Tummy Tuck Stuttgart

A tummy tuck is aimed at women and men who are looking for a permanent solution to excess skin, sagging and loss of contour in the abdominal area. In my many years of experience, the most common reasons for an operation are:

• Sagging abdominal skin after pregnancy and breastfeeding: Depending on the course of the pregnancy, the size of the baby and the elasticity of the skin, irreversible skin damage in the form of stretch marks and a permanent loss of contour in the waist area are not uncommon.
• Weakness of the abdominal wall and diastasis recti: After pregnancy, the straight abdominal muscles can separate (diastasis recti), which leads to a bulging lower abdomen. There is also often a hernia of the navel (umbilical hernia), which, thanks to my additional expertise in abdominal and visceral surgery, can be treated in the same operation.
• Excess skin after massive weight loss: Common causes are extensive diets or bariatric surgery, such as a gastric band, sleeve gastrectomy or gastric bypass. After significant reduction of the stomach and rapid weight loss, the abdominal skin often does not retract adequately, resulting in pronounced excess skin that can lead to eczema in the lower abdominal fold, chafing in everyday life and psychological strain.
• Age-related loss of elasticity: As we age, the skin loses its firmness. A tummy tuck can help you feel comfortable in your body again.
• The desire for a harmonious body image: A flat stomach contributes significantly to a positive body image and quality of life.

I know from my practice that, for many patients, the burden of excess skin goes far beyond the purely aesthetic. It can promote skin rashes, considerably limit sporting activities and often leads to psychosocial strain, which can go as far as avoiding swimming pools and saunas or problems in relationships. This is exactly where a tummy tuck can do more than just optimize contours. It makes possible a new body confidence that many of my patients describe as a profound turning point.

A tummy tuck is a demanding procedure that requires far more than just mastering the surgical technique. You as a person and individual are the focus for me, from the first consultation to the last follow-up examination. I place particular emphasis on an honest consultation on an equal footing, in which I put your wishes into realistic perspective and show you what can be achieved surgically without raising false expectations.

Compared to large clinics, I offer you personal care by a single specialist who operates on you himself and accompanies you for over a year after your operation. This means short distances, clear responsibilities and one contact person who knows your progress from the very beginning. I continuously develop the surgical techniques on the abdominal wall further, because I am convinced that natural and stable long-term results can only be achieved through constant refinement of the methods.

About an hour for your individual situation
In my view, a good consultation is the foundation of every successful tummy tuck. In a personal conversation, I first get a comprehensive picture of your motives, your expectations and your medical history. This is followed by a careful physical examination, in which I palpate your abdominal wall and check specifically whether there is diastasis recti, an umbilical hernia or other structural changes that should be treated as part of the operation.

On the basis of this examination, I work out the right surgical concept together with you. We clarify whether a mini tummy tuck, a full abdominoplasty or, for very large amounts of excess skin, the fleur-de-lis variant makes sense for you. We also discuss at this point whether simultaneous liposuction to contour the waist or define the abdominal midline is an option. You will receive an honest cost estimate, clear information about the course of the operation and aftercare, and plenty of room for all your questions. Should I advise against an operation from a medical point of view, I will tell you so openly and, where possible, show you alternative options.

The incision pattern is one of the key decisions before every tummy tuck, as it largely determines where your scar will later run and how much tissue can be removed. In my practice, three different incision patterns are used, which I choose individually depending on the excess skin, the initial findings and the desired result. With all three variants, I place the incision so low on the lower abdomen that the later scar remains hidden under bikini bottoms, underwear or swimming trunks.

In the classic incision pattern, a slightly curved incision is made just above the pubic hairline, which blends harmoniously into the natural body line. This variant is the proven starting point for most tummy tucks, because it allows careful correction of skin and connective tissue while leaving the least conspicuous scar. It is used for both the mini tummy tuck and the full tummy tuck.

If larger amounts of tissue need to be removed, especially if the excess skin extends well above the navel, the anchor incision is used. Here, a short vertical scar towards the navel complements the horizontal incision along the bikini line. Even though this additional scar means a little more visibility, it gives us considerably more scope for harmonious contouring and a coherent overall result. The anchor incision is often the right choice when, after a pregnancy or moderate weight loss, there is excess skin that could not be fully addressed with the classic curved incision.

In cases of pronounced sagging of the abdominal wall, I offer you the W-incision. As the name suggests, the incision runs in a W-shaped line just above the groin creases and the pubic bone. This incision pattern creates the conditions for particularly extensive and even tightening and is used wherever a simple curved incision reaches its limits. In practice, the W-incision is an important option for patients with particularly overstretched or sagging skin.

While the incision pattern describes how the skin incision is made, the extent concerns how much of the abdominal wall is actually tightened. Which variant is right for you depends on the excess skin, the condition of the abdominal muscles and the navel. We make the decision together in the consultation after a careful examination.

The mini tummy tuck is used when there is only a small amount of excess skin on the lower abdomen that reaches no higher than the navel, and the muscles of the abdominal wall are still sufficiently intact. In contrast to the full tummy tuck, the skin is only lifted to just above the navel and then tightened downwards. The navel itself remains in its original position, but gains a beautiful, slightly vertically oval shape thanks to the vertical tightening effect. The later scar is only about half as long as after a full tummy tuck and resembles a cesarean section scar. This variant is particularly suitable for slim women and men with loose skin limited to the lower abdomen.

The full tummy tuck is the method of choice when the excess skin or abdominal apron extends above the level of the navel or there is significant weakness of the abdominal wall. In this variant, the skin is lifted from the pubic bone to the costal arch, the navel is freed from the surrounding skin with a circular incision and, after tightening, moved to its new, anatomically appropriate position in the “new abdomen”. If necessary, I also tighten the inner abdominal wall with a so-called rectus plication, i.e. by suturing the separated abdominal muscles together. An accompanying umbilical hernia can also be closed at this point. The result is a flat, defined stomach with a scar that runs discreetly along the bikini line.

The fleur-de-lis variant, also known as T-incision abdominoplasty, is the most extensive form of tummy tuck and is used mainly after massive weight loss or bariatric surgery. Here, the normal incision along the bikini line is not sufficient to remove the excess skin completely. An additional vertical incision is therefore made from the pubic bone towards the breastbone, resulting in a T-shaped scar overall. The advantage of this method is the possibility of clearly emphasizing the waist and harmoniously removing even very pronounced excess skin. The resulting scarring is more visible than with the other methods, but in return patients gain a considerably better contour result that could not be achieved with a bikini-line method alone.

In many cases, a tummy tuck alone is not enough to achieve the desired contour. If, in addition to loose skin, there are also localized fat pads, for example on the flanks, waist or upper abdomen, I combine the tummy tuck with targeted liposuction. The choice of the exact technique depends on whether the main aim is to optimize the contour or to achieve a finely sculpted definition of the abdominal region.

In lipoabdominoplasty, I combine the classic tummy tuck with gentle liposuction. The fatty tissue directly beneath the abdominal skin is suctioned off, while the deeper fat layer remains untouched. This selective approach protects the blood vessels of the abdominal wall and ensures a good blood supply to the tissue after the tightening. Lipoabdominoplasty is the method of choice when, in addition to the excess skin, distinct fat pads on the flanks, upper abdomen or waist are bothersome. The result is a more harmonious overall contour, a more pronounced waistline and an overall slimmer appearance.

For particularly athletic patients, or if a finely defined abdominal contour is desired, I offer high-definition liposuction. Here, the fatty tissue is suctioned off very superficially and sculpted in a targeted way so that the natural muscle relief of the abdominal wall becomes visible. In women, the abdominal midline, the so-called linea alba, can be brought out as a fine “champagne groove” in this way. In men, a subtle six-pack relief can be shaped. High-definition liposuction is a technically demanding form of body contouring and requires a high degree of surgical experience and a good aesthetic eye.

Careful preparation is the basis for a good surgical result and an uncomplicated healing process. The following points are particularly important before a tummy tuck:

• Stable body weight and BMI below 30: If possible, you should have reached a normal body weight and maintained it for a few months. A body mass index below 30 should be the goal, in order to reduce surgical risks and ensure a stable long-term result.
• Completed family planning: A pregnancy can change the result of a tummy tuck later on. I therefore recommend having the operation only after family planning is complete. After a pregnancy, at least six to twelve months of postnatal recovery should also have passed.
• Ruling out hernias by ultrasound: Existing hernias of the abdominal wall, such as umbilical or inguinal hernias, should be confirmed by ultrasound before the operation. You can easily arrange this examination with your family doctor or a radiologist.
• No nicotine from at least four weeks before to four weeks after the operation: Nicotine has a considerable negative effect on wound healing. Avoiding it reduces the risk of wound healing disorders and protects the result of the operation.
• Current blood values two to three weeks before the operation: You can usually request these from your family doctor without any problems. You will receive all the necessary documents from my practice in good time.
• Well-controlled pre-existing conditions: High blood pressure or elevated blood sugar levels, for example in diabetes mellitus, must be demonstrably well controlled before the operation. Acute inflammation or infections of the abdominal skin must have healed completely by the date of surgery.

I also recommend that you make sure you get enough rest in the days before the operation, take care of important errands beforehand and organize support from family or friends for the first few days after the procedure.

On the day of surgery, depending on the planned type of anesthesia, you arrive on an empty stomach at the agreed time at the private clinic where I operate on you. There you are welcomed and prepared by the specialist staff. I go through the course of the operation with you once more at leisure, answer any last questions and draw the individual incision lines on your abdominal wall. After photo documentation, you are taken to the operating room and positioned.

Depending on the planned concept, the anesthesiologist now puts you under general anesthesia or local anesthesia is induced in combination with twilight sedation. In the operation that follows, I remove the excess skin and, if necessary, fatty tissue step by step. Depending on the findings, I perform additional surgical steps, such as internal tightening of the abdominal wall by rectus plication, closure of an umbilical hernia or reshaping of the navel. The simultaneous repair of an umbilical hernia in particular is possible in the same operation thanks to my additional expertise in general abdominal and visceral surgery, which many of my patients appreciate as a great advantage.

At the end of the operation, I suture all wounds particularly finely in several layers, insert drains if necessary and cover the abdominal wall with a sterile dressing. As a rule, you will already receive a compression belt or the compression garment in the operating room, which will accompany you over the coming weeks. After waking up, you first go to the recovery room, where you are closely monitored, and then, as agreed, to the ward, or you can be discharged home with an escort once you have recovered sufficiently.

The phase after the operation is at least as important for a good final result as the procedure itself, which is why I accompany you closely for at least one year. In the first few days, rest, calm movements and a slightly bent-forward posture are necessary to relieve the freshly operated abdominal wall. A certain feeling of tightness is normal in this phase and subsides step by step as you become more mobile. A balanced mix of gentle, short walks and rest periods with the hips and knees relaxed and bent has proven very effective.

For at least six weeks, you consistently wear the compression garment, which counteracts swelling and supports the stabilization of the abdominal wall. Adhesive strips covering the wound remain on the abdomen for about two weeks; the stitches at the navel are removed after around ten days. Once the wounds have healed without irritation, the phase of consistent scar care and scar massage begins, which you should continue for about nine to twelve months. I also recommend consistent UV protection of the scar for at least twelve months, because fresh scars can become permanently darker when exposed to sunlight. Lymphatic drainage and tissue massage can be a useful addition depending on the course of healing.

With office work, you can usually return to work after about two weeks; for physically demanding work, a longer break is recommended. Most of my patients are able to go out in public again after ten to fourteen days. You should avoid sports for four to six weeks, after which you start with moderate activities such as walking or light cycling and only increase the strain after consulting me. Ideally, you should only resume sauna, full baths and intensive abdominal exercises after about two months. A representative result of your tummy tuck is usually visible after six weeks, but the final result only shows after six to twelve months due to residual swelling and scar maturation. Especially if liposuction was performed at the same time, the final contouring takes a little longer.

Like any surgical procedure, a tummy tuck involves certain risks, side effects and possible complications, which I will explain to you openly and fully before the operation.

• Swelling and hematomas: Visible swelling and minor bruising are normal in the first few weeks and usually subside within a few weeks.
• Seroma formation: Wound fluid can accumulate under the skin, which in rare cases has to be drained with a needle. Drains and consistent compression help prevent this.
• Wound healing disorders: Because the skin is lifted, the blood supply to the wound edges is temporarily reduced, which can occasionally lead to delayed wound healing. Consistently avoiding nicotine reduces this risk considerably.
• Sensory disturbances: Temporary or, rarely, permanent numbness above the scar is possible, which in most cases subsides within months.
• Conspicuous scarring: Hypertrophic scars or keloids occasionally occur, especially in people with a corresponding predisposition. Consistent scar care over several months helps prevent this.
• Thromboembolic complications: As with any major operation, there is an increased risk of thrombosis, which I specifically counteract with preventive medication, compression stockings and early mobilization.
• Asymmetries and contour irregularities: Minor asymmetries are possible and can be corrected with small corrective procedures if necessary.
• Tearing of the muscle suture due to early strain: If rectus plication was performed during the operation, physical strain too early can cause the muscle suture to tear. Therefore, follow my recommendations on the recovery period consistently.
• Infections: As with any procedure, infections are possible in principle, but very rare thanks to the highest hygiene standards in the private clinics I use.
• Anesthesia risks: General anesthesia risks are discussed in detail in a separate consultation with the anesthesiologist.

The costs of a tummy tuck in my practice depend on the extent of the operation and the surgical method chosen. The following guide values apply for orientation:

• Mini tummy tuck: from around €4,500
• Full tummy tuck with navel repositioning and, if necessary, rectus plication: from around €8,000
• Fleur-de-lis tummy tuck (T-incision abdominoplasty): correspondingly higher, as is the case with simultaneous liposuction or high-definition liposuction

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