Tummy Tuck Information -2022

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Tummy Tuck Information -2022

A firm stomach and a slim waist – this is how many people wish for their ideal appearance. However, sport and healthy eating do not always help to achieve the figure you want. After extreme weight loss or pregnancy, the body often does not recede from the greatly expanded abdominal wall. The reason for this is slack or torn connective tissue structures in the subcutaneous tissue, which have previously given the abdominal skin support and firmness. The consequences are wrinkled, hanging flaps of skin (“fat aprons”) and visible overstretching of the subcutaneous tissue.

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Tummy Tuck

A slackening of the abdominal muscles can also be the result of long-term obesity or pregnancy. In particular, a drifting apart of the vertical straight abdominal muscles (rectus diastasis) leads to a wider waist. Even intensive training cannot reverse this relaxation.

A tummy tuck can help improve the abdominal region. Slack tissue is tightened downwards and excess skin flaps are removed. The navel is moved accordingly. A joining of the straight abdominal muscles is also possible.

A tummy tuck is not a way to lose excess weight. It is often performed in addition to liposuction. The best results are achieved in lean, healthy patients whose sagging abdominal tissue is unresponsive to exercise and diet. During the operation, a long horizontal scar is created over the genital area, which will fade over time but not become completely invisible. The doctor will discuss the placement of the scar with you. A small scar also remains on the navel. Sometimes an additional vertical scar is required. The abdominal wall is flatter and more even after the procedure.

The conversation with the specialist

A prerequisite for a successful procedure is a detailed discussion about the details of the operation and possible complications. Take the opportunity to clarify all important questions. Write down what you want to know. If necessary, take an accompanying person with you. If you still have questions after the interview, make another appointment or call your doctor. There should be enough time to think about it between the preliminary talk and the operation.

Before the operation, the plastic surgeon will discuss a consent form with you. This contains your personal data, an explanation of the type of treatment and the possible complications discussed. With your signature you agree to the procedure and assure that you have been informed about the risks.

If complications arise or you are dissatisfied with the result of the procedure, follow-up operations may be necessary. In the case of “medically not indicated aesthetic operations” , the statutory health insurance is obliged to make you a reasonable share of the costs of the subsequent operations in the event of fateful complications for which the doctor is not to blame. Before the first intervention, you can insure yourself against the risk of these follow-up costs. Ask your plastic surgeon about this option.

Before the tummy tuck

You should not take any painkillers containing acetylsalicylic acid (e.g. aspirin) 14 days before the operation. The blood-thinning effect delays blood clotting and can cause secondary bleeding. You should also avoid medication containing hormones such as estrogen preparations or birth control pills. Reduce consumption of nicotine and alcohol to a minimum before the procedure. If possible, quit smoking three to four weeks before the operation.

If you take medication regularly or suffer from allergies (e.g. to medication, disinfectants or plasters), be sure to tell your doctor. Be sure to tell him about any known illnesses. If you are prone to bruising or persistent bleeding after minor injuries, the plastic surgeon should rule out a coagulation disorder before the operation.

For the time after the procedure, you should plan at least seven to ten days off when you will not be able to work. In individual cases, together with your doctor, you can decide which activities you can trust again.

The procedure is usually performed on an inpatient basis in a hospital, since the patient needs medical care after the procedure. General anesthesia is usually used, which is monitored by an anesthesiologist during the operation. It is best to discuss with your plastic surgeon which preliminary examinations are necessary and when they are to be carried out. You will also have the opportunity to discuss the anesthesia with the anesthesiologist.

For smaller operations on the abdominal wall, the operation can also be performed with local anesthesia. Sedatives put you in a semi-sleep, so all you feel is a slight tug or squeeze.

The operation

Depending on the extent of the sagging skin, the surgical method can vary greatly. The ideal technique depends to a large extent on your physical requirements and individual ideas. Basically, with every tummy tuck, a long horizontal or differently curved incision is made over the pubic area, possibly also an anchor-shaped incision. The navel is separated from the skin tissue with a round incision. In order to be able to tighten the abdominal skin, the skin tissue is detached from the abdominal wall between the abdominal incision and the ribs. Depending on the need, the plastic surgeon tightens the straight abdominal muscles by rejoining and fixing them. This should make the abdominal wall firmer and the waist narrower.

The plastic surgeon then pulls the detached skin tissue down. Excess skin is removed and the skin flap is sewn on. To reposition the navel, a new approach is cut into the skin and the navel is sewn back in place.

If only the skin between the navel and the abdominal incision is detached and tightened, this is referred to as a “partial tummy tuck”. The incision required is usually smaller, and surgical relocation of the navel is often not necessary. However, by tightening the skin downwards, it also changes its position.

At the end of the procedure, drains are usually placed to facilitate the drainage of wound secretions and blood. Depending on the extent, the operation lasts between 1.5 and 3 hours.

After the tummy tuck

While still on the operating table, a bandage, custom-made compression garments or an abdominal bandage are pulled over the affected areas. These are intended to prevent the resulting cavities from filling with tissue fluid, blood or dissolved fat and causing lumps or scars. The bandage and drain will be removed a few days after the procedure. You must wear the compression underwear day and night for four to six weeks, otherwise the outcome of the operation could be significantly affected.

Slight pain and bruising can be expected immediately after the procedure. Both usually regress within days to several weeks. As with any operation, swelling of the affected areas is also completely normal with a tummy tuck. However, these go away completely within three months.

If stitches are not used with self-dissolving threads, the threads can be removed 10 to 21 days after the procedure. The scars are initially very red and swollen, but over time they adapt to their skin environment.

Depending on the predisposition, a short-term incapacity to work can occur, especially in the case of major interventions. In order to prevent swelling and thrombosis, exercise is fundamentally beneficial – but you should avoid sport for six to eight weeks. Massages and other excessive stress should also be avoided. With cold showers you can stimulate the blood circulation and support the healing process. Full baths should be avoided for a few weeks if possible. It is possible that you will receive additional anti-thrombosis injections until you are fully mobile.

In principle, another tummy tuck is possible. Before you plan another operation, you should wait until the first operation has completely healed. This can take up to a year.

What complications can arise?

Every operation carries risks. However, the risks of a tummy tuck can be minimized if the operation is performed by a qualified plastic surgeon with sufficient experience. Despite the greatest care, however, as with any surgical procedure, isolated complications can occur during or after the operation.

There is a general risk of bruising and bleeding. Infections can lead to wound healing disorders. Blood clots can block blood vessels (thrombosis) or get into the lungs (pulmonary embolism). Allergies and intolerances can occur when medication or narcotics are administered. If blood transfusions are necessary, an infection cannot be ruled out despite all precautionary measures. After the operation, numbness can occur due to pinched nerves or other positioning damage, but this usually subsides.

A typical consequence of tummy tucks is the occurrence of wound water (seroma) of varying degrees due to the relatively large inner wound surface. Wound drains are sometimes left in place longer to prevent fluid from remaining in the wound. Swelling and bruising usually heal on their own. Rarely, secondary bleeding can occur, which requires another surgical intervention. If the wound becomes infected, the use of antibiotics usually helps. Repeat surgery is rarely required.

Tips for choosing a doctor

You should take enough time to choose the right doctor. Be clear about what bothers you about your appearance and what you expect from the surgery. Ask your family doctor which specialist in plastic surgery he recommends.

A prerequisite for a satisfactory surgical result is the choice of a suitably trained specialist. We strongly advise you to choose a specialist in plastic and aesthetic surgery who has many years of further training. Together with you, he will select the appropriate surgical method in advance and clarify the possibilities, limits and alternatives of the planned intervention.

The plastic surgeon is a recognized specialist who, after completing his medical studies, completed six years of further training. During this time he has to carry out numerous operations under supervision. After this practical experience and theoretical further training, the doctor must take the specialist examination at the respective state medical association. Only then does he officially receive the title “Specialist in Plastic and Aesthetic Surgery” (currently the expiring title “Specialist in Plastic Surgery” is also used, the training of which was comparable) and thus for you, the patient, clear proof of a comprehensive qualification.

Only the title “Specialist in Plastic and Aesthetic Surgery” (or “Specialist in Plastic Surgery”) is protected. Other designations such as “cosmetic surgeon”, “cosmetic surgeon” or “aesthetic surgeon” are not protected titles and can be used by any doctor without proven further training. They say nothing about their training or further education.