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What Is An Extended Tummy Tuck Or Fleur-De-Lis Abdominoplasty?


An extended tummy tuck — also called an extended abdominoplasty — is quite similar to a standard tummy tuck, but it covers a more extensive area of the body. 

Standard Tummy Tucks vs. Extended & Fleur-de-Lis Tummy Tucks

A standard tummy tuck only addresses the  front of the abdomen in the stomach area, with an incision that runs from hipbone to hipbone. Extended tummy tucks, as the name implies, extend farther around the sides. This helps to address excess skin in the flank area, leading to a more contoured waistline.

Depending on the needs of the patient, an extended, fleur-de-lis tummy tuck may be indicated.  These require a midline, vertical incision that starts from the main horizontal incision and can run as high up as the bottom of the breast bone. Fleur-de-lis abdominoplasties are most common after a patient has lost an exceptional amount of weight, often resulting from weight loss surgery.

All abdominoplasties, regardless of type, tighten the abdominal muscles by bringing them back together at the midline (in the center). 

What’s the difference between an extended tummy tuck and circumferential abdominoplasty?

Circumferential tummy tucks require an incision that runs all the way around the patient’s hips and back — 360 degrees. It is sometimes referred to as a lower body lift, too, depending on what other contouring the patient requires, and is often combined with lipo 360  (also known as circumferential liposuction). When used as part of a lower-body lift , an extended abdominoplasty can also help contour the hips, buttocks, and even some areas of the thighs. 

When is a fleur-de-lis tummy tuck necessary?

In order to get the best results with patients who have more extensive excess skin around their waists, including “love handles” in the flank area composed primarily of skin and not fat, an extended abdominoplasty can often offer the best results. Our board-certified plastic surgeons, Dr. Kimberly Singh  and Dr. Nour Abboushi , will consult with you about your options, and let you know if this procedure is the best choice for your body contouring goals. 

Does an extended abdominoplasty include liposuction or fat removal?

Extended tummy tucks do not include liposuction; they are only designed to remove excess skin and tighten what remains while repairing loose abdominal muscles. Depending on the health of the patient and the amount of fat they would like removed, there are times when the two procedures can be done at the same time. However, it is not uncommon for the two to be completed during separate surgeries, after the first has had time to heal. If the liposuction required is fairly minimal, there is a better chance that they two may be done together. And, it should be noted, it is also much less common for large-volume liposuction  to be completed at the same time as an extended tummy tuck, although they are complementary procedures that can have absolutely amazing results.


How much weight can be lost with a fleur-de-lis tummy tuck?

Most of the time, the amount of weight loss is quite insignificant and can even be imperceptible, at least when judged purely by the numbers. It is not a substitute for weight loss. However, what is very apparent once the surgical incision has fully healed and swelling has receded is the remarkable change in patients’ body contour. Many women are able to finally able to achieve the “hourglass” shape of their dreams, even after several pregnancies or having lost a very large amount of weight with resulting skin laxity. The results of extended abdominoplasties are often life-changing for our patients. 

What are the weight and health qualifications for an extended abdominoplasty?

Qualifications for an extended tummy tuck include:

  • Excellent physical health
  • Being a non-smoker
  • The ability to maintain a stable body weight
  • A full understanding of the surgical procedure and recovery
  • Not being pregnant or planning to become pregnant

Can plus-sized or high-BMI patients quality for an extended abdominoplasty or fleur-de-lis tummy tuck?

Dr. Singh and Dr. Abboushi take into consideration their patients’ surgical goals, health and anatomy to tailor every procedure they perform to the individual, rather than using a specific BMI or weight limit to qualify (or disqualify) patients. In fact, plus-size extended tummy tucks  are a specialty of their Atlanta plastic surgery practice . The only additional requirement for higher BMI patients is that they must receive medical clearance from their primary care provider before undergoing surgery. And, if desired, large-volume liposuction and/or circumferential liposuction can also be discussed with  Dr. Singh or Dr. Abboushi during the initial surgical consult. 


What is the recovery like for an extended tummy tuck?

Extended abdominoplasties are performed under general anesthesia, in one of our Atlanta-area partner hospitals. Our doctors never perform surgery in their clinic for both the health and safety of our patients, and to ensure the best possible surgical care before, during and after the procedure. 

The length of the surgery is approximately 4 hours, after which time you will spend several more hours in recovery before being discharged that evening.

The basics of fleur-de-lis tummy tuck recovery:

  • Driving yourself home is not an option; you must have another adult available to pick you up and drive you home post-surgery.
  • Dr. Singh and Dr. Abboushi do not perform drain-free tummy tucks. You will have two surgical drains placed during surgery, and you must maintain and care for them as directed. Drains usually remain in place for about three weeks. 
  • After surgery is complete, our doctors will dress you in a compression garment that must be worn 24/7, usually for one month, to help control swelling and maximize your surgical results. 
  • You will not be able to stand completely upright for 10-14 days. This is normal, we promise!
  • You will need to sleep in a semi-reclined position until you are able to safely and comfortably lie flat. 
  • Our staff will call in any medications needed to your pharmacy at least 3 days prior to your extended tummy tuck — be sure to pick them up early so you have them ready and are able to minimize any discomfort from the start.

Recovery times vary, but, in general, we recommend that most patients plan to take at least two weeks off after an extended abdominoplasty. Final results are usually visible after approximately 6 months, but it is not unusual for it to take up to 18 for all swelling to recede and scars to flatten and lighten.

Talk to Our Doctors About an Extended Abdominoplasty / Fleur-de-Lis Tummy Tuck

Dr. Abboushi and Dr. Singh have created a boutique surgical practice in Inman Park that allows our entire team to care for our patients with the personal attention they deserve for the entirety of their surgical journeys. Our goal is to ensure you feel comfortable and at home with us from your first consult to your last follow-up. The atmosphere at Panacea is quite simply unmatched, and you’ll notice it the minute you walk into our Atlanta office. 

* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.