Surgeon recommended a fleur-de-lis tummy tuck, but I don't like the scarring. What are my other options? (photos)

You don’t need the fdl. Simple as that. Fdl tummy tucks are over recommended and people aren’t happy with them. Get another opinion.

From your photos, you seem like you'd be a reasonable candidate for either an extended abdominoplasty (where the low abdominal incision extends toward your flanks) or a circumferential body lift (where the incision extends 360 degrees). Both of these options would remove more skin than a traditional abdominoplasty and avoid a vertical scar.

I think you can do an extended (around the back) tummy tuck and get a nice improvement without the vertical scar! See a board certified plastic surgeon in your area. Good Luck!

You are certainly not alone in this feeling. Many women feel like the scarring from a fleur de lis abdominoplasty is a lot to undertake. However, there is no better procedure to maximize the contour of the anterior abdomen. The vertical scar allows the surgeon to most appropriately contour the skin above the belly button so that the abdomen is as "flat" as it can be when viewed from the side. Although this does leave a visible scar when not wearing clothes or when wearing a two piece bathing suit, it will greatly improve your contour in clothes, which is the main goal of most women undergoing this procedure.

The fleur de lis approach is used for patients who have significant loose skin above the belly button. It allows the surgeon to remove skin both horizontally and vertically. With an extended tummy tuck the incision will extend at least hip to hip. Much of the loose skin will be removed, but some looseness of the upper abdomen may remain. I encourage you to visit with a few board certified plastic surgeons to hear varying opinions. This may help you understand more what approach is best for you.

Hi Helpful 446097,
Your photos show that you have vertical/up and down excess and also have horizontal/right to left excess. Your surgeon suggested an FDL tummy tuck to deal with each--the vertical scar allows your surgeon to excise tissue in the right to left direction.
A 360 tummy tuck with liposuction might be an alternate solution--it would allow waist narrowing with liposuction, and the face-down approach first would allow the lateral excess to be chased into the back incision.
Hope this helps.
Best,Christopher Pannucci MD MSBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, Washington

The best option for you would be a tummy tuck and then a posterior extension to create a circumferential lift. I believe your waist is narrow enough that a fleur de lis is not needed.

Best Wishes,

Gary Horndeski, M.D.

It is great that you are expressing concern for scarring with fleur-de-lis. Although a great option in conjunction with traditional tummy tuck scar, this leaves a very obvious vertical incision. The benefit of the fleur-de-lis is that you will get rid of vertical and horizontal skin laxity. I always educate patients who are a candidate for this type of tummy tuck that although great for excision excess skin, they have to be ok with the large and visible scar. You are certainly a candidate for a traditional extended tummy tuck (with lipo would be great as well). This would leave you a very desirable result with a low hip-hip incision that can be covered by most clothing.

Thank you for sharing your story. You have features that are best managed with excisional surgery and liposuction. A Fleur-dis-lis tummy tuck involves removing excess laxity horizontally as well as vertically. This will leave a vertical scar. Portions of your tattoo are likely to remain. Although a vertical midline scar could achieve the flattest final appearance, an excellent improvement should be possible with standard tummy tuck and liposuction techniques.
When there is severe soft tissue laxity a vertical scar can be worth it. However, in addition to the additional scars, a fleur-dis-lis tummy tuck has a higher risk of complications that must be reconciled. Lifting and thinning the pubic area can be considered as well.
Best regards,

Dr. Mosher

Thank you for your question. I have been in practice 28 years and have done well over thousand tummy tucks. Based on your pictures, I do not believe that you would need a FDL abdominoplasty. I would recommend aggressive liposuction of the hips and flanks as well as puboplasty (tightening of the pubis). Best wishes to you.