After bariatric surgery
The classic scenario: massive weight loss leaving surplus skin both vertically and horizontally.
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Fleur-de-Lis abdominoplasty after major weight loss, by Dr. César Padilla at Quirónsalud Málaga Hospital.
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Fleur-de-lis abdominoplasty
What it is
The Fleur-de-Lis procedure is a specific form of abdominoplasty designed for people who have achieved substantial weight loss — after bariatric surgery or a radical change of habits — and are left living with the excess skin the scales did not take away: a surplus that runs not only horizontally, but vertically too.
Its name comes from the incision pattern, which resembles a fleur-de-lis: a horizontal line low across the abdomen and a vertical one down the midline. That geometry is what makes it possible to remove all of the surplus and re-tension the wall in both directions, where a classic tummy tuck would fall short.
Indications
The classic scenario: massive weight loss leaving surplus skin both vertically and horizontally.
When the abdominal “apron” comes with midline laxity that no horizontal technique could resolve.
Not only appearance: hygiene, chafing, mobility and clothes. Removing the surplus changes daily life.
Combined with WAL liposuction and abdominal wall repair when the case calls for it, within post-bariatric surgery.
Before surgery
The number one condition: a stable weight. After bariatric surgery, body-contouring comes once the weight loss has settled and in agreement with your bariatric team, with your nutrition in order — protein and the right levels are the building blocks of the healing this technique demands.
At your consultation we design the exact resection pattern and assess what to combine with it (liposuction, muscle repair). The rest of the protocol: no smoking — non-negotiable in large-flap surgery — medication reviewed, and a full pre-operative workup at Quirónsalud Málaga Hospital.
Aftercare
This is major body-contouring surgery: recovery is methodical, but the timescales have to be respected.
Hospital stay and monitoring; abdominal compression garment and gentle early walking, slightly bent forward to protect the closure.
Very quiet life at home, dressings as prescribed and particular attention to the junction of the T.
A light routine and non-physical work. The garment stays on; exertion waits.
Progressive exercise, cleared at your review appointment. The silhouette already shows the dramatic change.
Mature scars and the definitive result: the contour your weight loss had promised and your skin was hiding.
Scars
The Fleur-de-Lis leaves two lines: the horizontal one below the bikini line and the vertical one down the midline. The vertical scar is visible — pretending otherwise would be misleading — although with good technique and proper care it matures until it becomes discreet.
The honest question is a different one: is it worth it? For anyone living with kilos of surplus skin, patients answer with a resounding yes: it changes their clothes, their exercise, their hygiene and what they see in the mirror. The scar is the price of getting your body back, and it is agreed to with eyes open.
Surgical honesty
If the excess is only horizontal, a classic tummy tuck is enough and leaves less scarring. The Fleur-de-Lis is reserved for when it is genuinely needed.
It removes skin, not kilos. It comes after weight loss, never instead of it.
Operating mid-descent is a guarantee of operating again. Contour is sculpted on a settled weight.
The vertical line exists and it shows. Being honest about that toll is part of the first consultation.
Patient information
Every operation carries risks and this one is no exception. You will go through them in detail at your consultation and in writing in the informed consent form; this is the honest summary.
Expected, not a complication
Uncommon
Smoking multiplies the risk of healing problems in this technique more than in any other: stopping beforehand is not advice, it is a requirement.
Hospital
Consultation, surgery and post-operative follow-up in a leading centre: state-of-the-art operating theatres, intensive care and a private room.
12
Operating theatres
24 h
A&E and intensive care
100 %
Private room
Price
A quote that is fixed and tailored to you is given after your assessment: it varies with the extent of the resection and what is combined with it (liposuction, muscle repair). It includes the operating theatre and your stay at Quirónsalud Málaga, anaesthesia, the compression garment, dressings and review appointments.
About special offers. You will see plenty of them, and it is worth saying plainly: first inform yourself and choose your surgeon, then ask about prices. Not the other way round.
FAQS
It depends on the direction of the excess: if the surplus skin is only horizontal, the classic technique is enough and leaves less scarring; if there is also a vertical surplus — typical after major weight loss — the Fleur-de-Lis is what allows all of it to be removed. The examination makes this clear within minutes.
Until your weight has stabilised and your bariatric team gives the go-ahead, with your nutrition in order. Operating on the contour mid-weight-loss means working on a body that is still going to change.
It exists and it is visible — saying otherwise would be dishonest. It matures over the first year until it becomes discreet, and the surgeon’s experience with tension closures makes the difference. Patients accept it in exchange for shedding kilos of skin.
The protocol is decided at your consultation, with an assessment by the anaesthetics department at Quirónsalud Málaga Hospital as part of the pre-operative workup.
Content reviewed by
Dr. César Padilla
Specialist in Plastic, Aesthetic and Reconstructive Surgery
Member of the Spanish Society of Plastic, Reconstructive and Aesthetic Surgery (SECPRE)
15+ years of practice · Quirónsalud Málaga Hospital
Last content review: August 2026
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