Skin tightening (Dermolipectomy)

Following successful weight reduction excess tissue often remains on abdomen, thighs or upper arms, and the shape of the female breast undergoes detrimental change. The skin has lost its elasticity and is no longer able to contract. Such problems cannot be remedied by sport, massage or liposuction. Plastic surgery methods can be used to remove excess skin and fatty tissue to restore breast shape.

Surgical principal

Slack and therefore excess skin and fatty tissue is surgically removed following careful planning. These incisions are planned in such a way that the subsequent scars are as unobtrusive as possible. In such cases liposuction is no longer an option and can only be considered for shaping bordering areas.

Breast correction obtains improved shape by moving existing, sunken tissue back to the center of the breast, by tightening the covering skin and lifting the nipples. In some cases it is advantageous to combine this with beast prostheses (e.g. silicone gel implants).

Results

The dermolipectomy, i.e. the surgical removal of excess skin and subcutaneous fatty tissue, frequently produces long scars, but is the only way large amounts of fat and folds of skin can be removed. As with successful breast shaping, dermolipectomy restores a harmonious physical structure, sporting activities are again possible, subjective well-being is greatly increased.

The stay in the clinic

Only in exceptional cases can treatment be provided on an outpatient basis. A stay of 3 to 10 days at our clinic should be planned, depending on the extent of the surgery. Your health insurer does not always pay for the treatment. Today, it is normal for this matter to be sorted out prior to the treatment. The Medizinischen Dienst der Krankenkassen (MDK) often examines and reports on cases. We would be delighted to provide help as regards appropriate certificates.

Preparation

The surgery requires no particular preparation on your part. The only precaution is to take no painkillers containing acetylsalicylic acid (e.g. aspirin) during the ten days before the surgery. The same applies to medicines that delay blood clotting, as this can cause bleeding after the operation and can prevent wounds from healing. We recommend undergoing surgery when the desired amount of weight has been lost and the correct weight has been maintained for at least six months. Of course, the surgery will be even more successful the closer you are to your ideal weight. If you suffer any inflammation in the skin folds, you should consult a skin specialist prior to undergoing surgery.

The operation

On the day before the operation the parts of the skin to be removed are closely examined and the incisions are precisely marked with a pen. The shape of the breast depends very much on what you have in mind. The operation is carried out in our central operating theatre, in other words using all the facilities, equipment and specialist personnel our hospital complex has to offer. Once the anaesthetic has been given, the skin concerned is disinfected several times and then covered with sterile cloths. The excess skin and associated fatty tissue is removed, and liposuction might also be carried out on neighbouring areas. When the wounds are then sewn up, mainly using material which is reabsorbed, the remaining skin is tightened. Bruises or wound secretions can always occur. For this reason, drainage tubes must remain in the wounds for a few days, in a sealed low pressure system. Bandages are applied whilst the patient is still under narcosis. At the same time, we try, whenever possible, to use individually fitted compression corsets or bras.

Abdomen tightening entails removing the skin from the lower abdomen, i.e. between navel and mons pubis, and mobilising the skin of the upper abdomen. Only then can the wound be closed, the navel then being sewn into the drawn down skin. The scar is similar to that resulting from a caesarean and is just as easily concealed.

Tightening the upper thigh is sometimes achieved by simply tightening the skin between groin and ischium. More often, however, a long incision is additionally required on the inside, down to the knee.

On the upper arm, we make the incision on the inside, between armpit and elbow, so that the resulting scars can be well concealed. Naturally, in some cases, excess tissue has to be removed on quite other parts of the body. In such cases, the location of the incisions is discussed with you beforehand.

After the operation

After the operation you will be looked after by our doctors and nursing staff with expertise and sensitivity. Painkilling drugs may well be necessary, and should be used. In this way you are provided with the peace and relaxation healing requires. You will be given antithrombosis stockings and medicines to prevent blood clots and embolisms. The wound will have healed on the surface within around 14 days, but the internal healing process will not be complete for several weeks. Therefore compression bandages and supporting bandages must be worn for at least six weeks.

Risks

Before treatment commences you will be questioned in depth about your state of health. In event of any blood vessel disorders, thromboses or embolisms, special precautionary measures will have to be discussed with your own doctor. We also have to consider other illnesses and any medicines regularly taken. You should also not fail to inform us of any allergies to drugs, plasters or ointments. Prior to the operation we will examine your blood in the laboratory, check your heart by means of ECG, and measure lung function. X-rays of heart and lungs are not necessary in all cases.

Complications

Some of the operations mentioned herein occasion extensive wounds. Healing processes can be set back by bruises or build up of secretions, bacteria are also a factor. As the remaining skin has to be considerably tightened, feeling, in this area, will only return after some considerable time and will be permanently impaired around the scar. Major blood loss is very rare, so blood transfusions can almost always be avoided. Thromboses and embolisms are always made more likely by lying down for prolonged periods, and are particularly more prevalent in patients who take contraceptives. Smoking, too, can cause complications. Unsightly scars can mostly be avoided using the special techniques of plastic surgery. If, despite this, they still arise, they can be corrected later under local anaesthetic.

Aftercare

We only use state-of-the-art stitches that are particularly well tolerated by the body, and we prefer re-absorbable material that dissolves. We remove other types of stitches after approximately 2 weeks. Along with careful use of compression bandages, support tights, medical bras and corsets, we recommend regular skin care. Modern silicone preparations can be used to good effect on scars.

What care is to be taken after the operation?

You can normally return to work as soon as three weeks after the operation, depending on your type of job, although it is always wise and safest to plan a sufficiently long period of rest in which to avoid any major physical stresses from either work or leisure pursuits. Sudden, abrupt and jerky pulling stresses in the area of the incisions are particularly to be avoided. After slowly getting your body used to stresses, you can enjoy sporting activities again in just 10 to 12 weeks.

Who do I contact?

You can call our Center for Plastic-Reconstructive and Aesthetic Surgery round the clock on +49 (0)911-398-7220, or e-mail us at: aesthetik@medizinplus.com.

At an initial consultation, we determine what you want and consider your individual circumstances. Only then is it possible to make definite plans. For an extensive consultation we charge expenses amounting to 50 Euro.