Age-old question: Anchor Cut or Not?

Thanks in advance for your help, guys. I have spent the last couple of weeks digging through this forum's posts--good info.

I'm just starting the plastics journey and feeling overwhelmed. In fact, I seem unable to make a decision, which is unusual for me. I'd like your opinion and experience here, guys.

Basically, here are my questions, the narrative that follows gives you some facts if you need background:

1) What do you guys think about the fleur de lis/anchor cut TT?
2) Have you had it and did you have incision issues as described below by Doc 1?
3) Would you get a fleur de lis AND a brachio at the same time?
4) If you had just a regular TT (without anchor cut) are you pleased with your results or do you wish you had the anchor cut instead? How's the scar? Do you have some "minimal loose skin" issues as Doc 1 describes or is it just fine?

If you can think of anything else I'm too naive to ask yet, let me know! Thanks in advance.
---------------------------
My story:

After losing 190 pounds, my abdomen is a bit of a mess and my arms could use some help. I think I can only handle, physically and financially, one round of plastics, so this is probably my only shot. I had a lap DS, so I do not have a large scar on my abdomen right now.

I had two consults and each doc says they don't need to do a full LBL on me. Both think they can get a good result without having to risk an incision issue on the butt area. Here is what they say they want to do for me:

Doc 1:   extended TT, past hip to past other hip with some lipo on my abdomen. This doc says he WILL do a brachioplasty at the same time. When asked about the fleur de lis, here is what he said:

First of all, I have performed fleur de lis abdominoplasties and you are
right that in major weight loss patients there may be some residual loose
skin in this central portion of the abdomen.  In my experience, most have
preferred the extended abdominoplasty with some minimal loose skin than
having a very visible vertical incision that cannot be hidden.  The fleur
de lis abdominoplasty has a higher risk of skin breakdown at the inverted
T portion of the incision.  If you are not adverse to having a visible
vertical scar as opposed to having the horizontal scar than it can
definitely result in more skin excision in that central abdomen.  I use it
more in those patients who already have vertical incisions. 

Doc 2: extended TT, past hip to past other hip with fleur-de-lis, NO brachio at the same time. He says that is brutal recovery to do both at the same time. This doc is already talking about THREE stages of plastics for me, which is not going to happen, so I'd have to settle for just the fleur-de-lis TT.

I think I'm going with Doc 1, based on the info given, the feeling I got with him, the results I have seen. PLUS, I feel like he is trying to help me get to a normal woman's 40-year old body NOT a Barbie doll, like I think Doc 2 might be trying to do with all of his staged procedures (LOL). I just need some advice on the anchor cut business.

Thanks a million for your feedback!

Nicolle

It all depends on your skin and where you carried the majority of your weight.  Some have had just a TT and are thrilled, other have had the TT w/anchor cut and are thrilled, and then there are those who have had a TT and did develop some loose skin above the BB and wish they had done the anchor cut and those that have the loose skin but would rather have that than the scar. That said, it depends on what you are comfortable with.  I had the LBL with the anchor cut and had absolutely no problems with the inverted T incision.  My dr did warn me that there was a possiblity of necrosis or wound opening there.  I had an open DS so I already had vertical scar so that didn't bother me.  Even if I didn't have it I would have opted for it to get the best results for me.  Our skin is so different from non-WLS patients and it has a tendency to stretch over time which is another reason why I went for it.  I had my LBL 8 months ago and I just had my anchor incision tightened up more because there was a tiny bit of loose skin so it was revised for free.  I had almost 10 pounds of skin removed and carried it all over my belly, not jut below my BB.   Had I had only about 3 or 4 pounds and carried it low then I may not have considered the anchor cut. 

It's tough doing the arms with any other procedure.  I just did my arms with my thighs, lipo, plus scar revision.  It can be done but if it's either that or not doing the arms at all, then you might consider it.  I couldn't tell you if it would be harder doing it with the TT or thighs.  I'm two weeks out and so glad the pain is over with.  Not fun.

I know it's a tough decision to make but no matter what you decide, you are going to love the results!

Good luck,
Melissa

You're going to get differing opinions on this based on whose surgeon is comfortable doing several procedures at once as opposed to those that take a more cautious approach. My surgeon will combine a couple procedures at once and that's how I've done it so far. I had the extended fleur-de-lis in conjunction with my breast lift and augmentation. I'm pretty sure he would have combined it with a brachioplasty if I had not wanted the breast work. Second phase, I did inner thighs and brachioplasty. He made sure to explain to me that arms and anything lower was a tougher recovery, but they also realize that for most of us our funds are limited so they will combine procedures to help with the cost. It's not fun but it's doable.

I opted for the fleur-de-lis for 3 reasons. 1. My DS was open so I already had a vertical scar.
2. I'm going to be 48 next month and walking around in a bikini is not my thing. (I'm realistic)
3. I had a lot of skin above my belly button and on my sides. With a snug fitting pair of jeans on I most definitely had the muffin top and I wanted it gone. I'm flat and hard pulled in at the waist. I like having the curves it provided and with a shirt tucked in there is no muffin top to be seen.

I had the extended TT and will return for a revision to Anchor Cut TT when I reach goal.  I have a lot of excess skin upper tummy and need this done.  I think you have to really look at your body when you're sitting down and if you have skin that hangs over your waist, then you probably need the Anchor Cut TT.  Just my opinion.

 Nicolle, as you know I've had an anchor cut TT 10 years ago.  At the time, I went to quite a few PS here in town and no one else was either doing them or suggesting them.  It may have been a new concept in 1999.  I can tell you now, that the recovery is no picnic, especially if they do the muscle repair.  I had quite a bit of separation due to my pregnancies and that was a *****  

I finally decided to go with it because of the logic that it presented.  First, my tummy was a road map of stretch marks, and no bikini was ever seeing this body, so the vertical scar wasn't a problem.  Second, I had minimal waist definition, and the vertical incision allowed the doc to create one by tightening the skin from side to side.  It also helped some of the back rolls since that's the direction of the pull.  After surgery, he told me he removed a swath of 6 inches from the vertical, and everything from my old belly button down.  That's alot of territory.  The end result (before i regained weight) was pretty spectacular.  I went from wearing a 14 to a size 10, even with the swelling.  And honestly, even now (after I had regained 100 pounds) but am now close to the weight (20 pounds away) from where I was when i had it, I can see the same effect and I'm pretty amazed.  I'll show you my before pics next time I see you, then I'll flash you in the bathroom for an "after" shot.. lol.  If you only want one round of PS, I would definitely go with the anchor cut.  I had no healing issues at the inverted T portion.  And I smoke, so I was at higher risk for not healing properly.  The scar is still pretty visible, but hey, who gives a crap.. lol

Hope this helps a little.

I had an LBL with no anchor on the tummy first time around. None of the docs I consulted with ever suggested the anchor. Now I'm going in for my thighs and breasts and will get the vertical incision. When I sit down or try to wear any pants besides my old faithful yogas I have pooches and pools of fat. It drives me crazy. I never thought I would care, but unfortunately, I do.

My first round I had an LBL and arms. I didn't really have any difficulties recovering with the arms (Although the doc did not take enough skin off so I'm hoping for a revision on them).
My mom had an anchor TT with arms (she's in her 60's) the recovery was rough, she did have the issues with skin breakdown at the T intersection, but it can be done.

Best of luck on your decision.

Robin

I had the anchor cut -- but I already had a vertical incision and I was having a hernia repair.  However, I cannot imagine not having the upper abdomen work done.  But you are a lot younger than I so the scar may make a difference to you.  I knew my middie tops and bikini days were long behind me so the scar wasn't not an issue.  But I did have an issue where the two incisions meet and now my scars are very faint but I have a spot where they meet that is still pretty pink.  I am hoping in time it fades but if not I can get it revised.

red

I had 7 surgeons look at me..........6 were going to do to "regular" TT....the last guy I saw suggested the Anchor Cut....I was shocked but he explained why and once I saw the pictures it all made sense to me.  I went for the Anchor Cut because I had a lot of loose skin above the BB and on my sides.  If I had not done the Anchor Cut I would have been able to "pinch an inch or about 3 inches!".

1) What do you guys think about the fleur de lis/anchor cut TT?   Depending on the body type it's great.
2) Have you had it and did you have incision issues as described below by Doc 1?  I did not have any skin breakdown or heaing issues.
3) Would you get a fleur de lis AND a brachio at the same time?  I did not do my arms at the same time.  All surgeons I met with recommended I not do them together because you need your arms to get you up and down since you CANNOT use your stomach muscles at all
4) If you had just a regular TT (without anchor cut) are you pleased with your results or do you wish you had the anchor cut instead? How's the scar? Do you have some "minimal loose skin" issues as Doc 1 describes or is it just fine?

If you can think of anything else I'm too naive to ask yet, let me know! Thanks in advance.  FYI - there is a lot of good into on www.realself.com   too.

Best wishes on your decision