Fleur-de lis or tummy tuck? (Photo)

When my patients have had massive weight loss, they sometimes have horizontal or vertical excess for their abdominal tissue. They often have stretch marks and have poor quality skin. When they have all this excess tissue then sometime we remove it horizontally and vertically. This gives an upside down T scar and we call it a Fleur de Lis. It is best to visit with a board certified plastic surgeon to have an exam and see which surgery is best. Some of my patients do not want the additional vertical scar, so they have to understand that the skin may still feel a little loose in the upper abdomen if it is not removed.

Thanks for your question and congratulations on your weight loss! Unfortunately, it is impossible to make an accurate recommendation without a formal history and physical examination. Some questions to consider: is your weight stable? Have you reached your goal weight? If you are continuing to lose weight, or if you would like to achieve more weight loss, you are better off waiting until you have reached your goal and your weight has stabilized prior to proceeding to the operating room. If you undergo either tradition abdominoplasty, or fleur-de-lis, and then lose weight, you can alter your final result dramatically. I suggest that you meet with a board certified Plastic Surgeon to discuss your concerns and formalize a plan. best of luck!

It important to have more photos of your body, from the front and the back, and photos that show from below the neck down to the knees, to evaluate your case and see where and how much extra skin you have and tell what procedure will be the best for your case.

It's difficult to say without examining you person, but it really depends on your goals. Most people don't need a vertical scar unless there is a significant amount of horizontal skin excess. I would make sure to reach your goal weight and then have consultations with several board-certified plastic surgeons. Speak with them about your goals and multiple opinions will help you decide which procedure is right for you.

Hello and thank you for your question.   Congratulations on your weight loss.  Based on your
photograph, you are a great candidate for a full tummy tuck with liposuction and will not need a fleur de lis.  This can be done through a low
incision, all completely below the bikini line. 
The belly button can be designed to look natural and have no scars on
the exterior.   Your muscles can also be
plicated resulting in a flat abdomen. 
Make sure you specifically look at before and after pictures of
real patients who have had this surgery performed by your surgeon and evaluate
their results.  The most important aspect is to find a surgeon you are
comfortable with. I recommend that you seek consultation with a qualified
board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Due to your history of weight loss surgery a Fleur de lis tummy tuck would likely give the best outcome. Of course an exam in person is needed to confirm this so I recommend consulting with a few plastic surgeons in your area for a good exam and review of your medical history.Best wishes,Dr.Bruno

Congratulations on your achievement!!! 
You have developed a severe degree of saggy skin on abdomen, but not only vertically but also horizontally (excess of width), It will be great if you share additional pictures and medical information to evaluate your complete case.
So my recommendations will be to stage all procedures because of SAFETY. First stage: Lower Body Lift-Fleur de Lis which means a Circumferential (360) Tummy Tuck, muscle repair to achieve a smaller waist, pubic lift, front thigh lift, outer thigh lift, buttocks lift and a mid vertical incision  in order to remove also the excess of skin on the width. Losing the extra weight will ONLY make your surgery safer and the possibility of achieving a wonderful result.
I suggest you to visit my Facebook you will find couple of patients with the procedure I am recommending,
Be encouraged!!! 
~Dr. Cardenas

Majority of patients who lose significant weight will need a circumferential tummy tuck, i.e. a lower body lift. Weight loss does not just present itself at the front and is often circumferential. As for a vertical extension,this is per case basis. Most often it is not required and the reality is that a horizontal distribution will do the trick . But if the mid portion is redundant then a fleur the lys Is recommended.Good luck.

Dear shawndah,based on your photos and description, you will most likely need a tummy tuck. But an examination is required to be sure. Do you currently have a goal weight in mind. Optimizing your weight prior to surgeries such as a tummy tuck will improve your results and prevent a loss of results if you were to lose the weight after surgery.  Otherwise I think you would be a great candidate. I would consult with a plastic surgeon to go over all the details.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

usually want as much skin removed as possible... and from my past experiences with doing both on such patients, the FDL WINS all the time!  It provides the flattest, tightest tummy you can get from what you start with but it also comes with its downsides like fullness at the upper end of the vertical scar.  If you have a traditional tummy tuck, your skin will be jiggly... guaranteed!  So FDL is my recommendation on any massive weight loss patient.