What is a Fleur-De-Lis Abdominoplasty?
This is a tummy tuck procedure that I do for patients that have skin excess in the horizontal and vertical axis. What is means is that a person will have excess skin that you can stretch side ways above the belly button as well as excess skin below the belly button. The muscles and fascia can be stretched out as well.
With the increase in Bariatric surgery, more patients will present with significant weight loss. As a result they will have a lot of excess skin in the hips, waist and flanks.
With a Fleur-Di-Lis Abdominoplasty the skin is also resected above the belly button which results in better contouring of hips and waist. The waist can be significantly narrowed with this procedure. This removal of skin above the belly button usually results in an inverted T scar. The extra vertical scar is the trade off for correction of the excess lateral skin above the belly button and a more narrow waist and hips.
Some Some physicians are reluctant to perform a Fleur-De-Lis abdominoplasty because they think that there is a higher complication rate with this procedure compared with the standard abdominoplasty.
Friedman 1 in 2010 did a study on 499 patients that had traditional and Fleur-De-Lis abdominoplasty procedures. He had 154 patients or 31% who had FDL (Fleur-De-Lis) and 345 or 69%that had traditional abdominoplasties. He compared the complication rates for the two groups. Contrary to what was thought, both groups had similar complication rates. The only complication rate that was slighter higher in the FDL group was wound infection 6.5% compared to 2.7%. This was the only complication that was statistically significant to the p=0.004.
The area where the vertical and horizontal incision meet is called the T-junction. This the area of greatest tension and usually were most of the dehiscences or openings will occur. Studies have shown this to occur up to 35% of the time.
Patients with higher BMIbs or body mass indexes are at higher risk for complications such as wound breakdown or infections.
The most common complications with this procedure is wound breakdown, wound infection, seroma or fluid collection, narrowing of the belly button and blood clots. Luckily, most of these complications are small.
In conclusion, the Fleur-De-Lis abdominoplasty procedure is a safe and effective procedure that can be performed on patients with massive weight loss. The complication rates are comparable to the traditional abdominoplasty and this procedure will correct skin excess in both the horizontal and vertical axis. Better sculpting of the waist and hips will also result.
1. Friedman T. et al. Fleur-De-Lis abdominoplasty: a safe alternative to traditional abdominoplasty for the massive wight loss patient. Plast Reconstr Surg. 2010 May; 125(5):1525-35.