Your tummy tuck in Sindelfingen

Patients benefit most from this operation when they are primarily bothered by excess skin on the abdomen rather than a voluminous abdomen. The following principle applies: the less fat there is, the better the tightening. It is therefore understandable that in the case of obesity, a tummy tuck is usually not a treatment option, and exercise and changes in eating habits should rather be encouraged. In selected cases, liposuction can be a sensible treatment alternative or complement.

Further indications for a tummy tuck include remaining changes after pregnancy, where, as part of the so-called abdominoplasty, internal tightening of the abdominal wall is also advisable in addition to removing excess skin, especially if the straight abdominal muscles have not closed adequately despite postnatal exercises (diastasis recti). This can be corrected by so-called rectus plication and can additionally contribute to a narrower waist.

Depending on the extent of laxity and the tissue condition (lower abdomen, upper abdomen, navel region, flanks, etc.), different surgical techniques are used regardless of the underlying problem (e.g. mini tummy tuck, classic tummy tuck with navel repositioning, so-called T-incision tummy tuck).

If there is significant excess skin or a remaining apron of fat that extends above the level of the navel and into the flanks, a classic tummy tuck is required in most cases. Here, not only the excess tissue on the lower abdomen can be tightened, but also the navel region, by repositioning and tightening the navel stalk. This also results in a small circular wound inside the navel. Reshaping the navel (umbilicoplasty) has a very favorable effect on the overall appearance of the abdomen and is planned accordingly from an aesthetic point of view. In the same session, the inner abdominal wall is additionally tightened if necessary (rectus plication).

In the case of large amounts of excess tissue also on the upper abdomen, it is advisable in some cases to extend the procedure to a so-called T-incision abdominoplasty, in which, in addition to the low, horizontal incision, a central, vertical incision is also required in order to sufficiently tighten the upper abdominal region. Finally, additional tightening of the mons pubis may be advisable in order to achieve a harmonious transition from the lower abdomen to the intimate area. Should this make sense, I naturally integrate the mons pubis lift into the tummy tuck at no extra charge.

In a mini tummy tuck (mini abdominoplasty), on the other hand, the navel is not repositioned and the tightening concentrates exclusively on the lower abdominal region up to the level of the navel. With this technique, however, the shape of the navel itself is favorably influenced by vertical traction, so that slight excess skin in the navel region can also be elegantly corrected. The wound area and the length of the horizontal incision are correspondingly smaller. This form of tummy tuck is therefore primarily suitable for skin laxity on the lower abdomen, as is typically seen with changes after pregnancy

On the day of the operation, I will go through the procedure with you once again and, together with you, determine the exact extent of the tissue to be removed by means of planning markings. You will then be prepared for the operation by the specialist staff and the anesthesiologists. Strictly following the planning drawing, the tissue is then gradually removed during the operation and, if necessary, further surgical steps such as internal tightening of the abdominal wall, navel reshaping, etc. are carried out. At the end of the operation, two drains are usually inserted to drain any tissue fluid from the wound cavity and to support the adhesion of the previously detached tissue layers. After the wound has been sutured, a sterile wound dressing and a compression bandage are applied, which you will wear 24 hours a day for the next 6 weeks.

After the operation, you will first recover from the procedure. With the bandage in place, you will be positioned in a special way (beach chair position) so that your freshly tightened abdominal wall is not exposed to unnecessary tension. Once your circulation has recovered and you are feeling well, we will mobilize you gradually and practice with you how to get from the bed into a sitting and standing position as gently as possible and without pain. At first, you will walk quite bent over and feel considerable tightness in the abdominal wall. Please do not be afraid of pain; we will provide you with sufficient care. Our goal is freedom from pain! Your drain containers will accompany you at least through the first night. Depending on the amount of fluid, the drains can often be removed the following day or a few days later. Please do not be afraid of the drain removal either; there are bizarre myths circulating! With the right technique, removal is practically painless!

In general, it should be noted that you benefit most from a tummy tuck when you have as much excess skin and as little fatty tissue as possible. In your own interest, therefore, strive to achieve a normal body weight before the operation that you can also maintain. If you are planning a pregnancy, a tummy tuck beforehand is of course not advisable. Before the operation, instabilities in the abdominal wall such as hernias and other pathologies should be ruled out by your family doctor or a radiologist, preferably by ultrasound, so that no unnecessary risks have to be taken during the operation. Acute inflammation or infections of the abdominal skin must have healed completely and without irritation by the date of surgery. We also need current blood values from you (not older than 3 weeks) to ensure operability, which you can request from your family doctor, for example. I will discuss with you personally and/or in consultation with your family doctor which medications you can stop, pause or safely continue taking before the operation.

For optimal hygiene conditions and to reduce inflammation or wound infections, please thoroughly shave your intimate area and navel one day before the date of surgery; men may also need to shave all hair on the front of the body up to chest level.

After the operation, your body needs sufficient time to recover. After a tummy tuck, you should take at least 2 weeks off work so that a certain basic stability has been established in terms of your physical condition and the surgical wound. Arrange for sufficient support from your partner, family or friends in advance and take care of important matters before your operation.
You can usually return to administrative work such as office work after 2 weeks; physically heavy work, for example in nursing or skilled trades, must be avoided for 6 weeks. Especially in the first 2–3 weeks, the focus is on external wound healing, i.e. the surgical wound must be kept free of any tension and the dressing must be kept clean and dry. You may and should shower from the first or second day after the operation; the dressing must then be dabbed dry or left to dry in the air, and the bandage put back on. After the second to third day, a first dressing check and change if necessary are usually advisable, so that damp wound dressings can be replaced.

You are not confined to bed. Although you will not and should not cover long distances in the first few days after the operation, stimulate your circulation and thus wound healing by soon taking a few steps at home – even if still slightly bent over – and then short walks. In between, however, always allow your body breaks to recover. Avoid sitting low down for long periods or standing for long periods, and carry out all movements slowly and deliberately. Lying down and walking is the motto. You can usually resume everyday activities, with the exception of lifting heavy loads (over 5 kg), after a few days. But always listen to your body! Drink plenty of still water and eat only easily digestible food for the first days to weeks. When lying down at home, make sure the abdominal wall is relaxed by raising your legs and bending at the hips. Be sure to avoid nicotine for the first 6 weeks after surgery, as it has a significantly negative effect on wound healing and often ends in protracted wound healing problems.

After about 6 weeks, the wounds and your body have usually stabilized sufficiently, so that after a check-up and consultation you may gradually increase physical strain again and take off the compression bandage. For physical exertion, it is advisable to continue wearing it at first. Once the surgical wound has healed without irritation, the focus is now on consistent scar care and scar massage and, if necessary, lymphatic drainage and tissue massage, which you should carry out consistently, ideally for 9–12 months after the operation. Due to residual swelling and scar maturation, the final result of a tummy tuck can usually only be assessed after about 6–12 months. I support you for at least 1 year after the operation, so that you always have a contact person for all phases of healing and for any questions or uncertainties that arise.

The treatment costs depend on the surgical technique. For a mini tummy tuck, the costs are €3,500 (outpatient). For a classic tummy tuck, which also includes rectus tightening and, if necessary, a mons pubis lift, the costs are approx. €5,000 plus anesthesia and overnight costs in the private clinic. If a very time-consuming T-incision abdominoplasty is required, the costs amount to €6,000 plus anesthesia and overnight costs. Regardless of this, taking out follow-up cost insurance is highly recommended.