Will a lower body lift fix the top above my belly button or will I need an FDL to address this? (photos)

Question

Looking to get Lower body lift in December but worried about above my belly button not being eand bulging still. Seen 2 surgeons 1 said Fluer de lis other said lower body lift.I booked with Lower body lift but can always add Fluer de lis in if needed I thought LBL might pull it down enough not to need FDL

Carmina Cardenas, MD · Answer

It is wonderful you have achieved a significant weight loss!!! Congratulations.You have developed serious flaccid skin on your abdomen with severe stretch marks even on top of the belly button which is only letting us know, you have developed also excess of skin on the width of the upper abdomen and not only the excess of length (which will be removed during a regular Lower Body Lift). So because you have developed significant saggy skin on your abdomen, sides of abdomen, most likely the pubic area, front and outer thighs and buttocks (I can see many stretch marks all over)  so you will be a great candidate for ROYAL LOWER BODY LIFT which will include in my hands: 360 skin resection, Muscle repair to tighten the muscle and achieve a smaller waist and flatter abdomen, pubic lift (and reduction if needed), front and outer thigh lift, real buttocks lift and I will complete the feminine transformation sculpting the lower back and waist doing some liposuction ONLY in those 2 areas and use that fat to transfer to buttocks to add a little bit of curves to your result.If you do not mind ending with excess of width on your abdomen, which will be noticeable when you bend over or sit, then you may skip the Fleur de Lis, but if you dream is to have a tight abdomen, no folds or skin hanging when you bend over, then you will need the Vertical incision. At the end of 1-1.5 years, that scar is almost invisible in the majority of the patients.So be encouraged!! You already started a great and wonderful journey.Dr. Cardenas

J. Timothy Katzen, MD, FACS · Answer

G’day,  thank you for your question regarding whether a lower body lift or a fleur-de-lis surgery would be the best surgery for your belly button.  During a 360 circumferential lower body lift, an incision is made all the way around your lower torso. During the 360 circumferential lower body lift, excess skin and fat from the pubic region to above the umbilicus is removed. Also, excess skin and fat of the upper, outer thighs and upper buttock is removed. In addition, during the 360 circumferential lower body lift, the rectus abdominis muscles are sutured together.  The mons region is raised and flattened.  The result is a flat abdomen, raised and flattened lateral thighs and a raised buttocks. The surgery will also help to eliminate a lot of sagging skin and dimpling as a result of massive weight loss. During a fleur-de-lis surgery only the anterior abdomen is addressed. The abdomen is pulled down (the horizontal incision)  and pulled together (the vertical incision). The fleir-de-lis incision does not address the hips or the buttocks. In my opinion, in your case, the 360 circumferential lower body left would be a much better surgery than the fleur-de-lis surgery.   In your case the 360 circumferential lower body lift would address more areas of your body than the fleur-de-lis. The fleur-de-lis would only take care of your anterior abdomen.   If you have any more  questions regarding what would be the best option for your body either a 360 circumferential lower body lift or a fleur-de-lis surgery, please contact my office. Good luck with your surgery.  Sincerely, Dr.Katzen. (Certified by the American Board of plastic surgery and member of the American Society Plastic Surgery.)

Jeremy Hunt, MBBS, FRACS · Answer

Hi,

A body lift will address vertical excesses of skin above and below the umbilicus/tummy button. When there is a side to side, or horizantal excess , the solution is a Fleur De Lys component to the procedure that will add a vertical scar in the midline but will allow horizantal tightening of the skin, much like buttoning up a jacket

The benefit is a tighter result, but the down side is the vertical scar , and so as surgeons we would like to avaoid that if possible, but if needed to achieve the result the patient desires, then is an acceptable price to pay, to achieve the desired result

I hope that is of some help

Jeremy Hunt

Jake Lim, MBBS, FRACS · Answer

An abdominoplasty or a Lower bodylift will address your area of concern above your belly button. If you have skin excess in your flanks and your lower back, a Lower Bodylift will address these areas as well.
I do not like the vertical scar of a Fluer De Lis and would rather recommend a reverse abdominoplasty (transverse scar in your breast crease) for upper abdominal laxity. It is not uncommon for those patients that has lost a very significant amount of weight to have laxity in the upper abdomen that also extends into the lateral chest and upper back. In this case ,an upper Bodylift will improve all these areas.

Daniel Barrett, MD · Answer

Dear Reserved3568,
Based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Based on your photos, it looks like you don't have much loose skin on your back and sides so a combination with liposuction might be an option. I would suggest you to consult a board-certified plastic surgeon because 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

Steve Merten, FRACS - Account Suspended · Answer

Hi, part of your decision should be what you need around the sides and buttock area. A lower body lift will address these areas, whereas an abdominoplasty (even with the vertical FDL excision) will not.I usually do a lower body lift, which usually does allow adequate tightening of the upper abdomen and improves the lateral abdomen, lateral upper thighs and buttocks. If there is still some upper abdominal looseness, a later vertical excision can always be done, but is rarely necessary.Regards, Dr Steve Merten, Sydney

Mark Baldwin, MBBS · Answer

Yes a LBL will do something to that area....the real million dollar questions is not how much change will be effected, but will you be satisfied with the results. ie your goals and expectations are more important in this situation than the technical outcome. 
Personally, I judge this based on whether or not the patient identifies the upper abdominal skin/ stretchmarks/ bulge etc as being a problem or not. If they do pick it out as an issue, I almost always say FDL. If they pick it out as a problem and they *don't* pick out buttock/back laxity as a problem, I always say FDL. 
Best wishes, MB.

Ven Erella, MD · Answer

Thank you for your question. Based on the picture LBL will likely good result without FDL. Please consult with a board certified PS for evaluation and to discuss your goals.

Maher Anous, MD, FACS (retired) · Answer

Not having had the pleasure of knowing you and judging only from photographs and being totally in the dark about your psychological makeup, I would say: FDL, absolutely! That is if you are absolutely driven and want an abdomen without an ounce of extra skin and not a single stretch mark. However, real life is nuanced and this form of absolutism is never the total truth when the real patient behind the pictures is properly assessed. I believe you are material for a great result, physically at least.

Peter Fisher, MD (retired) · Answer

Hello and thank you for your question. You will not need an FDL . The tummy tuck portion of the lower body lift will help your whole abdomen. Good luck.Peter Fisher M.DPost massive weight loss body contouring specialist

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