Abdominoplasty / Belly apron removal

After considerable weight loss or after pregnancy, the tightness of the abdominal skin may diminish, resulting in the formation of folds in the abdominal area, sometimes even in the formation of a belly apron.

A tummy tuck can restore a smooth, balanced and slender abdominal region.

What results can be achieved?

In slim patients, a firm silhouette is recreated. In plump patients, the waist circumference is reduced significantly after the surgery and a smoother overall shape is obtained in the abdominal area. The excess skin and fat disappears. However, a plump figure cannot magically be transformed into a delicate one.

Forms of anaesthesia

This operation is always performed as an inpatient procedure under general anaesthetic.

What happens during the operation?

I usually perform the tummy tuck in combination with a fat removal procedure (liposuction, aspiration lipectomy).

After the liposuction, a transverse incision is made deep in the lower abdomen and the flap of skin/fat lifted up from the fascia as far as the costal arch.

The umbilicus is separated and after the excess skin and fat has been removed, is replaced in the midline position. In some cases where there is weakness of the abdominal musculature, the two parts of the straight abdominal muscle are joined with permanent stitches. In this way, the anterior abdominal musculature is tightened. After silicone drains have been inserted (in order to drain away surplus wound fluid), the skin is closed in multiple layers using the finest suture material, with the superficial suture under the skin not being visible.

Post-operatively, an abdominal binder is applied.

How should I prepare for the operation?

Aspirin and other blood-thinning medications should not be taken for a period of 14 days prior to the surgery. It is also recommended that alcoholic drinks be avoided. Skin care using elasticity-enhancing creams for a period of around 4 weeks is beneficial.

To strengthen the abdominal musculature in advance, I recommend abdominal gymnastics, e.g. Pilates.

What happens after the operation ?

You will experience a feeling of tightness in the abdominal skin, but little or no pain. Blue discolouration of the skin in the lower abdomen and in the mons pubis area will fade after 10 to 14 days. The swelling will recede in four to six weeks.

What risks do I need to be aware of?

If there is post-operative bleeding, the area operated on will need to be reviewed and the bleeding stopped.

In some cases, haematomas or seromas (accumulation of lymph fluid) will have to be removed around 14 days after the surgery (painless). Patients will be given antithrombosis injections to counter the risk of thrombosis and embolism. Despite the preventive administration of antibiotics for around 1 week, inflammations in the wound area cannot be ruled out with absolute certainty, but these do heal spontaneously. A feeling of numbness of the abdominal skin will disappear after several months.

What follow-up treatment is required?

The drains will be removed after two to four days. The use of absorbable sutures eliminates the need for sutures to be removed. The bandage will be taken off after approx. one week, and I then recommend that an elastic compression garment be worn. Persons in employment can resume their work – depending on their job – after two to four weeks. Sporting activities can be resumed, with caution, after about 6 weeks.

 

Membership of professional associations:

International Society of Aesthetic Plastic Surgery
Deutsche Gesellschaft für Ästhetisch-Plastische Chirurgie
Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen

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