order to capture a lot of the loose skin you will need an extended incision for the tummy tuck that possibly goes all the way around.  If you have a lot of laxity of the outer thighs and buttocks you can do a lower body lift that also has a circumferential incision.Discuss all of these options with your plastic surgeon so you can get the best result possible.  If you do not have a vertical scar on your abdomen I would also try to avoid a FDL tummy tuck.Best WishesDr. Peterson

Great question.  The answer depends on what you would like to accomplish.  A full or extended tummy tuck would allow you to be smooth and tight while standing straight but without a FDL you may have residual loose skin when you bend over.  A circumferential TT would only be warranted if you have loose thigh and buttock tissue that would benefit from being pulled up.Good luck with your surgery.Dr. Remus Repta

The answer to your question depends totally on what result you prefer. A surgeon can help you determine that after an exam.