A tummy tuck is usually associated with a single horizontal scar placed low on the abdomen. For many people, this standard approach is enough to remove loose skin and tighten the abdominal wall. However, some patients have excess skin not only from top to bottom, but also from side to side. In these cases, a fleur-de-lis tummy tuck can offer a more complete correction. This guide explains what a fleur-de-lis abdominoplasty is, who may benefit from it, and what to expect from recovery and scarring.
What Is a Fleur-de-Lis Tummy Tuck?
A fleur-de-lis tummy tuck, often shortened to FDL abdominoplasty, combines the classic horizontal incision of a tummy tuck with an additional vertical incision running down the centre of the abdomen. When the two incisions are drawn together, the pattern resembles the fleur-de-lis symbol, which is where the name comes from.
The horizontal incision allows the surgeon to remove excess skin in the vertical direction, from the upper abdomen down. The vertical incision allows additional skin to be removed in the horizontal direction, from one side of the abdomen to the other. This two directional tightening can create a narrower waist and a flatter abdomen in people with significant skin laxity.
How It Differs From a Standard Tummy Tuck
In a standard tummy tuck, the skin above the navel is pulled down and the excess is removed along the lower incision. The abdominal muscles are often repaired at the same time. This works well when the main problem is vertical excess, such as a lower abdominal skin fold after pregnancy.
When there is also a large amount of horizontal excess, a standard tummy tuck may leave some looseness around the waist or upper abdomen. The FDL technique addresses this by removing a central wedge of skin and bringing the sides together, which contours the waist more effectively.
Who May Benefit From an FDL Tummy Tuck?
The fleur-de-lis approach is not needed for most tummy tuck patients. It is usually considered for people with more extensive skin changes, such as those who have:
- Lost a significant amount of weight, either through diet or after bariatric surgery
- Loose skin around the waist and upper abdomen, not only below the navel
- Had multiple pregnancies that stretched the skin considerably
- An existing vertical scar on the abdomen from previous surgery, which can sometimes be incorporated into the new incision
Suitable candidates are generally at a stable weight, do not smoke, and are in good general health. Stability of weight matters because further weight loss after surgery can cause new looseness.
What About the Vertical Scar?
The main trade off of an FDL tummy tuck is the additional vertical scar. This is the most important point to discuss during the consultation. For many patients with extensive loose skin, the improvement in shape outweighs the visibility of the extra scar. For others, a standard tummy tuck with a single scar may be preferable, even if the result around the waist is less dramatic.
Scars usually appear red or pink in the first months and gradually fade and flatten over a period of twelve to eighteen months. Their final appearance depends on genetics, skin type, and aftercare. Scar care such as silicone products and sun protection can support healing. Our article on tummy tuck scars explains this topic in more detail.
Can It Be Combined With Other Procedures?
An FDL tummy tuck is often performed together with other procedures to create a balanced result. Common combinations include:
- Liposuction of the flanks: to refine the waist from the side and back
- Breast lift, with or without implants: especially after weight loss or pregnancy, when the breasts have also changed
- Abdominal muscle repair: to correct separation of the muscles and support a flatter profile
When several procedures are combined, the length of surgery and the patient’s overall health are carefully considered. In some cases, staging the procedures over two operations is the safer choice.
Preparing for Surgery
Preparation usually includes a medical assessment, blood tests, and a review of current medications. Patients are generally advised to stop smoking several weeks before and after surgery, since nicotine affects blood flow and can slow wound healing. Reaching a stable weight beforehand also supports a predictable result.
During the consultation, Assoc. Prof. Dr. Ulaş Bali examines the skin in both directions, assesses the abdominal muscles, and discusses whether the benefit of the vertical incision justifies the additional scar for each individual patient.
Recovery After a Fleur-de-Lis Tummy Tuck
Recovery is similar to a standard tummy tuck, although the additional incision may require slightly more attention to wound care.
- Hospital stay: Usually one night, depending on the extent of surgery.
- First two weeks: Patients walk in a slightly bent position to reduce tension on the incisions. Drains, if used, are typically removed within the first week or two.
- Compression garment: Worn for around six weeks to support the tissues.
- Return to work: Desk based work is often possible after two to three weeks.
- Exercise: Light activity can usually resume after four to six weeks, while heavy lifting and abdominal training are delayed for longer.
The waist and abdominal shape continue to improve as swelling settles over several months.
Possible Risks
Risks include delayed wound healing, particularly at the point where the vertical and horizontal incisions meet, fluid collection, changes in skin sensation, infection, and visible scarring. Following the surgeon’s instructions, avoiding smoking, and attending follow up visits can reduce these risks.
If you are considering abdominal contouring after weight loss or pregnancy, you can contact the clinic to discuss which tummy tuck technique suits your body.
Frequently Asked Questions
Is a fleur-de-lis tummy tuck more painful than a standard tummy tuck?
The discomfort is broadly similar. The additional incision may cause some extra tenderness in the central abdomen during the first weeks, which is managed with medication.
Will the vertical scar be visible?
Yes, the vertical scar runs down the centre of the abdomen and can be visible in swimwear that exposes the abdomen. It usually fades over time but does not disappear completely.
Can the navel be preserved?
In most cases, the navel is preserved and repositioned to sit naturally within the new abdominal contour.
How long should I wait after weight loss before having an FDL tummy tuck?
It is generally advised to maintain a stable weight for several months before surgery. Your surgeon can advise on the right timing based on your situation.
Can an FDL tummy tuck be done at the same time as a breast lift?
It is often possible, depending on the patient’s health and the total duration of surgery. This is assessed individually during the consultation.
