Abdominoplasty

You should be in as good a general state of health as possible, especially before a planned operation. Please keep nicotine and alcohol consumption to a minimum. If you regularly take medication, discuss this in detail with your surgeon. You may need to temporarily stop taking hormone-containing medication (the pill, hormone replacement products). In any case, you should stop taking aspirin or similar medication at least ten days before the operation. It is advisable to plan around seven to ten days off work after the operation, as your physical mobility will be restricted in the initial period after the procedure.

A tummy tuck is performed on an outpatient basis at our prevention center.

The type of anesthesia:

Tummy tucks are usually performed under general anesthesia so that you are asleep during the entire operation. You will be examined by an anesthesiologist before the operation to determine your fitness for anesthesia.

The anesthetist is present during the entire operation and controls the anesthesia. As an alternative to general anesthesia, regional analgesia with injection of local anesthetic is available. With local anaesthesia, you will also receive a sedative (either as a tablet or as an intravenous injection into the arm vein), which will put you into a kind of twilight sleep.

You will then be awake but relaxed and insensitive to pain. However, you may feel a pulling or similar sensation during the operation.

A tummy tuck usually takes between 1.5 and 3 hours, depending on the extent of the procedure. The individual extent of your tummy tuck depends on your anatomical requirements and your expectations as well as the recommendations of your surgeon. In principle, the operation proceeds as follows:

To begin with, a long incision is made just above the pubic hair, extending from one pelvic bone to the other. In addition, the navel is freed from the surrounding tissue with a small circular incision. With a partial tummy tuck, the incision is much smaller and it may even be possible to dispense with the incision around the navel. However, this can lead to distortion of the navel in the direction of the tissue tightening.

A large area of skin is then removed from the abdominal wall to the top of the ribs to expose the abdominal muscles. The straight abdominal muscles are approximated in the middle, tightened and fixed in their new position. This results in a firmer abdominal wall and a narrower waist.

The mobilized skin area is then pulled downwards. Excess skin is removed. The now covered navel is given a new small hole and sutured in place. Thin drainage tubes are used to drain blood and wound secretions during the first post-operative phase (12 to 24 hours). Finally, the incisions are closed again and a wound dressing is applied. For a partial tummy tuck, the skin is only tightened between the navel and the incision line. This area of skin is pulled downwards to remove the excess skin and then sutured back into place.

You will feel pain in the wound area in the first few days after the abdominoplasty. This will restrict your normal movements. You will usually be given pain-relieving medication.

The drains inserted during the operation are usually removed on the first day after the operation. The dressing will be removed over the next few days. You should rest as much as possible in the first few days after the operation to minimize swelling.

Any swelling, bruising and possible numbness of the skin usually disappear completely in the weeks following the operation. Immediately after the operation, the previously measured compression bandage or compression pants are applied on the operating table.

The skin sutures are removed eight to ten days after the operation. Initially, the skin scar is red and firm; after a few months, the scar becomes paler and blends in with the surrounding area. Scar care using suitable ointments and creams can be started from the third week after the operation.

Exposure of the scar to the sun should be avoided for the first 6 months (suitable clothing, plaster). Depending on the physical strain, you can resume your normal everyday activities after a few days.

Nevertheless, you should plan a period of rest in the first week after the operation. Sport is permitted again after about 6-8 weeks following consultation with your doctor. Reduce your nicotine and alcohol consumption to a minimum postoperatively and avoid going to the sauna and steam bath for a few months.

Showering is permitted after the operation with an adhesive bandage.

Most clients are very happy and satisfied with the results achieved if their expectations are realistic and the indications are correct. By optimizing their external appearance, customers finally enter a new phase of life in which they feel an increased sense of self-esteem and greater satisfaction with themselves.

In principle, the tummy tuck can be repeated if necessary. Any complications that arise can be detected and resolved at an early stage through regular check-ups with your plastic surgeon.

If problems occur, the corrective measures to be taken must be examined on a case-by-case basis

• Post-operative infection, post-operative bleeding with hematoma formation, loss of sensation in the skin.
• Reduced sensation in the scar area: usually improves within a few weeks or months, but can persist permanently (rare).
• Formation of skin folds in the area of the lateral incisions
• Swelling and discoloration due to bruising, which usually disappears on its own; cooling helps here.
• Post-operative bleeding and bruising, even several days after the operation, which usually does not require treatment and only in extremely exceptional cases does surgical hemostasis become necessary.
• Softening of the wound edges under mechanical stress, e.g. when doing hair; this can have an unfavorable effect on scar formation and in very rare cases may even make scar correction necessary.
• In extremely rare exceptional cases, unwanted side effects such as allergic reactions or material intolerance to the anesthetic (swelling, itching, but also severe circulatory reactions up to shock), side effects in the central nervous system (restlessness, cramps, breathing disorders), rise or fall in blood pressure, cardiac arrhythmia and slowing of the heartbeat may also occur as part of a local anesthetic or with the additional injection of a hemostatic drug during twilight sleep.
• Rare inflammatory reactions of the wounds, especially with submerged suture material, can prolong the duration of treatment.
• Scars: Scars cannot be avoided as a result of the operation. However, when making incisions, we make sure that they are as hidden as possible in skin folds. The natural redness of a fresh suture disappears after around two to three weeks. In rare cases, however, this can persist for several months. Small skin cysts that can develop in the scar area are simple and easy to treat.
• Impairment of scarring: Depending on the location, painful, bulging and itchy scars may occur (scar proliferation, keloid). A new surgical procedure is only necessary in rare cases, as these scar growths usually disappear under conservative treatment.
• In practice, severe scarring in the muscles and skin only occurs in cases of long-term nicotine abuse and severe bleeding without inflammation. Scarring distortions that occur after such a complication often have to be corrected by means of a repeat operation.
• This can lead to a cosmetically inadequate result, which can be corrected by another operation if necessary.
• Strain can cause the suture to tear in the area of the muscle or skin, which may mean a repeat operation.
• An umbilical hernia may be detected during the operation and must be treated surgically.
• Moving upright after the operation is restricted and may affect your everyday life for up to 4 weeks.
• The scars will be red for a few weeks and then fade after a few months.

After pregnancy, looking in the mirror can lead to a loss of self-confidence for many women. They realize that their body has changed as a result of pregnancy and breastfeeding. Mothers often suffer from an expanded abdominal wall, sagging breasts and excess fat that has accumulated during pregnancy.

However, a lot of sport and a healthy diet can sometimes not be enough to completely tighten the stomach again. At the prevention-center Zurich, we are happy to sensitively address your desire to regain your figure. Dr. Köhler can treat the affected areas of the body with a so-called “mommy makeover” and thus tighten a sagging abdominal wall, for example.

Depending on the initial situation, several operations (e.g. eyelid, breast lift and tummy tuck) are combined in a “mommy makeover” to shorten the recovery time. The medical conditions must of course be fulfilled.

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