Fleur de Lis Abdominoplasty (Tummy Tuck) Post Weight Loss
A fleur de lis abdominoplasty (tummy tuck) removes excess skin from the abdomen in 2 directions after significant weight loss. It uses both a horizontal incision across the lower abdomen and a vertical incision up the midline, which lets me treat skin laxity that a standard abdominoplasty cannot. It is major surgery, and I perform it at Maitland Private Hospital in the Hunter Valley.
This page covers the essentials. For the complete guide to the operation, read my comprehensive guide to fleur de lis abdominoplasty (tummy tuck) after weight loss.
Is This the Right Operation for Your Skin Pattern?
The direction of your loose skin decides the operation.
If your loose skin hangs mainly downward, a standard or extended abdominoplasty (tummy tuck) with a horizontal incision along the lower abdomen is usually enough. That incision tightens the skin from top to bottom.
After significant weight loss, many patients also have loose skin running side to side around the waist. A horizontal incision alone cannot correct this. The vertical incision of a fleur de lis abdominoplasty removes that side-to-side excess and brings in the waistline.
A useful self-check: stand in front of a mirror and pinch the skin of your upper abdomen from side to side. If you can gather a large fold, you may have the pattern this operation is designed for. I confirm this with a formal assessment at consultation.
What the Operation Involves
- Removal of excess skin and fat through a horizontal incision across the lower abdomen and a vertical incision up the midline
- Repair of muscle separation (diastasis recti) where present. This is more common after pregnancy than after weight loss alone, and I assess for it at consultation
- Repair of umbilical, epigastric or other abdominal hernias during the same operation where present
- Reconstruction of the belly button (umbilicus)
- VASER liposuction (ultrasound assisted lipectomy) of the flanks or other areas where appropriate
- General anaesthetic, typically 3 to 5 hours of operating time
- Performed at Maitland Private Hospital with a stay of 2 to 4 nights
- 2 surgical drains, usually removed before you go home or at your first review
Why Come and See Me?
I am Dr Bernard Beldholm, FRACS, a Specialist Surgeon based in the Hunter Valley. My practice focuses on body contouring surgery after significant weight loss and pregnancy, and fleur de lis abdominoplasty (tummy tuck) is a core part of that work.
What you can expect from my practice:
- Your first consultation runs for about 1 hour and includes a physical examination and a full discussion of your options and risks
- Telehealth consultations are available for regional patients, with examination completed before surgery
- I operate at Maitland Private Hospital, which has 24-hour medical cover and an on-site ICU
- I see you on my ward rounds each day you are in hospital
- Your follow-up is structured and included in your surgical fee: reviews at 4 weeks, 3 months, 6 months and 12 months
Where skin laxity extends beyond the abdomen, I also perform 2 techniques I have developed for this patient group: the dual vector abdominoplasty and the circumferential hybrid abdominoplasty.
Risks and Recovery
This is major surgery and the recovery should not be underestimated. Risks include bleeding, infection, wound healing problems along the incision lines (particularly where the vertical and horizontal incisions meet), seroma, blood clots (DVT and pulmonary embolism), changes in skin sensation, and scarring that matures over 12 to 18 months. Some patients need revision surgery. Most people take 4 to 6 weeks away from work depending on their job, and longer before returning to full exercise. Results vary between patients, and I go through your individual risk profile with you at consultation. I have written about both topics in detail: read my fleur de lis abdominoplasty recovery article and my fleur de lis abdominoplasty complications article.
Cost and Medicare
The cost of a fleur de lis abdominoplasty (tummy tuck) depends on your individual surgical plan, your health fund and whether you qualify for a Medicare item number. I provide a written itemised quote after your consultation.
The relevant item number after significant weight loss is MBS 30176. To qualify, you need:
- A weight loss of at least 5 BMI units
- Stable weight for at least 6 months
- Skin problems such as intertrigo that have not settled with 3 months of non-surgical treatment
- Excess skin that interferes with your daily activities
I assess whether you meet these criteria at consultation. For a full breakdown of fees, Medicare criteria and health fund considerations, read my fleur de lis abdominoplasty cost article.
Your Steps to Surgery
1. Get your GP referral
A referral from your GP is required before your consultation.
2. Have your consultation with me
A second consultation is always included at no cost, in person or remote, to review your blood results and discuss your surgery further.
3. Receive your written quote
An itemised quote covering surgical, hospital and anaesthetist fees, along with any applicable Medicare item numbers, usually within a week of your consultation.
4. Prepare for surgery
A comprehensive blood panel, with nutritional correction before surgery where needed. Most patients have surgery 1 to 3 months after consultation.
5. Have your surgery
At Maitland Private Hospital, usually with a stay of 2 to 4 nights.
6. Recover with structured follow-up
Reviews at 4 weeks, 3 months, 6 months and 12 months, included in your surgical fee.