Midline scars are simply incorporated into the planned resection, but off-centered ones such as open cholecystectomy scars may require modification of the vertical resection to incorporate the previous surgical scar and bring the final planned closure off midline ( Fig. Adjunctive liposuction marks are made along with existing scars and hernias. We performed a circumferential body lift with Fleur-de-Lis.
#Fleur de lis tummy tuck with body lift skin#
All markings should be double-checked intraoperatively prior to incision. We also performed a Tummy Tuck to take out the excess loose skin and tighten her abdomen. Bra-Line Back Lift Nipple Correction Body Surgery Menu Toggle. The planned vertical resection is elliptical, tapered at the xyphoid process superiorly and near the planned horizontal incision inferiorly ( Fig. During a fleur-de-lis tummy tuck, the surgeon makes two incisions, a horizontal and a vertical, to remove larger amounts of loose skin. The excess tissue in the transverse dimension is then marked using strong bimanual palpation ( Fig. The superior portion of the abdominoplasty incision is usually judged to be just above the umbilicus. This results in the upper third of the hair-bearing mons being within the planned resection. 26.3 The standing patient is asked to strongly lift excess abdominal skin, and the lower incision is marked at the level of the pubis. Preoperative photographs are taken in five standard views for the fleur-de-lis abdominoplasty, with an additional three views for a circumferential procedure.įIG. Ptosis is corrected as part of the abdominoplasty closure and will be addressed later in the chapter. If the patient perceives the region as unacceptably full, treatment options include liposuction and direct skin excision. Treats vertical skin laxity The procedure can remove large quantities of excess skin that hangs vertically, i.e. Excess skin, adiposity and ptosis frequently remain after massive weight loss. Pros Removes large amounts of excess skin A Fleur de Lis tummy tuck is capable of removing significant quantities of inelastic skin. The mons should be evaluated independently. All three procedures can be performed safely during one anesthetic. Any regions of excess adiposity can be addressed with concurrent liposuction. Often there is associated ptosis of the flanks and buttocks, and the patient may be best served with a circumferential body lift and fleur-de-lis abdominoplasty. Patients found to have an excess of abdominal tissue in the vertical and transverse dimensions are offered a fleur-de-lis abdominoplasty. Using physical exam findings and patient wishes, a surgical plan is formulated. Frequently the hernia can be repaired and reinforced with midline muscle plication at the time of surgery.
Note the hernia marked in red as a result of a prior open bariatric procedure. The patient is marked for fleur-de-lis abdominoplasty.
26.2 Typical preoperative patient presenting for body contouring.
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