One variation of the usual abdominoplasty (tummy-tuck) is known variously as the “anchor”, the “vertical” or “Fleur-de-lys” abdominoplasty. This involves removing not only the lower abdominal skin and fat, but also adding a vertically-oriented segment shaped like an inverted “V” in the upper midline. When the surgery is completed, this leaves a T-shaped or “anchor” shaped incision, but it is a very effective tightening operation for those who need it.
It’s usually only performed for our patients that have lost a major amount of weight (>100 lbs), and who have obvious fullness or laxity in that upper midline zone of the abdomen. Standard abdominoplasty techniques don’t correct horizontal laxity of the upper abdomen very well, so this technique may be useful for patients with that particular issue.
Also, for patients that have had a previous traditional open-style gastric bypass operation, and who have a scar there already, the fleur-de-lys approach is a reasonable option, as we are not adding any new scars, and are merely using the pre-existing midline incision to take out a little more skin there.
As is commonly the case in excisional body lifting surgery, this operation is a trade-off: more scars, but better tightening.
Advantages of the fleur-de-lys approach:
– better tightening of upper abdominal zone when obvious laxity is present
– may permit excision of previous old-fashioned gall-bladder surgery scars
– gives horizontal tightening, unlike a standard abdominoplasty
– more scars, which are not as well hidden as a standard abdominoplasty
– has potential for wound healing problems at intersection of incisions
– umbilicus shaping is more complex, prone to post-operative shape changes