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FAQThe questions listed below have been put together by our medical director, Dr. MichaelKremer, MD, from online as well as from personal consultations. The questions are being updated constantly and are included here to provide you with additional information. Should you have any questions yourself, please feel free to contact us!

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I am 28 years old and have had 3 pregnancies. I am very interested in a tummy tuck. I have tried several ways to lose weight and tighten my stomach, but nothing works. It has been several years since my last kids and my weight has stayed stable. I know that I am not fat, but I am bothered by my stomach. The only thing that I am worried about is a scar.

Answer from Dr. Kremer:

What type of tummy tuck you need is very much a function of what is causing your excess abdominal size. Patients who have excess skin and fat may need to have the skin and fat simply excised. If there is underlying weakness of the abdominal wall or separation of the abdominal wall muscles, abdominal wall work would be needed as well. This is particularly common in mothers following giving birth and may be the case in your particular situation as well. The length of the scar is really a function of how much excess skin and fat you have. If there is a great deal of excess tissue, particularly toward the sides of the abdomen, then the scar will need to be quite long. I try to determine the course of the resulting scar with my patients preoperatively as detailed as possible and - if desired - hide the scar within the so called "bikini line".

All body contouring surgery, unfortunately, involves trading scar for improved contour if there is excess skin or fat that needs to be excised.

What is the difference between cosmetic and reconstructive surgery? I have had difficulty with my insurance calling things cosmetic which I do not think are really cosmetic.

Answer from Dr. Kremer:

Cosmetic surgery is performed to reshape “normal” structures in order to improve the patient’s appearance. Cosmetic surgery is not covered by health insurance.

Reconstructive surgery is performed on “abnormal” structures of the body caused by congenital defects, developmental abnormalities, trauma, defects following surgical treatment of cancer, or other diseases or difficult wounds. It is often performed to improve function but many of these operations are also done to improve appearances as well. Reconstructive surgery is usually covered by most health insurance plans, although coverage for specific procedures and the amount of coverage for these procedures varies greatly between health plans. Accident insurance policies often cover the treatment costs for "cosmetic" surgery after trauma.

There are several common operations performed in plastic surgery that are increasingly difficult to get covered by insurance plans. Breast reduction is one of these operations. Other procedures, such as surgery to correct congenitally abnormal ears, remove keloids or widened scars, or scar revisions are additional procedures that are difficult at times to get covered by insurance plans.

Please contact your insurance carrier early ahead of time. Our office will assist you in explaining your individual situation to your health or accident insurance, if necessary by a detailed assessment and photo documentation. Eventually, at least a partial coverage agreement can be negotiated.

Is there any treatment available for reducing the the appearance of stretch marks?

Answer from Dr. Kremer:

This is a very common question and, unfortunately, there is not a simple answer. Treatment of stretch marks is somewhat a function of where they are located. Some people get stretch marks under the arms, many get them on the abdomen after childbirth and pregnancy, and patients of both sex get them on various parts of the body after a significant weight loss. Sometimes the stretch marks can be eliminated by direct surgical excision of the redundant skin, such as in the case with an abdominoplasty ("tummy-tuck").

Many kinds of body contouring procedures can be done to improve the contour of the area, remove or minimize stretch marks, albeit at the cost of an additional scar from the surgery itself. Most topical preparations for stretch marks are not effective. Laser treatments or injectable treatments from our experience don't seem to improve stretch marks at all.

The information on this web site is only intended as an introduction to this procedure and should not be used to determine whether you will have the procedure performed nor as a guarantee of the result. The best method of determining your personal options is to schedule a personal consultation with Dr. Kremer. He will be able to answer specific questions related to your situation.
Aesthetic Plastic Surgery Munich
Dr. Michael A. Kremer, MD

Mauerkircherstr. 40 - D-81679 Munich
Phone: +49 (0) 89 - 55 27 450