Is Circumferential abdominoplasty going to be adequate to tighten up the upper & roll ? Possibly need fleur de lis, also?(photo)

61 y/o triathelete and competitive swimmer (National level) w 103 lb wt loss a year ago. Currently, 5ft 2 in, 131 lb, Finally planning on getting rid of excess skin! Competition suits will finally fit better. Already decided on circumferential abdominoplasty, but reading posts on this web site has me re thinking if that will be enough to get rid of upper body roll? I had a mastopexy w extended incisions around to upper back in Aug 2015. I would really love to have a waist again.

Doctor Answers 10

Circumferential vs. fleur-de-lis abdominoplasty

Congratulations on your weight loss and athletic determination!
Either procedure will result in a good improvement for you.
I prefer the circumferential abdominoplasty.  You do not have any incision on your anterior abdomen and the vertical portion of the fleur-de-lis excision will result in an incision that is not always hidden under undergarments. The circumferential tummy tuck will pull your smaller circumference waist down over your wider circumference hips (like a lamp shade) and also pull up your outer thighs and buttocks.
Though the scar is longer and the procedure is a little more to recover from your final result will be better.

Toronto Plastic Surgeon
4.9 out of 5 stars 33 reviews

Circumferential Bodylift vs Fleur de lys

I think you will get a fantastic result from either procedure.   You upper abdomen will be improved by both methods.  I would choose the circumferential lift if you desire correction of the hips/outer thigh/lower back/buttock area.   I wish you a safe recovery and amazing result.

Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
4.8 out of 5 stars 87 reviews

Tummy Tuck Options

An extended tummy tuck is usually a better alternative than a fleur-de-lis pattern tummy tuck that has a shorter horizontal extension but has the vertical scar. There is no question that adding the vertical excision will improve transverse tightening above and around the belly button as it is removing tissue. But the trade-off of the vertical scar is not going to very appealing for a lot of patients. But with your existing breast scars and your desire to a tighter feeling waistline that may take precedence over the scar concerns.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

Is Circumferential abdominoplasty going to be adequate to tighten up the upper & roll ? Possibly need fleur de lis, also?(photo)

Based on your photos, I think that you will be happier with a fleur-de-lis incision. This will really bring in the waistline by removing excess tissue in the horizontal plane. This will slightly increase the risk of a wound healing issue, but well worth it. Good luck!

Keith Hodge, MD
Leawood Plastic Surgeon
5.0 out of 5 stars 28 reviews

Which type of tummy tuck

Without seeing you in person, it appears that your already have a vertical incision from the belly button down to the hairline. If there is no laxity of the hip and buttock or you are not concerned with either I would think that a T shaped incision (Fleur-de-Lis) pattern would best address the skin laxity both in the vertical and horizontal dimensions. In my opinion, once the shape and contour of the abdominal wall is pretty the additonal vertical scar becomes inconsequential. Good Luck. 

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 54 reviews

Upper Roll Concerns

Thank you for your question and photos.  Congratulations on your weight loss. A well performed tummy tuck or body lift would address the upper roll effectively. An inverted T tummy tuck is used to address vertical not horizontal laxity at the expense of a vertical scar and a high horizontal incision. It is useful in some cases but not necessary in yours. Best wishes.

Robert F. Centeno, MD, FACS
Columbus Plastic Surgeon
4.9 out of 5 stars 77 reviews

Fleur-de-lis vs circumferential

I appreciate your question.
In my experience it is a tradeoff of scars vs skin removal
The fleur-de-lis allows for the most amount of skin resection especially for the upper roll and contours the waist by pulling horizontally. 
As an athlete you could wear the bathing suit with the fabric down the middle
if that scar is too mud, then the circumferential is your next best choice.

The best way to assess and give true advice would be an in-person exam.
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative plastic surgery.

best of luck!

Dr Schwartz

Jaime S. Schwartz, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 93 reviews

Abdominoplasty | Tummy Tuck

Thank you for your question about tummy tuck.

Yes, a circumferential belt abdominoplasty can go a long way in tightening both the upper and lower abdomen.

Yes, it may be possible to get it even tighter with the addition of a fleur de lis, but in my experience, many patients would find the vertical scar unacceptable.

To be sure, see two or more experienced, board-certified Plastic Surgeons for a complete evaluation to make sure you are a good candidate and that it is safe for you to have a tummy tuck or related procedure.

I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 183 reviews

Tummy tuck vs. Fleur-de-lys abdominoplasty in a triathlete after 103lbs. weightloss!

Hello canag54, 
Thanks for your question.
From your photos it seems like all the excess skin is in front.
You could have a standard tummy tuck and get the upper roll, but you may have a longer incision going out to the sides.  I think that fat contouring with liposuction would need to be a little less aggressive to maximize safety.  Also if you have any incisions that change blood supply, this operation may not even be safe from a wound healing standpoint.
You also could have a Fleur-de-lys type abdominoplasty if you don't mind the long vertical incision in the middle of your abdomen.  An advantage here is that lateral liposuction can be added to really trim your waistline.  The problem is a 2-piece bathing suit is a little difficult to wear with the long midline incision.  Also, that midline scar tends to have a lot of tension on it and may have less ideal scarring.  I personally think this option makes the tightest waistline.
Speak with a board-certified plastic surgeon in person to see which option makes the most sense for you.
Good luck,
Dr. Shah

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 56 reviews

Tummy Tuck Vs Fleur de Lis

Dear Canag54,

Congratulations on your weight loss! Having a tummy tuck will remove all the skin excess you have and it will improve your ability to compete at such a demanding sport as a triathlon. Taking a look at your pictures there is a possibility for you to have a classical extended low scar tummy tuck to achieve the results you are seek but a physical examination is going to be necessary determine if this will be possible. Best wishes.  

Kelvin Eusebio, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 35 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.