Abdominal liposuction

In order to correctly assess the results of liposuction on the abdomen, some basic knowledge of anatomy is required. There are two types of fat on the abdomen: the fat under the abdominal wall – intra-abdominal fat or visceral fat – and the fat between the skin and the abdominal wall, also known as subcutaneous fat (fat under the skin).

The fat under the abdominal wall, i.e., visceral fat, is responsible for weight and is closely linked to typical lifestyle diseases such as diabetes, high blood pressure, high blood lipids, etc. You can only change this fat by changing your eating habits or by following a diet.

Visceral fat can only be reduced through diet or a change in diet. Neither liposuction nor fat removal injections, ultrasound or Cryolipolysis (cold method) can reduce this area of fat!

We recommend our weight loss programs for the treatment of visceral fat; we would be happy to provide you with more information.

Subcutaneous fat, on the other hand, can be reduced or even completely removed by liposuction, fat removal injections, the cold method Cryolipolysis or ultrasound. These are the areas that usually cause discomfort under clothing because they form "fat sausages" when standing or sitting. This fat, sometimes called "baby fat", is often resistant to exercise and dieting. Immediately after the treatment, the body silhouette can be improved efficiently, but the weight itself will not change.

This gives you an idea of how much fat will disappear after treatment:

On the left, the initial findings: In the above case, the subcutaneous fat layer is barely indented, so the result of liposuction will be minimal. In the lower case, the subcutaneous fat layer is thick, so the result will be very visible.

Realistic expectations are very important to us: Many patients come with visceral fat and expect an unrealistic result from liposuction. They forget that only the subcutaneous fatty tissue can be removed by liposuction.

Realistic results very often look quite different, as in this case:

Case 1: The suctionable subcutaneous fat has been completely removed, but in this case there is a lot of fat under the muscles (visceral) – unfortunately, this is not treatable.

Case 2: The suctionable subcutaneous fat tissue has been completely removed. The "residual belly" consists of fat under the muscles, which will only disappear with a change in diet.

Case 3: The suctionable fat has been completely removed; for an optimally slim result, it would now have to be removed (visceral fat cannot be liposuctioned).

Patients who only have subcutaneous fat

For patients who only have subcutaneous fat, liposuction can lead to excellent results. The soft fat that interferes with body-hugging clothing is completely gone after the procedure. In such cases, the body silhouette is perfect after liposuction.

Below you can see "before/after" photos of patients who only had subcutaneous fat and were liposuctioned. Basically, you can imagine the result as follows:

Patients who have mainly visceral fat

In patients who have both subcutaneous and visceral fat under the abdominal wall, liposuction removes the fat under the skin (the subcutaneous fat), but the fat under the abdominal wall remains unchanged.

Only a diet or a change in diet with weight reduction will reduce this fat volume. Although the results of liposuction are clearly visible and your clothes will fit better, liposuction will not make you thinner. If you find it difficult to get started, we recommend our special weight loss concepts. Below you can see "before and after" examples of what an abdomen with visceral fat can look like after liposuction. The subcutaneous fat has disappeared, but the fat under the abdominal wall is still present.

In the case of liposuction with a lot of fat under the abdominal wall, the procedure does produce a certain result, but the result is very limited. The reduction in subcutaneous fat is clearly visible on the CT scan (see the black and white images on the right). However, the fat under the abdominal wall remains unchanged and can only be reduced by losing weight.

Abdominal problem: Sagging skin and fat

In the case of sagging skin, the skin will neither contract nor tighten well with a standard liposuction procedure. The abdomen then looks wrinkly and unattractive. Therefore, in such cases, additional techniques are required for an optimal result.

The problem is the excess skin. The treatment of choice in such cases is a "major" abdominoplasty, in which the excess skin with the fat is cut away and the belly button is transplanted, as shown in the diagram. This procedure is called abdominoplasty or "tummy tuck".

This is a very complex operation with a hospital stay, general anesthesia, scars and costs of CHF 15 000-20 000. Complications are possible: These include post-operative bleeding, "water in the abdomen" for months (seroma formation), infections and wound healing disorders. The scars, which usually remain visible forever, are a problem with this procedure.

The main problem with this procedure is that the entire abdominal wall, including the fat, must be "sharply" dissected, which can lead to heavy bleeding that must always be stopped with electrocautery. This procedure leads to poor blood circulation in the tissue and massive lymph flow, which is responsible for the frequent complications after the procedure. For this reason, we never perform this procedure as a one-sided "tummy tuck", but split the treatment into two procedures.

The "two-step concept" according to Gallenkämper/Linde

Splitting the procedure into two treatments allows for a "harmless" operation with virtually no complications worth mentioning. In the first step, the fat under the skin is removed on an outpatient basis by liposuction (Smooth Lipo in combination with skin tightening using plasma heat/RENUVION). If the skin is not as firm as you would like after this procedure, the skin is surgically tightened in a second step. The second operation is also performed on an outpatient basis under local anesthesia.

In almost all cases, our patients are so satisfied with the first part of the treatment that the second procedure is not necessary.

Step 1

Liposuction of the suctionable fat – also on the sides – and tightening of the skin with RENUVION as an outpatient procedure in twilight sleep and under local anesthesia. As a rule, 90% of our treated patients can return to work just two days later. There is no anesthesia, no unsightly scars and no hospital stay. The costs range from CHF 7000.00-8500.00. As a rule, almost everyone is satisfied with this first step. However, some people want even firmer skin, in which case step 2 follows.

before/after pictures >

Step 2

As the fat has been removed and only excess skin remains, this is now removed as part of an outpatient procedure under local anesthetic and in twilight sleep. A stay in hospital is not necessary. Depending on the abdomen and the findings, the abdominal wall muscles can also be tightened at the same time ("rectus tightening"), which can result in an even firmer abdomen.

The scar is barely visible and hidden in the bikini line – where many women also have a caesarean scar.

This procedure is performed by Dr Werner Gallenkämper, MD, who specializes in such procedures. The costs are usually CHF 7000.00-CHF 9000.00. During a free consultation, Dr. Gallenkämper will discuss all aspects with you and answer all your questions.