Overview of the surgery:
Fleur-de-Lis abdominoplasty is also known as fleur de lis tummy tuck, a plastic surgery procedure focuses on removing a large amount of excess skin from theabdomen. The surgeon will also remove some targeted fat and repair abdominal muscles during the procedure if this is needed, as with a standard tummy tuck.
A fleur de lis tummy tuck gets its name from the incisions shape. The surgeon removes a panel of skin thats shaped like the three petals of a fleur de lis. The top peak of this panel is near the
breastbone, while the farthest peaks at the sides are around the hip bones.
After removing the panel of excess skin, the surgeon shapes the underlying fat and muscle as needed. At this point, the surgeon pulls the remaining skin together for a shapely contour.
CANDIDATES FOR A FLEUR DE LIS TUMMY TUCK:
A fleur de lis tummy tuck is designed for patients with an extreme amount of unwanted skin. These
tend to be patients who have succeeded with major weight loss. While they lose the unwanted fat,
their skin may not be elastic enough to conform to their slimmer shape.
Preparation Prior To Surgery:
• Medical history assessment (any allergies, serious medical condition and all medications
taken both prescribed and non-prescribed), physical examination, and laboratory tests will be
performed during consultation.
• Avoid smoking for about 3-4 weeks prior to surgery, as nicotine interferes with circulation
and will greatly affect healing process.
• Stop drinking alcohol, a week before the surgery and throughout your recovery period.
• Taking any medications should be avoided such as hormones, anticoagulants, anabolic
steroids and supplements at least 4-6 weeks to prevent complicating medical factors prior to
surgery, and also avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can
During the procedure:
Usually an incision is made just above the pubic region. The longer the scar the more tissue can be removed and you will need to discuss the length of your scar at a consultation. A vertical line is drawn down the middle of the abdomen and skin is excised on either side of this in a triangle. The skin is separated from the underlying tissue from the pubic region upwards. The extent of dissection will vary from patient to patient. The abdominal wall is tightened and the tummy button relocated. Excess fat and skin is removed. The incisions are closed with dissolvable stitches and the skin is repositioned. It is unusual to require drains and a compressive dressing is almost always required.
It takes 4-6 hours depending on the area of the abdomen are being addressed.
Type of Anesthesia use:
This surgery is usually done under general anesthesia
Hospital Stay 2days.
Days to stay in Thailand:
At least 14 days.
Risks and Complications:
The vast majority of patients are delighted with the procedure although common complaints include numbness, bruising, swelling especially around the scar line and often there is a slight difference between the two sides of the abdomen. Uncommon complications include infection, haematoma, delayed healing/skin necrosis/skin loss, seroma formation and thickened scar. There are uncommon risks of general anaesthesia such as respiratory / cardiac compromise and deep vein thrombosis.
Sensation usually changes following a fleur de lis abdominoplasty. Although permanent numbness is uncommon, sensation can take a number of months to return. The scars following a mini tummy tuck can be red for a number of weeks / months after surgery and it can take some time before the scars start turning purple / pink and then start fading into a white line. It is unusual to develop abnormal scars and unusual to have irregularities requiring scar revision. Any revisions to the scars should not be considered for at least a year following surgery. The scar is often not symmetrical and the scar can move slightly with time. The abdomen can become lax with time and the result can fluctuate with fluctuations in weight.
After the surgery,
- You will usually return to the ward within an hour following surgery and you will be encouraged to mobilize.
- You will not have a catheter in place and it is unusual to require drains.
- You will be able to eat / drink and and mobilize as soon as the anaesthetic wears off.
- You will feel swollen and have abdominal discomfort that will usually require analgesia.
- You will be able to go home the next day and should keep the wounds dry for the next week.
- You should arrange for someone to pick you up following surgery and have some support at home on discharge.
- You will be reviewed in clinic and the wounds checked at a week.
- You should avoid excessive straining in the first week and should continue to wear a support garment for 4-6 weeks after surgery.
- You will be able to resume light exercises after a week and normal exercise by 3-4 weeks.
- You should begin massage to the scar once healed. The healing from a fleur de lis can be longer than a standard tummy tuck and frequently the point that has the most problems is the join of the vertical and horizontal scar. This ladies preops and 1 week images can be compared to 4 weeks where there is a healing issue at the join. This does heal but can take a few weeks. Her longer term scar is shown for comparison.