What is a Fleur de lis Abdominoplasty?
A fleur de lis abdominoplasty is an operation designed to rejuvenate the abdominal area and removes excess fat and skin. It is often performed for patients who have a lot of skin/fat excess in the upper abdomen and the flanks. It can also be used where patients already have midline abdominal scars to help rejuvenate.
What to expect during your consultation?
The success of the consultation depends on your openness and honesty in relation to what troubles you and your expectations of surgery. You will be asked questions about your health, desires and lifestyle. Different operations can be tailored to your needs and the potential outcomes and the risks and complications will be discussed with you. The operation removes excess tissue from the upper and lower abdominal area and needs to be tailored to the individual. It also helps to marrow the waist and addressed the excess tissue in the flanks. A fleur de lis abdominoplasty can be tailored to each individual and can be combined with liposuction and other rejuvenation procedures such as breast rejuvenation. It involves abdominal skin removal and tightening of the abdominal muscles. A consultation regarding the risks and limitations of surgery will help you to choose a procedure that will meet with your expectations.
Preparing for fleur de list abdominoplasty surgery
This is a procedure that is performed under general anaesthetic. Your health is a prime importance and any cosmetic surgery should be postponed if you are unwell for any reason. It is important that if anything changes with your health that you make contact with us. You should ideally stop smoking 6 weeks prior to surgery and stop taking aspirin, anti-inflammatory drugs and herbal supplements before surgery. You may need preoperative tests prior to surgery, which we will arrange if required.
You will generally experience abdominal discomfort following the surgery and should aim to be off work for at least 2 weeks depending on the type of work you do. Often it can take 4 weeks to recover from a fleur de lis abdominoplasty and occasionally there can be healing issues at the join of the vertical and horizontal scar.
A fleur de lis abdominoplasty takes between 2-3 hours. 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.
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.
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.