Fleur de Lis Abdominoplasty
A fleur de lis abdominoplasty is a more extensive variant of the tummy tuck, designed for patients with significant loose skin both above and below the belly button — most often after major weight loss. By combining a vertical incision with the standard horizontal one, I can address excess skin in both directions, achieving a tighter, more sculpted result than a standard abdominoplasty could offer in these circumstances.
Comparing abdominoplasty techniques
| Mini abdominoplasty | Full abdominoplasty | Lipoabdominoplasty | Fleur-de-lis abdominoplasty | |
|---|---|---|---|---|
| Ideally suited to | A small amount of loose skin and fat confined below the belly button | Significant loose skin across the lower and central abdomen | Loose abdominal skin combined with excess fat around the abdomen, waist or flanks | Substantial excess skin in both vertical and horizontal directions, often after major weight loss |
| Skin removal | Limited removal below the belly button | Skin removed from the lower abdomen, with tightening extending above the belly button | Full abdominal skin removal combined with targeted liposuction | More extensive removal of skin from the lower and central abdomen |
| Liposuction | May be added selectively | Limited or not routinely required | A central part of the procedure, used to contour the abdomen, waist and flanks | May be added cautiously where appropriate |
| Muscle repair | Limited lower abdominal repair may be possible | Full muscle repair can be performed when required | Full muscle repair can be performed when required | Full muscle repair can be performed when required |
| Belly button | Usually remains in its original position | Repositioned through a new opening | Repositioned through a new opening | Repositioned through a new opening |
| Scars | A shorter horizontal scar above the pubic area | A longer low horizontal scar, usually from hip to hip, plus a scar around the belly button | A low horizontal scar and a scar around the belly button; small liposuction access scars may also be present | A low horizontal scar, a vertical midline scar and a scar around the belly button |
| Main advantage | Shorter scar and less extensive surgery | Removes substantial loose skin and repairs muscle separation | Treats loose skin, muscle separation and surrounding fat for more comprehensive contouring | Provides the greatest correction of extensive skin excess and narrowing of the waist |
| Main limitation | Does not correct significant looseness above the belly button | Less effective for fat around the flanks unless combined with liposuction | More extensive contouring may increase swelling and recovery | The improvement in contour is achieved at the cost of a prominent vertical scar |
| Typical return to light activities or desk work | Approximately 1–2 weeks | Approximately 2–4 weeks | Approximately 2–4 weeks | Approximately 3–4 weeks |
| Avoiding strenuous exercise and heavy lifting | Approximately 4–6 weeks | Approximately 6 weeks | Approximately 6 weeks | At least 6 weeks |
Recovery varies between individuals and may be longer when muscle repair or more extensive surgery is required.
This is a longer, more complex operation than a standard abdominoplasty, and I discuss the trade-off between the extra scar and the improved contour carefully with every patient before we proceed.
Assessment & planning
I assess the pattern and degree of your skin excess to confirm a fleur de lis approach — rather than a standard or mini abdominoplasty — is genuinely needed.
Vertical and horizontal skin removal
A vertical incision runs from around the lower ribs to the pubic area, combined with the usual low horizontal hip-to-hip incision, allowing excess skin to be removed in both planes.
Muscle repair
As with a standard abdominoplasty, separated abdominal muscles are repaired in layers to restore a firmer, flatter abdominal wall.
Contouring & closure
The remaining skin is redraped and closed under appropriate tension to define the waist, with drains placed to manage fluid while the larger wound heals.
Who is it for?
A fleur de lis abdominoplasty is typically reserved for a specific group of patients. You may be a suitable candidate if you:
Have significant excess, hanging skin both above and below the navel, most often after major weight loss
Have already tried, or would not benefit from, a standard abdominoplasty alone
Are willing to accept a vertical midline scar in addition to the usual hip-to-hip scar
Are at a stable, healthy weight, ideally at least several months after any bariatric surgery
Are fit for a longer operation and are realistic about a more involved recovery
Before & After
Coming soon
Before-and-after photographs are shared only with each patient’s consent. Examples will be added here in due course — in the meantime, Dr Borges is happy to discuss expected results at your consultation.
This procedure leaves an inverted-T, or 'anchor', scar pattern: a vertical scar running from the lower breastbone area to the pubis, meeting a horizontal scar low across the hips. The vertical scar is the trade-off for tightening skin above the navel, which a standard tummy tuck cannot address. Scars are firm and pink initially, softening over 12–24 months, and the point where the vertical and horizontal scars meet needs particular care while healing.
What to expect
Because the wound is longer and the operation more extensive, recovery takes a little longer than a standard abdominoplasty, and I monitor healing closely, especially where the vertical and horizontal scars meet.
Week 1
Expect significant tightness and swelling, with support from your abdominal binder day and night. Drains and the junction of the two scars are checked closely.
Weeks 2–3
Mobility improves gradually; driving usually becomes possible towards the end of this period once comfortable.
Weeks 4–6
Your follow-up reviews wound healing in detail, as the T-junction scar can be slower to settle than the rest of the incision.
From week 8
Gentle exercise can resume, building gradually, with core training left until around 12 weeks.
Why choose this procedure
Advantages of a Fleur de Lis Abdominoplasty
Addresses skin excess in both directions
Where a standard tummy tuck only removes skin below the navel, this approach tightens skin above it too.
A more sculpted waist
Removing skin vertically as well as horizontally allows a more defined, hourglass-like contour.
Single-stage solution
Achieves in one operation what might otherwise need staged procedures after major weight loss.
Improved comfort
Resolves skin folds that commonly cause rashes, irritation or hygiene difficulties in major weight-loss patients.
Stronger abdominal wall
Muscle repair is performed as part of the same procedure, improving core support.
Risks
This is a more extensive procedure than a standard abdominoplasty, and carries a correspondingly higher risk profile. Potential risks include:
Wound healing problems
The point where the vertical and horizontal scars meet carries a higher risk of delayed healing or minor breakdown than the rest of the incision.
Infection
Superficial infections are usually manageable with antibiotics, but the longer wound carries a somewhat higher risk than a standard tummy tuck.
Bleeding or haematoma
May occasionally require a return to theatre to drain.
Seroma
Fluid collections are relatively common given the larger area of tissue disruption and may need drainage in clinic.
Scarring
The vertical scar is longer and more visible than in a standard abdominoplasty, and can take up to two years to fully fade.
Altered sensation
Numbness of the abdominal skin is common initially and can persist in places.
Blood clots
Deep vein thrombosis or pulmonary embolism are rare but serious risks of longer surgery, which we actively work to minimise.
Fleur de lis abdominoplasty is usually a private, cosmetic procedure, and an exact quote follows your consultation, with a price guide available on request. Where significant excess skin above and below the navel is causing genuine functional problems after massive weight loss, this procedure can occasionally be considered for NHS or insurer funding via a bariatric plastic surgery pathway — I'm happy to discuss whether this may apply to you.
Book a ConsultationLocations
Consultations and surgery take place at accredited hospitals and clinics across Kent and London, with consultations available in English, Portuguese and Spanish.
Nuffield Health Tunbridge Wells Hospital
Kingswood Road, Tunbridge Wells, Kent, TN2 4UL
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Wells Health, Fordcombe Hospital
Fordcombe Road, Fordcombe, Tunbridge Wells, Kent, TN3 0RD
Google Map →Wells Health, Tunbridge Wells Hospital
Tonbridge Road, Pembury, Tunbridge Wells, Kent, TN2 4QJ
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