A standard abdominoplasty leaves a scar running across your lower tummy in a similar location to a Caesarean section scar, although it is usually significantly longer. This allows your surgeon to remove skin in an up-down direction, resulting in tightening in that direction only.
Usually this is sufficient for most patients, but in some cases it there is also skin looseness in a side-to-side direction too. This is more often the case if you have experienced a significant amount of weight loss or multiple previous patients. If that is the case then it may be necessary to remove skin in a side-to-side direction, requiring an additional midline scar. This is called a "fleur-de-lys abdominoplasty" because the pattern of skin removal looks, with the eye of faith, a bit like the flower it is named after.
If you would benefit from a fleur-de-lys abdominoplasty this will be discussed with you in advance. It is worth very careful consideration. The usual low abdominal scar can be hidden by underwear or swimwear, and there are tricks to hide your belly button scar as much as possible too, but there is really no disguising a midline abdominal scar in usual underwear or a bikini (see before and after photographs below).
As always, please talk through your choice with your surgeon and make sure you are happy with the plan well before the day of surgery!