Bauchdeckenstraffung: Fühlen Sie sich mit einem straffen und schlanken Bauch wieder athletisch

The difference between twilight sleep and general anaesthesia is artificial respiration. Paralysis of the respiratory muscles, as caused by general anaesthesia, is no longer a prerequisite for painless surgery. Pain elimination techniques have evolved tremendously. Thanks to the precisely dosed administration of sleeping pills and painkillers, abdominoplasty can be performed comfortably and safely in twilight sleep ^[5]. The targeted anesthesia of the skin nerves of the abdomen ensures that you have less pain even after surgery ^[6]. As of 2021, over 15 scientific studies have been published confirming the comfort and safety of targeted anesthesia of the abdominal wall nerves before, during, or after abdominoplasty ^[7]. The benefits of twilight sleep with targeted nerve anesthesia are:

1. They are more quickly awake and fit after surgery ^[8]. ^[9].
2. You need less strong painkillers.
3. After an operation in twilight sleep, you do not have to stay overnight in hospital.
4. The risk of a blood clot interrupting blood flow in the leg (thrombosis) or lung (embolism) is lower with twilight sleep than with general anesthesia ^[10].

The paired straight abdominal muscles run from the bottom of the ribs to the pubic bone. In the midline, the muscles are connected by a white strip of collagen fibers (Latin name: linea alba). During pregnancy, the growing child stretches the abdominal wall. Especially after several pregnancies, the connective tissue between the straight abdominal muscles can be stretched from one to two centimeters to over five centimeters. Since the tissue made of collagen is inelastic, the gap does not form back after pregnancy. As a result, the straight abdominal muscles take an arcuate course. The altered direction of progression is suspected to promote back pain ^[11]. With an abdominoplasty, the muscles can be moved back to their original position in the middle of the abdomen. There is evidence that rectus diastasis correction improves straight abdominal muscle strength and back pain ^[12].

Of course, the question about the cost of a tummy tuck is one of the most frequently asked questions. To find out the price of a tummy tuck in just a few clicks, you can use our price calculator.

Due to the constant increase in size of the child, the skin cells multiply and the skin mantle on the abdomen increases. If cell proliferation cannot keep up with the increase in circumference, the skin may tear internally. Stretch marks form. The adaptability of the skin decreases with age. Cigarette smoking and frequent sunbathing also damage skin elasticity. If the skin does not recede sufficiently, the sagging skin forms wrinkles around the belly button or above the caesarean scar. Scientific studies show that fat deposition inside the abdomen around the viscera increases after pregnancy ^[13]. A rectus diastasis also leads to an increase in the circumference of the abdomen. The shape and color of the belly button can also change unflatteringly due to pregnancy. Redistribution or increase of fatty tissue often also affects the mons pubis, back and waist.

A birth is accompanied by many changes. The abdomen and breasts are the areas of the body that change most significantly with pregnancy. The skin on the areolas, pubis, armpits, and around the belly button (linea nigra in Latin) may turn dark. After birth, the body metabolism and hormone balance changes. Many changes that occurred during pregnancy regress after birth. The dark discoloration of the skin fades after a few months. The collagen of the stretched skin is remodeled. The metabolic processes of the skin can be compared to those of a healing scar. Women who have given birth by caesarean section notice that the scar appears red and somewhat hardened in the first few months. After half a year, the scar becomes paler and softer. Metabolic processes that lead to the regression of the skin are similar to the remodelling processes of a scar. During the first nine months, the skin may recede somewhat. For this reason, we recommend waiting this period after childbirth before performing an abdominoplasty. Since any surgery involves the administration of medication, you should have weaned your baby by then. A life-changing procedure, such as a tummy tuck, should be performed under the best possible circumstances. Keep in mind that you should avoid heavy lifting and carrying for the first four to six weeks after surgery. Therefore, make sure that you can get support from your family, friends or colleagues during the first few weeks.

When you can return to work after the abdominoplasty depends largely on the extent of the operation and the requirements of your professional activity. On average, our patients return to work after one to three weeks. After a mini-abdominoplasty, young and healthy patients can return to work at home after only a few days. If your job requires you to lift or carry heavy loads frequently and persistently, you should allow a recovery period of four to six weeks after correction of a rectus diastasis.

Washing myself (with shower patches):	On the first day
Dressing and undressing:	On the first day
Walking in the house / apartment:	On the first day
Stair climbing (1 floor):	On the second day
Outdoor walking (10 minutes):	On the second day
Cooking (a small meal for myself):	On the second day
Housework (laundry, vacuuming the floor):	After a week
Doing the shopping (groceries):	After four to five days
Driving (up to 50 km):	After four to five days
Sexual intercourse:	After two to three weeks
Sports (one hour of light fitness training):	After four weeks*
Endurance training (cardio training):	After six weeks

*If rectus diastasis has been treated, abdominal exercise should be avoided for at least three months.

The data are approximate values for orientation. Depending on the general
health condition or extent of the abdominoplasty, the information on physical stress varies, so there may be discrepancies. Always listen to the instructions of your specialist in order to prevent possible complications and not to jeopardize an optimal result.

• After the operation we would like to be convinced of the proper healing and your satisfaction. At the same time as the operation, we therefore also arrange the appointments for aftercare, which in individual cases can take place by video consultation.
• Drains are not needed for every tummy tuck. If an increased bleeding tendency is detected, drains are used, which are usually removed the very next day.
• On the first day after the operation you can shower as usual. It is best to use shower plasters to keep the bandages dry. It is recommended that you take your first shower just before your follow-up appointment so that the dressings can be changed afterwards.
• The wound in the bikini area is sutured with fine threads that dissolve by themselves. Only at the navel the sutures are removed between the tenth and fourteenth day after the operation.
• During the first two weeks, make sure that the hips are slightly bent when lying down (side position with legs drawn up or supine position in a stepped bed). Thus you relieve the abdominal wall and support the healing process.
• The compression garment supports the decongestion. If a rectus diastasis has been corrected, the girdle protects the sewn straight abdominal muscles like an abdominal belt. We recommend that you wear the compression garments day and night for the first six weeks.
• Scar healing begins immediately after surgery. Your surgeon sets the stage for fine and inconspicuous scar healing. By massaging the scars and applying silicone patches, you can make a significant contribution to beautiful healing in the weeks and months that follow. Refrain from sunbathing while the scar is healing so that the scar does not discolor.
• The decongestant effect of arnica, bromelain, or of combination preparations such as Wobenzym has not been proven by scientific studies ^[14].

We recommend an abdominoplasty for the beautification of the
Abdominal contours. The physical requirements must be taken into account: Abdominoplasty is particularly suitable for healthy women or men who suffer from increased fat accumulation and skin folds on the abdomen.

Before a tummy tuck you should have reached your desired weight. Weight variations can affect the final result. If you gain weight, your abdominal circumference will increase even after a tightening. However, it is not the case that the liposuctioned fat tissue forms anew. There is also fatty tissue in the abdomen, around the intestines, which increases in volume when you gain weight.

Conversely, a strong weight loss after a tummy tuck can also have a negative effect on the result of the operation.

Since severe overweight increases general possible risks of the operation such as thromboses, embolisms and wound healing disorders, we advise against abdominoplasty for patients with a BMI over 40.
An abdominoplasty should be performed under the best possible circumstances. This, of course, concerns the operation, which our entire surgical team meticulously prepares.

The time after the operation also requires a certain amount of preparation. Avoid binding appointments during your recovery period. A perfectly executed operation will not lead to an optimal result if recovery or aftercare following the operation is not guaranteed.

Occasionally people ask about the best time of year for a tummy tuck. The time of year does not affect surgery or healing. During the aftercare, you should above all be able to rest. A compression girdle should be worn for four to six weeks. The special fits as well as the light and breathable fabric of the bodices are usually not perceived as uncomfortable. At any time of the year, it is of course advisable to adapt to the weather by wearing appropriate clothing and air conditioning in order to avoid freezing or sweating after the operation.

Immediately after the removal of excess skin, the abdomen is already firmer and the contours are slimmer, so you will see a difference in the first few days. Healing is an ongoing process. The following picture should give you an impression of the healing process:

Operation Day	Depending on the extent and state of health, you can stay overnight at home.
Day 1	Inspection of the wound, checking the correct fit of the bodice and renewal of the dressing. After liposuction, the dressings absorb the fluid from the tissue injections for the first 24 hours.
Day 3	On-site inspection of the wound and renewal of the dressing. Naturally, there is a slight swelling in the area of the operation.
Day 6	On-site visit or video consultation. Occasionally, bruises are now a little more noticeable as the blood spreads through the tissues and follows gravity.
Day 10	On-site inspection of the wound and renewal of the dressing.
Day 13	Removal of fine stitches from the belly button and instructions for scar care. Due to the breakdown of the blood pigment hemoglobin, the bruises are now orange-yellow. The colour initially changes to violet via green to yellow.
41st day	On-site visit or video consultation. As a rule, a clear reduction in swelling is already noticeable. You do not need to wear the girdle now. It is quite normal that the abdomen still feels a little numb.
90th day	On-site visit or video consultation. In 90 percent of the patients, the final result is 90 percent recognizable.
180. Day	On-site visit or video consultation. The scars slowly become a little softer and paler. Scar healing progresses faster and better the more regularly and consistently you care for your scars.
360. Day	Site visit. About a year after the operation, it can be assumed that the tissue no longer changes. Now the before and after pictures can be compared and judged best.

The answer to this question is, as so often, it depends! Already from a body mass index of 25 kilograms per square meter one speaks of overweight. The question about body weight is used to estimate the risks of surgery. There are a wide variety of factors that influence the risks of surgery. The interaction of these factors means that each patient must be considered individually and as a whole.

The increase in surgical risks due to a limited state of health and the extent of an operation is scientifically well documented. The characteristics that influence the health status include: Age, body weight, cigarette smoking and concomitant diseases. The extent and duration of surgery are determined by the dimensions of the abdomen and the surgical goals.

A risk is usually expressed as a percentage. A risk cannot be described in terms of “never” or “always”. Cigarette smoking is a risk. Smoking twenty cigarettes a day is more harmful than smoking one cigarette a day. Even someone who smokes only one cigarette a day lives more dangerously than a non-smoker.

In young, healthy non-smokers, body weight therefore plays a subordinate role. Nevertheless, we do not recommend an abdominoplasty if your BMI is over 40.

Ideally, an abdominoplasty should be performed after family planning has been completed. Nevertheless, there is no need to fear any disadvantages in pregnancy after an abdominoplasty, neither for the expectant mother nor for the growing child ^{[15] [16]}. An abdominoplasty is also not an obstacle to natural childbirth ^[17]. Before pregnancy, we recommend waiting one year after abdominoplasty.

The costs of an abdominoplasty are only covered by health insurance in exceptional cases. The Social Security Code stipulates that the benefits provided by the health insurance funds must not exceed what is necessary. This requirement applies to both private and statutory health insurance.

Medically necessary, for example, is the removal of skin folds in case of recurrent skin inflammations after exhaustion of all non-surgical treatment options. The removal of a disfiguring fat apron, which constantly attracts many glances, is also considered medically necessary. If a mental impairment is certified, the Medical Service of the Health Insurance Funds (MDK) usually recommends mental treatment, but not surgery. The benefits provided by health insurance companies are limited to what is medically necessary.

Justifiably high demands on cosmetic surgery are not compatible with the goals of a medically necessary treatment. The assumption of the costs of a tummy tuck requires an application by the insured person.

During a tummy tuck, excess fatty tissue and skin is removed. Since the tissue does not reform, the result lasts a lifetime. Nevertheless, the abdominal circumference can change again after a tightening operation in case of pregnancy or weight gain.

The fatty tissue around the abdominal organs, also called visceral fat, can increase with lack of exercise and poor diet and lead to an increase in circumference. Therefore, make sure you eat a balanced and healthy diet and get enough exercise.

Before treatment, your goals must be precisely defined, as each treatment method has different objectives. An abdominoplasty serves to tighten the abdominal skin. Liposuctionreduces the volume of fat and beautifies the contours of the body. In the case of a protruding abdomen, there is usually both an increase in fatty tissue and excess skin.

Therefore, we usually recommend combining an abdominoplasty with liposuction. In the case of a pot belly, the excess skin is in the foreground. In a potbelly, on the other hand, there is often an increase in fatty tissue and occasionally a rectus diastasis.

Every treatment is associated with opportunities but also with risks. The likelihood of the risks changes with the patient’s health and the extent of the surgery. Your safety and satisfaction are our top priority. To keep the risks as low as possible, cigarette smoking should be avoided before and after surgery. In order to reduce the risk of thrombosis, the use of the contraceptive pill should be temporarily discontinued.

The rate of complications requiring treatment for
Abdominoplasty is roughly put at four percent ^[18]. Among the general
Surgical risks include inflammation, secondary bleeding, thrombosis and embolism. Food supplements (omega-3 fatty acids, St. John’s wort preparations, etc.) and vitamin preparations (A, E) can impair blood coagulation and increase the surgical risk of secondary bleeding. We therefore recommend that you stop taking certain dietary supplements four weeks prior to
of a tummy tuck.

Specific complications of an abdominoplasty include numbness, usually temporary, wound water collection, and skin peaking. Careful planning and preparation as well as regular follow-up are important to prevent any complication in rare cases, to detect them in time and to treat them.

Yes, in principle, cosmetic surgery on different parts of the body can be combined. Performing a tummy tuck and breast surgery at the same time is called a “mommy makeover” in the US. We recommend the combination of different surgical procedures
to be weighed carefully: When sitting or lying down, the flow rate of blood in the body vessels is reduced.

This is why there is a risk of blood clots forming in the leg veins during air travel, for example. As expected, the risk of thrombosis is greater for long-haul flights than for short-haul flights. It is therefore not surprising that an operation that lasts, for example, an hour, is in principle less expensive.
than a surgery that takes 8 hours.

Scientific studies have been able to prove this connection, and recommend not to exceed a surgical duration of six hours ^{[19] [20]}.

Nearly 27 percent of tummy tucks are performed between the ages of 51 and 64 ^[21]. Many are actively shaping their transition into retirement and would like to further expand their social participation. Through healthy living and physical activity, biological age can be many years younger than chronological age.

Those who are physically fit do not need to limit themselves in their leisure activities. Even in late adulthood, you can still climb mountains. This also applies to cosmetic surgery.