Fleur-de-Lis Tummy Tuck

A fleur-de-lis tummy tuck, or fleur-de-lis abdominoplasty, combines the standard low horizontal tummy tuck incision with a vertical incision down the middle of the abdomen. The horizontal part removes excess skin from top to bottom; the vertical part removes excess from side to side, narrowing the waist. The combined scar resembles an inverted T, and the name comes from the shape of the skin removed, which looks like the French lily.

Patients whose loose abdominal skin is excessive in width as well as in height. After massive weight loss the skin is often slack across the whole front, with vertical folds and a waist that stays wide even after a standard tummy tuck pulls it down. The vertical excision removes that horizontal excess, which a low scar alone cannot reach. When the skin is loose mainly from top to bottom, a standard tummy tuck is enough.

Vertical tummy tuck is another name patients use for a fleur-de-lis abdominoplasty, because of the vertical midline scar. It is sometimes also called a T tummy tuck or an inverted-T abdominoplasty. The vertical incision is almost always combined with a horizontal one; a purely vertical excision is used only in particular situations, such as when a long vertical scar already exists.

Often, yes — these are the patients for whom it was designed. After bariatric surgery or weight loss with semaglutide (Ozempic, Wegovy) or tirzepatide (Mounjaro), the skin has been stretched in every direction and does not retract. Surgery is planned once weight has been stable for several months; GLP-1 medicines are usually paused about two weeks before surgery as directed by the anaesthesia team, never on your own.

Frequently it is the logical option. If an open operation — for example an earlier abdominal or bariatric procedure — has left a vertical midline scar, the fleur-de-lis design can include that scar in the skin that is removed. You end up with a new, neater vertical scar in place of the old one, and the extra width of skin is treated at the same time.

The vertical scar. It runs down the middle of the abdomen and is visible in a bikini or low-rise clothing, unlike the horizontal scar, which is hidden in underwear. For patients with marked side-to-side excess, the improvement in waist and contour usually outweighs the scar, but it is a personal decision made with clear information at the consultation.

There is a low horizontal scar across the front, as in a standard tummy tuck, and a vertical scar in the midline from the upper abdomen down to meet it, forming an inverted T. The belly button is brought out along the vertical line. Both scars are closed in layers and usually fade over 12 to 18 months, but the vertical scar remains visible.

The belly button stays attached to the abdominal wall and is brought out through the skin at its new position along the vertical closure, then shaped so it looks natural. When the original navel is stretched or damaged, a new one can be created. Its final look is discussed at the consultation.

Yes, when they are separated. The vertical incision gives direct access to the whole midline, from the breastbone to the pubic area, so separated rectus muscles (diastasis recti) and small midline hernias can be repaired in the same operation. If a larger hernia is present, the plan is coordinated with a general surgeon.

An extended tummy tuck lengthens the horizontal incision onto the flanks; a 360 tummy tuck continues it all the way around the back. Both treat looseness from top to bottom and around the body. A fleur-de-lis adds a vertical excision to treat looseness from side to side across the front. The approaches can be combined — a circumferential operation with a vertical component — when the excess is in every direction.

Yes, with care. Liposuction of the flanks or waist can refine the contour, but the skin flaps in a fleur-de-lis rely on a good blood supply, so liposuction close to the incisions is limited. The amount is decided case by case.

Sometimes with a breast lift, but after massive weight loss the larger plan is usually staged: the abdomen first, then the breasts, arms or thighs in a later operation. Staging keeps each anaesthetic shorter and each recovery more manageable.

Besides the risks of any abdominal operation — bleeding, infection, fluid collection (seroma), blood clots and anaesthetic risk — the specific concern is delayed healing where the vertical and horizontal scars meet, because the skin at that junction has the most limited blood supply. A visible or widened vertical scar is the other trade-off. Not smoking, stable nutrition and careful design reduce these risks.

Comparable to a full tummy tuck with muscle repair, with tightness along both scars. Ultrasound-guided nerve blocks are placed by the anaesthesiologist before you wake, which markedly reduces the early pain and the need for strong painkillers, and helps you walk sooner.

Expect a short hospital stay, walking from the first day and one to two weeks of rest at home. Most patients return to desk work at around two to three weeks, wear the compression garment for about six weeks and return to the gym at six to eight weeks once the muscle repair has healed. Manual Lymphatic Drainage starts in the first week.

It depends on the extent of dissection and liposuction. Progressive tension sutures can close the space where fluid collects and, in limited cases, allow a drainless recovery; after more extensive operations a drain may be used for a few days.

The removed skin does not return, so the result is long-lasting as long as your weight stays stable. Ageing continues, and a significant weight regain or a pregnancy can stretch the abdomen again.

The cost depends on the extent of the excision, any hernia repair, liposuction or combined procedures, and the hospital stay. Fees are quoted individually after the consultation and include the surgeon, the anaesthesiologist with nerve blocks, the hospital and theatre, compression garments, discharge medication and follow-up. No fixed price list is published.

Yes. Many of Dr. Michels' body-contouring patients live in Dubai. All consultations and surgery take place at Elyzee Hospital in Abu Dhabi, and pre-operative tests, surgery and follow-up visits are grouped where possible to reduce the number of journeys.