115lbs loss, should I get an FDL or is extended enough for me? (Photos)

I would not think a vertical scar is "necessary". My bet would be that you will look fine with the standard skin excision. The vertical scar extends to between your breasts and can be unsightly so it behooves one to consider carefully. Thank you.

Thank you for your query. You can get more horizontal/transverse skin tightening with an FDL tummy tuck, compared to an extended tummy tuck. The price, however, is a vertical scar which is less hidden than the “bikini scar” of an extended tummy tuck. I usually discuss the trade-off with my patients, but when in doubt, I advise an extended tummy-tuck, to minimise the scarring. Please discuss this with your surgeon and let him/her know of your preferences as well. All the best!

Thank you for the photos. Based on the laxity you have in two dimensions (horizontal and vertical) FDL is the right choice

Dear Gregarious756560,

Congratulations on your significant weight loss of 115 pounds. This is a remarkable achievement, and it's understandable that you want the best surgical option to address the resulting excess skin and reshape your body.

Based on the details you've provided and the shrinkles visible in your photos, although an extended tummy tuck might offer a substantial improvement, a body lift might indeed be more beneficial for your specific situation. Let's explore the differences between the procedures you're considering:

Extended Tummy Tuck: This procedure is designed to remove excess skin and fat from the abdominal area, extending around the sides to improve the waistline. It's more comprehensive than a standard tummy tuck but primarily focuses on the front and sides of the abdomen.

Body Lift (Circumferential Lower Body Lift): A body lift goes a step further by addressing not only the abdominal area but also the hips, buttocks, and lower back. This procedure encircles the entire lower torso, removing excess skin and fat from these areas, and providing a more significant lift and contour to the entire lower body. It's particularly effective for individuals who have experienced massive weight loss, as it can dramatically transform the lower body's appearance by correcting sagging skin and irregular contours around the hips and buttocks, in addition to tightening the abdominal region.

Fleur de Lis (FDL) Tummy Tuck: The Fleur de Lis tummy tuck is another option, where, in addition to the horizontal incision of a traditional tummy tuck, a vertical incision is also made. This is typically recommended for individuals with significant excess skin in both the horizontal and vertical dimensions of the abdomen. It can offer more dramatic contouring than an extended tummy tuck but doesn't address the lower back, buttocks, or hips.

Considering the extent of your weight loss and the areas of concern mentioned, a body lift could provide the most comprehensive results by addressing the excess skin and sagging not just in the abdominal area but also around the hips and buttocks. This approach could yield the contour and silhouette you're likely seeking post-weight loss.

If you're hesitant about undergoing a body lift, the extended tummy tuck is a viable alternative, especially if your primary concern is the abdominal area and hips. However, for the most dramatic and all-encompassing improvement, including the removal of excess skin and lifting of the buttocks and outer thighs, a body lift would be the optimal choice.

It's crucial to have a detailed discussion with your surgeon about your aesthetic goals, the specific areas of concern, and the outcomes you can realistically expect from each procedure. This will help ensure that you make an informed decision that aligns with your desires for your post-weight loss body contour.

Sincerely,

Dr. Katzen
Plastic Surgeon

Unfortunately, your photographs are not showing your breasts. However, I would recommend beginning from the top with a breast surgery. The reason I say to begin with the breasts first is it will pull up the upper abdominal skin and may eliminate the need for a fleur de lis. From your photographs, it may be possible that you will need a back lift with a breast lift and then a circumferential tummy tuck. The breast lift technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained.

Best Wishes,

Gary Horndeski, M.D.

Congratulations on your weight loss. In person consultation is necessary to determine the amount of horizontal skin laxity you have (determining if a FDL vertical incision is worth it for you). No matter what, a lipoabdominoplasty with lateral hip extended incisions will be a great option. Good luck on your tummy tuck journey.

You are an excellent candidate for a tummy tuck. I have never found it necessary to do the fdl tummy tuck. Nit worth the extra scar and can have wound healing problems

Congratulations on your weight loss! I think the extended tummy tuck should do well for you. Do remember that the back side still may be loose.

hi, thanks for your question. Well done with your weightloss this is a great achievement. I think you are an 'inbetweenie' - both of these options could work for you and I am not sure I can say which of these I would do just based on the photos - probably would depend on the feel of skin - how stretchy and loose it feels especially in the midline.

Congratulations on your impressive weight loss! An FDL is a good option for those that do not mind the vertical scar in order to address excess vertical tissue of the upper abdomen. An in person evaluation is the best way to determine if this is the correct approach for you. If you are adverse to the vertical scar you can consider an extended tummy tuck only but may have laxity that remains in the upper abdomen. I've included a video that I hope you find helpful.