Tummy tuck in Zurich

Pregnancy stretches the skin, the subcutaneous tissue and the fascial sheet between the straight abdominal muscles. If this sheet remains stretched, the muscles drift apart (rectus diastasis). The abdomen then bulges, particularly when standing or towards the evening, regardless of body weight.

Stretch marks arise in the deeper layers of the skin and cannot be treated; only skin that is removed anyway — usually below the navel — can be eliminated.

After significant weight loss, an apron of skin often remains, which can chafe, lead to skin inflammation and restrict movement and clothing. A prerequisite for planning is a weight that has been stable for several months.

Skin

The assessment considers how much skin is excessive at rest, whether it forms folds and how elastic it is.

Fat

Subcutaneous fat can be removed by liposuction. Fat inside the abdominal cavity cannot — it can only be influenced by weight reduction.

Abdominal wall

The distance between the straight abdominal muscles is checked lying down with the abdominal wall tensed. If a hernia is also present, it is treated at the same time or investigated beforehand.

With good skin condition and an isolated fat deposit, liposuction is often sufficient — with smaller incisions and a shorter recovery.

If there is relevant excess skin or a weakened abdominal wall, liposuction alone will not achieve the goal and can make the contour appear looser.

With limited excess skin below the navel, a shorter scar may be sufficient; the navel is usually not repositioned. The effect remains limited to the lower abdomen — little changes above the navel.

With marked excess skin, the skin between the navel and the pubic area is removed, the abdominal skin is mobilised downwards and the navel is brought out anew. The scar runs across the lower abdomen and around the navel.

If a rectus diastasis is present, the straight abdominal muscles can be brought together again with a suture of the fascial sheet. This tightens the waist and can favourably influence symptoms when straightening up. The suture is sensitive to strain in the first weeks and determines the restrictions during recovery.

In a full lift, the navel remains on its stalk and is brought out through the new skin cover. This creates an additional, usually inconspicuous scar around the navel. The shape and position of the navel change.

The transverse lower abdominal scar is planned as low as possible so that underwear or swimwear can cover it. Its length follows from the amount of skin removed and is marked and discussed before surgery.

Supplementary liposuction of the flanks can shape the waist more harmoniously. In the mobilised area of the abdominal wall, fat removal is performed conservatively so as not to endanger the blood supply. Whether and to what extent procedures are combined depends on the tissue, the operating time and the risk profile.

The procedure is performed under general anaesthesia. The operating time depends on the extent and any combinations. Drains and an inpatient stay are usual depending on the approach.

Walking and thrombosis prevention

Early, short walks are important. In the first few days a slightly bent posture is often adopted; it straightens up over time. Additional thrombosis prevention measures are determined individually.

Lifting and carrying children

Lifting and carrying strain the abdominal wall suture and must be restricted for several weeks. Childcare should be organised in advance.

Compression

A compression garment is worn for several weeks.

Sport

Light movement early, endurance sport later, abdominal muscle training last and only after medical clearance.

Scar maturation

The scar is red and firm at first; it changes over twelve months and longer. Sun protection and scar care are recommended.

Seroma

Fluid collections beneath the abdominal wall are among the more common complications and may require punctures.

Wound healing problems

The risk is increased particularly in the middle of the scar and in smokers, people with diabetes or those with obesity. Stopping smoking before and after surgery is essential.

Changes in sensation

A numb area between the navel and the scar is usual and may remain partly permanent.

Further risks

Postoperative bleeding, infection, thrombosis and embolism, widening of the scar, remaining contour differences, so-called dog ears at the ends of the scar, and the risks of anaesthesia.

Revision

Minor corrections to the ends of the scar or the contour are possible and are discussed no earlier than after healing is complete.

Future pregnancy

Pregnancy after the procedure is possible but can change the result again. If you wish to have children, waiting is usually recommended.

The medical consultation for surgical procedures costs CHF 250. If you subsequently book an operation with us, the consultation fee is credited in full against the price of the operation. Following the examination, you will receive an individual cost breakdown that clearly states which services are included.

• Dr. med. Michael W. Payne

  Specialist in Plastic, Reconstructive and Aesthetic Surgery

• Dr. med. Dr. Phil. Annemarie Nijboer

  Specialist in Surgery

• Body surgery — overview
• Liposuction
• Upper arm lift
• Liposuction or tummy tuck — decision guide
• The abdomen after pregnancy — decision guide
• Excess skin after weight loss — decision guide

The initial consultation is about clarification, not selling. It does not necessarily end with a surgery date — often it brings the realisation that a different approach, or no procedure at all, is the right choice.

The consultation process

1. 01

   Discussion

   We listen to your concerns, medical history, expectations and what you would like to change about your appearance.

2. 02

   Examination

   A careful clinical examination and assessment of your underlying anatomy.

3. 03

   Options

   Possible procedures, alternatives, limitations and risks — explained clearly and without time pressure.

4. 04

   Time to reflect

   You decide in your own time. Any outstanding questions can be addressed in a further consultation.