Fleur de lis tummy tuck in Turkey

• One incision or two

  A standard abdominoplasty uses a single low horizontal incision and removes skin downwards. The fleur de lis adds a vertical one, so skin is also removed side to side.

• The scar you are left with

  A standard tummy tuck leaves a line that underwear covers. This operation leaves that line plus a vertical scar up the centre of the abdomen, which nothing covers.

• What it can correct

  Horizontal looseness, the fold that gathers when you pinch skin across your waist. A horizontal incision alone leaves that fold behind, which is why revision is common when the wrong operation was chosen.

• How much surgery it is

  Longer on the table, more wound length to heal, drains for longer, and a slower recovery than a standard tummy tuck. It is a bigger undertaking, not a variation.

If you pinch the skin across your abdomen from side to side and only a small amount gathers, a standard tummy tuck will very likely give you the result you want without the vertical scar. Surgeons reach for the fleur de lis when the horizontal excess is too large to ignore, not as an upgrade.

The vertical scar is permanent, visible in a bikini or with the shirt off, and it is the part patients most often say they underestimated. It is worth knowing what it actually does over time.

For the first weeks it is flat and pink to red. Over the following months it usually raises, firms and darkens, which is normal scar maturation and not a sign that something has gone wrong. From around three to six months it begins to soften and fade, and it goes on fading for a year or longer. What you see at six weeks is not what you will be living with.

• The T junction is the weak point. Where the vertical and horizontal incisions meet, the blood supply is at its most stretched. This is the spot most likely to open, heal slowly or widen, and it is why surgeons are careful about tension there.
• Smoking changes the odds sharply. Nicotine narrows the small vessels that keep the skin edges alive. Surgeons commonly require you to stop well before surgery, and some decline to operate otherwise.
• Tension widens scars. Closing under strain, or gaining weight while the scar matures, tends to stretch it. Following the activity restrictions genuinely affects the final line.
• Skin tone matters. Darker skin is more prone to raised or keloid scarring. Say so at consultation, and ask what the surgeon does differently.

Some surgeons add liposuction of the flanks and back in the same operation, which patients often call a 360 fdl tummy tuck. Done well it narrows the waist from all sides rather than only from the front. Done carelessly on the same skin flap that has just been raised, it can compromise the blood supply the closure depends on, so surgeons vary in how much they will do at once. Ask specifically what will be suctioned and what will be left for later. The lipo 360 page covers the liposuction on its own, for people who do not need skin removed.

• Plan a longer stay than for a standard tummy tuck. Drains, the first dressing changes and a wound check all happen before you should be flying. Agree the length of stay with the clinic in writing, and keep the return flight changeable.
• Treat the flight as part of the medical plan. Long-haul travel after abdominal surgery raises the clot risk. Ask what the surgeon wants you to do on the way home.
• Ask who looks after a wound problem. T junction breakdown is the complication most likely to appear after you land. Find out before you travel who reviews photographs, who answers, and what happens if you need to return.
• Bring your weight-loss history. Bariatric surgery, current weight, how long it has been stable, and any supplements. It changes both the surgical plan and the anaesthetic risk.

• Ask why this operation and not the standard one. A surgeon who can show you, on your own body, the horizontal fold that needs the vertical incision is making a considered choice.
• Ask how many they do a year. Post weight loss body contouring is its own practice. Ask what proportion of their work it is.
• Ask to see scars at a year, not results at a month. Photographs taken before the scar has matured tell you nothing about the thing you will actually live with.
• Ask what they would refuse. Active smoking, an unstable weight and untreated deficiencies are all reasons to postpone. A surgeon who never postpones is a warning.
• Ask about staging. If you need several operations, a surgeon who wants to do everything in one trip should be able to explain why that is safe for you.