Tummy Tuck – Abdominoplasty
The tummy tuck is a particularly efficient procedure that, when successful, means great relief for those affected and brings a significant improvement in quality of life.
Important facts and information about tummy tucks
Most often, a tummy tuck is performed for aesthetic reasons, but there are also a number of medical indications — in these cases, the health insurance covers the costs of the procedure.
Aesthetic reasons include:
- Wrinkled and sagging skin on the abdomen after pregnancy (or pregnancies)
- Wrinkled and sagging skin on the abdomen after weight loss
- Persistent fat deposits in the abdominal area
- Rectus diastasis (under 5 cm)
- Stretch marks
Medical reasons include:
- Massive apron of fat after significant weight loss
- Intertrigo (skin irritation)
- Pronounced rectus diastasis (from 5 cm)
- Abdominal wall hernias
Techniques and scar patterns
Depending on the degree of abdominal wall deformity, the procedure can be performed with varying levels of complexity and with or without additional measures. A distinction is generally made between mini abdominoplasty, midi abdominoplasty, and maxi abdominoplasty, which is also referred to as the “classic abdominoplasty.” The maxi abdominoplasty is performed most frequently because it is very effective and the majority of patients require substantial improvement. During the operation, the skin is lifted from the lower abdomen up to the costal arch and tightened downward, and the resulting excess tissue is removed.
An essential and often necessary addition to a tummy tuck after pregnancies is the correction of rectus diastasis. This refers to the reuniting of the inner edges of the two straight abdominal muscles, which often separate after pregnancy.
To accentuate the waist, further additional measures such as tucks at the muscle fascia and the removal of excess skin through a vertical incision can be performed. Accompanying liposuction can also contribute to improving the overall result.
A tummy tuck should (especially if correction of rectus diastasis is also planned) only be performed after completion of family planning and after reaching a stable target weight.

Tummy tuck – overview
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Faq
What happens during a tummy tuck (abdominoplasty)?
In the area of the abdomen, the skin along with the underlying fat is tightened, and the excess is removed. Access is gained through a horizontal incision in the lower abdomen, which can optionally be supplemented by a vertical incision if an accentuation of the waist is desired.
Where is the scar located after a tummy tuck?
Most often, the incision runs in a curved line downward above the pubic area from hip bone to hip bone. However, underwear-wearing habits can be taken into account when determining the incision line, so other scar placements are also possible.
What happens to the navel during a tummy tuck?
The navel is detached from its original position and, after the removal of excess skin, is reinserted into the abdominal skin at the same height. Attention is paid to achieving an attractive shape (longitudinal oval) and a moderate indentation.
What does the term “rectus diastasis” mean?
Rectus diastasis refers to the separation of the paired straight abdominal muscles (rectus abdominis muscles). Rectus diastasis often occurs in women due to pregnancies and in men due to massive weight gain. It appears as a more or less wide and clearly palpable gap in the middle of the abdomen when the muscles are tensed.
How is rectus diastasis corrected?
The facing edges of the two parts of the straight abdominal muscles are stitched together with firm sutures. In technical jargon, this procedure is referred to as “plication of the rectus sheath.” After a plication of the rectus sheath, lifting weights over 5 kg should be avoided for a period of three months, and a supportive girdle should be worn.
When should a tummy tuck be avoided?
In general, only physically healthy people should undergo surgery. Furthermore, women should have completed their family planning, as pregnancy can naturally worsen the results of a tummy tuck. Large weight fluctuations also endanger the outcome, so the procedure should be performed at a body weight that can be maintained after the operation.
Can stretch marks be removed with a tummy tuck?
Yes, but only those that are located on the portion of excess skin to be removed. Stretch marks above the navel area cannot be removed but will be shifted significantly lower, so the overall appearance improves in any case.
When does health insurance cover the procedure?
When the procedure is medically indicated, that is, in cases of a massive apron of fat after significant weight loss, intertrigo (skin irritation), pronounced rectus diastasis (from 5 cm), or abdominal wall hernias.
How many nights of hospital stay are to be expected?
In general, two nights are sufficient; in more severe cases, three to four nights of inpatient hospital stay may be necessary. In mild cases, especially when no plication of the rectus sheath was required, the hospital can already be left after one night.
What complications can occur?
The most common medical complication, due to the large wound area, is postoperative bleeding, as well as infections and wound healing disorders. Complications affecting the result include asymmetric scars, displacement of the navel, tearing of the plication sutures, tissue steps above the pubic area, dog-ear formation, and keloid scars. With careful work, medical complications are very rare; the frequency of aesthetic complications depends more on the surgeon’s experience.
When is one “fit for action” again after a tummy tuck?
After about 10 days, if only the excess skin was removed; if the rectus sheath was plicated, depending on individual pain sensitivity, one to two weeks longer. Physical activities involving abdominal muscle tension must be avoided for a period of three months.
What are the long-term results after a tummy tuck?
If large weight fluctuations can be avoided, the result is permanent.
Can liposuction replace a tummy tuck?
No. Liposuction only reduces fat volume and cannot achieve the necessary tightening of the abdominal skin. However, liposuction can be used as an accompanying measure to improve the overall result.
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