Fleur De Lis Tummy Tuck after Massive Weight Loss

Massive weight loss results in excess abdominal skin in the vertical and horizontal dimensions. Plus-size people who have lost major weight not only have a large hanging pannus, but also large skin folds that extend from the flanks to the back.

Some plastic surgeons who specialize in plus-size tummy tucks recommend a Fleur De Lis Tummy Tuck to their patients in order to be able to also reduce the width of the abdomen and remove the extra rolls on the flanks.

Fleur De Lis abdominoplasty involves making a vertical incision in the middle of the abdomen to “tuck in” the sides and reduce the width of the abdomen. This vertical scar is in addition to the lower abdominal horizontal scar that is customary with a regular tummy tuck.

According to some scientific studies, adding a vertical scar can increase the infection rate and expose the patient to the additional risk of partial skin loss. On the other hand, other studies report no significant additional complication rate with Fleur De Lis. 

Because of the complexity of the Fleur De Lis and its increased complication rate, many expert plastic surgeons reserve this surgery for patients who have a tremendous amount of excess skin in the horizontal as well as vertical dimensions and are expected to have more than 30-50 lbs of excess skin removed. They tell their patients to accept a visible vertical scar in return for the removal of loose abdominal skin. Furthermore, they don’t consider Fleur De Lis for rather smaller patients who don’t have extreme folds of excess abdominal skin.

Are There Good Alternatives to Fleur De Lis Abdominoplasty?

Many plastic surgeons advocate doing a staged tummy tuck with a subsequent upper body lift as an alternative to the Fleur De Lis tummy tuck. 

Others, including myself, would rather perform an Extended Abdominoplasty or even a Body lift to avoid an unsightly vertical scar, in addition to extra surgical risk. 

I believe that a body lift helps to remove the excess horizontal skin as well as the back rolls via a bikini line circumferential scar. This eliminates the need for a vertical scar. 

The advantage of a body lift is that it also pulls up and lifts the sagging hips, thighs, and buttocks. 

In patients who truly have upper back and upper flank rolls, I recommend an upper back lift, which will address this issue more directly than a Fleur de Lis tummy tuck technique.

Obviously, all patients’ body contouring needs are different, and therefore, a plastic surgeon who specializes in tummy tuck after major weight loss has to tailor his surgical approach to the specific patient’s needs, while at the same time discussing the pros and cons of each body contouring technique with the patient.

Also, it’s the patient’s responsibility to search for many tummy tuck before and after pictures of those who have the same body type as them. They also need to ask many questions and spend quality time with the plastic surgeon to truly understand what is involved, including the risks, complications, and the recovery course. 

They have to be ready to take on not only a major surgery but also the recovery and the healing time that follows.