Tummy tuck (Abdominoplasty)

With a tummy tuck superfluous skin and fat at the belly can be enduringly removed. If necessary it is possible to combine this surgery with a small liposuction at the hips. Please discuss this with your doctor. The scars can usually easily be hidden under the underwear or a bath suite.

Basic preconditions:
	You are over 18 years old, in good physical and psychological condition and have a realistic idea.
	You are not pregnant and not nursing your baby.

Preparations:
	About 4 weeks before the surgery, you should reduce smoking. Moreover alcohol should be avoided.
	On the day of the surgery you should not have your menstruation.
	About 2 weeks before the surgery you should not take anticoagulants (Aspirin, acetylsalicylic acid containing drugs).
	Not later than 3 weeks before the surgery the birth control pill must be discontinued.

Surgery preparations and examinations:
	For the surgery you need a blood count and an ECG. Your GP can provide both. Please bring the findings with you (it should not be older than two weeks).
	If you are over 40 you need a complete blood count and an ECG for the correction of bone structure

Length of the surgery:

Usually the surgery takes about 2-3 hours and is conducted during a stationary stay in hospital of 2-3 days.

Course of action:

Before the surgery you will be informed during a detailed counselling talk on how the surgery is done, possible complications, risks, and alternatives. Maybe you want to write done your questions on the surgery. The surgery will be conducted under general anaesthesia. Before the anaesthesia you will be advised by an anaesthetist about the risks, complications and possible alternatives to a narcosis. The anaesthetist will be present during the surgery. A general anaesthesia means stress for the body. During narcoses risks or complications can occur, depending on previous diseases and your general state of health.

Before the surgery the affected areas are marked on the skin. For a tummy tuck the incision is placed just above the pubic hair. The incision runs from one pelvic bone to the other. The belly button is separated from the surrounding tissue. In order to lift abdominal muscles and fix them to the new position, the skin of a quite large region (from the abdominal wall to the rips) is lifted. Usually the waste can be made slimmer and formed. Then the lifted skin is tugged downwards so that superfluous skin can be removed. A new opening for the belly button is created and fixed.

With the lifting of the abdominal wall (partial lift) the incision is usually much smaller and separating the belly button from the surrounding tissue may be avoided. During the surgery thin drainages are inserted so that blood and ichor can drain off. After about 2-3 days the drainages are removed, depending of the scale of the surgery. The wound is closed by a wafer-thin suture. Right after the surgery you get compression clothing which you have to wear for 4-6 weeks day and night. The wound healing and the lifting effect can be improved by wearing the compression clothing.

Perception and possible complications:

CLike after every other surgery, there are risks of possible infections, anaesthtic scars, enduring feelings of tautness, pain, and haematoma. A circulatory disorder as a result of nicotine can lead to a wound necrosis. Pain or a dragging felling in the affected area, usually subside after several days. The pain after the surgery can be alleviated by pain killers.

Like after every surgery secondary haemorrhages cannot be excluded. Therefore you should avoid taking acetylsalicylic acid (Aspirin) and other acetylsalicylic acid containing drugs two weeks before the surgery. Despite aseptic measures inflammations can occur. Preventively you get antibiotics.

After a surgery there can occur blood clots in the main veins (thrombosis), these can be carried further and thus block a blood vessel (embolism). As prevention it can be considered to take anticoagulant drugs (i. e. injections of heparin), however these cause an increased bleeding tendency and in very rare cases grave dysfunctions of blood coagulation.

Moreover, in order to prevent thromboses and embolisms you should move your legs and feet regularly. Theoretically possible complications are a necrosis of the belly button and disorders in wound healing which could lead to conspicuous, broad scars. Even when the wound healing is normal, scars can initially become red or harden. After a while they will fade, they become inconspicuous. You will be informed on further risks and possible side-effects in a comprehensive handout.

After the surgery:

One day after the surgery you will have a follow-up examination. Please only take those drugs that you get from the doctor in hospital or another doctor. To make it easier for you, you should have an accompanying person with you, as you should not drive yourself when travelling home. Make sure that you take enough breaks.

The stitches can usually be taken out after 10-14 days by your GP. Swellings, haematoma, and possible feelings of numbness subside after a short period of time. For your well-being you should allow yourself a period of recovery of two weeks after the surgery. Please avoid bending or tearing (i. e. when lying down or getting up) of the suture. You should also avoid physical stress and sports for about 2 months.

You should avoid sun, solarium, and sauna for 8-10 weeks. Usually you can take showers again after the wounds are completely closed. After about 3 weeks you can apply scar ointments or crèmes on the scars. You can support the connective tissue of the abdominal wall by regularly applying lotion, taking hot and cold showers, and peeling. Thus the elasticity of the skin can be preserved.


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