25/F/265lbs->165lbs/Never been pregnant- Extended tummy tuck with or without Fleur de Lis? (Photo)

I am down 100lbs through diet and exercise and it has left a lot of loose skin throughout my abdomen. I have gotten mixed opinions on whether or not the Fleur de Lis is necessary/beneficial in my case. The skin below my breasts stretches quite a bit- Doctor 1 recommended an extended TT w/ FDL while Doctor 2 (more conservative) said an extended TT w/ a possible second surgery for a reverse TT would be better. Scars don't bother me so they are not a factor here. I just want the best outcome.

Doctor Answers 10

Extended abdominoplasty options

Extended abdominoplasty optionsI generally start with a standard extended abdominoplasty unless there is already a midline scar from previous surgery.. but i discuss the options with my patients and the pros and cons of the vertical incisions


Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

25/F/265lbs->165lbs/Never been pregnant- Extended tummy tuck with or without Fleur de Lis

You have both a horizontal and a vertical skin excess on your abdomen. If you are willing to accept the vertical incision, I think the Fleur de Lis would give you a significantly better final outcome.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 26 reviews

Type of abdominoplasty

As the flour-de lys is bidirectional, it will absolutely remove more skin and give a better waistline result.  The other advantage is that the underlying muscle can be tightened without skin undermining. Even in the absence of pregnancies, the weight gain undoubtedly stretched the underlying muscles to some degree. 

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25/F/265lbs->165lbs/Never been pregnant - Extended tummy tuck with or without Fleur de Lis?

Either an extended tummy tuck or the Fleur de Lis tummy tuck would be a reasonable option in your case.  It really comes down to the issue of the vertical scar vs. the amount of circumferential skin that can be removed with the FDL.  If you are uncertain about the scar you can have an extended tummy tuck and if not pleased the vertical portion of the FDL could be performed at a secondary procedure  a few months after the first.  The cost would be a little greater with the two stage approach; however, the result may be a little better as your surgeon may be able to be somewhat more aggressive with the skin resection than with a one stage FDL.  Best wishes, Dr. Lepore. 

Vincent D. Lepore, MD
San Jose Plastic Surgeon
4.9 out of 5 stars 50 reviews

Fleur de lis

I prefer to avoid the vertical incision whenever possible because it the scarring is unpredictable and can sometimes extend all the way up between the breasts.  I believe that you should start with a standard abdominoplasty.  If you still have excess upper abdominal skin (and you very likely will), then a reverse abdominoplasty with the horizontal scar in the folds under your breasts would leave the best scar.  This is especially true if you need and are considering any sort of breast lift procedure (which many women in your circumstances are).  Once you have that vertical scar, you will have it forever.  You can't go back.  It would be possible to do that later if you don't get the result you like with the first operation.

25/F/265lbs->165lbs/Never been pregnant- Extended tummy tuck with or without Fleur de Lis?

It's ours do not bother you, then a fleur-de-lis will remove the most skin. However, many patients want to avoid the vertical scar in the midline. In this situation, I would recommend an extended abdominoplasty procedure. It would not remove all of the excess skin, but it would allow you to avoid the midline incision.Congratulations on your upcoming surgery.

Fleur de Lis worth it?

Congratulations on your weight loss. Your photos demonstrate significant vertical and horizontal laxity so if you truly believe that the obvious additional scar burden, then the extended Fleur de Lis might be a terrific bet. Best wishes

Craig Harrison, MD, PA
Tyler Plastic Surgeon
5.0 out of 5 stars 23 reviews

Fleur de Lys Tummy Tuck

Hello,Doctor number one is correct. The fleur de lys will address what a conventional or reverse tummy tuck can't: horizontal skin excess. I don't know about how 'extended' it has to be, i.e. going around the hips towards the back, but a vertical component is necessary to address your circumferential (horizontal) excess. Go visit a few ABPS certified/ASAPS member surgeons. 

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 79 reviews

25/F/265lbs->165lbs/Never been pregnant- Extended tummy tuck with or without Fleur de Lis?

Dear aruss2 Congratulations on the amazing job with the weight loss! In my experience, since you have both horizontal and vertical skin excess, a FDL approach will give you the best contour. Having said that, I think you will have an excellent result with a standard TT with a longer incision. Since you are younger and likely to decide you might want children, you should consider that as part of you decision process. A standard TT might be a better option in that light. Look for experienced and well trained plastic surgeons certified by the American Board of Plastic surgery. See more than one consult. Make a well informed decision.

Afshin Parhiscar, MD
Bay Area Plastic Surgeon
4.9 out of 5 stars 49 reviews

Tummy Tuck

If scars don't bother you, you will get the best tightening with the Fleur de Lis. Many women decline that scar and we still get a very nice result with a standard TT but extended around to the back.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.