125 pound weight loss - Is it possible to get a flatter upper abdomen with no Fleur De Lis? (Photos)

This is a great question and indeed a challenging case. Since there is excess skin in both the horizontal and vertical dimensions, a Fleur-de-lis tummy tuck (abdominoplasty) would address the excess skin the best, leading to the best possible contour. If you prefer to avoid a vertical incision from the FDL, performing a traditional tummy tuck with a staged reverse tummy tuck can help remove the upper rolls and extra skin, however it will not take away the extra skin horizontally. Liposuction around the rib cage can be an effective tool to help with the overall contour and figure, but since you have extra skin and rolls in your upper abdomen, the liposuction will not effectively address the skin laxity and may not be the best option for you.
Deciding which procedure is right for you is an personal decision that should be discussed with your surgeon to come up with what is best for you and your goals.

First of all, congratulations on the amazing weight loss! I think its important to understand why you want to avoid the Fleur-de-lis. When done well, the scar line can heal very well and is a wonderful way to tighten your trunk in both horizontal and vertical directions. It is extremely powerful in its ability to give you the flat abdomen you deserve. It would also certainly make the addressing your back rolls much easer when it comes to the midback lift by removing redundant tissue and tightening your trunk overall. To stage a reverse tummy tuck is certainly an option but again you're subjecting yourself to a similarly long scar, if hidden under the breasts. As always, speak with your board certified plastic surgeon and explore their post-op results from Fleur-de-lis, and I think you'll be surprised at how great they can look.

Dear Reserved165995,

Congratulations on your remarkable weight loss achievement! Based on your photos and your goals, I believe you are an excellent candidate for a comprehensive body contouring approach that doesn't necessarily include the vertical cut associated with a Fleur De Lis tummy tuck.

For your case, a 360 lower body lift would be highly beneficial. This procedure addresses excess skin and fat around the entire circumference of your abdomen, waist, and back, effectively lifting and tightening these areas. It provides a significant transformation, particularly for patients with substantial weight loss, by removing the "belt" of excess skin and improving body contour.

In addition to the lower body lift, a breast augmentation with lift will rejuvenate and enhance your breast shape and size, complementing the lower body lift and creating a harmonious overall appearance.

Given your concern about the upper abdominal roll, a second-stage procedure, known as a horizontal torsoplasty, can be particularly effective. This involves an incision made along the bra line to specifically address and reduce back rolls. This stage may also include liposuction to further refine and contour your silhouette, focusing on achieving the most aesthetically pleasing result.

The advantage of staging these procedures is that it allows for targeted, precise corrections with a more manageable recovery process, and potentially minimizes complications associated with extensive single-session surgeries.

Your journey is unique, and choosing a plastic surgeon experienced in post-weight loss body contouring is crucial. Look for a surgeon with an extensive portfolio of before-and-after photos of patients with similar backgrounds and goals. This will give you a better understanding of their skill level and the potential outcomes you can achieve.

By opting for a 360 lower body lift followed by a horizontal torsoplasty and breast work, you're likely to achieve a beautifully contoured figure that reflects your weight loss journey and goals. Remember, the key is to work closely with a plastic surgeon who understands your vision and has the expertise to make it a reality.

Sincerely,

Dr. Katzen
Plastic Surgeon