Plastic and reconstructive surgery

Dr. med. Petra Scheffer

Chief of

Plastic, Reconstructive and Aesthetic Surgery / Hand Surgery

Reconstructive surgery becomes necessary when the form and function of the body must be restored. This is often the case after an accident, cancer surgery, or congenital malformation. Our doctors specialize in restoring form and function after severe injuries, burn injuries with tissue loss, and other soft tissue damage.

Treatment focus

Breast correction
Fat distribution disorder
Lifting operationatWeight loss
Lipedema therapy
Lymphedema therapy
Scar treatment
Tumor surgery

Breast correction

Different breast sizes in a woman have different causes. Many women notice small differences in themselves, without any pathological value. However, there are also congenital deformities in which the breasts have developed differently or are even almost non-existent. An example of this is the tubular breast, as well as Poland syndrome with one-sided breast underdevelopment, pigment disorders and in some cases even underdeveloped pectoral muscle.

Another common cause of asymmetry is surgery due to breast cancer. Here, initial findings ranging from small defects to complete removal of the breast are possible. We will show you the complete therapy options in our clinic.

Enlargement of the too small breast by implant or own fat or the adjustment of the healthy or too large breast are common procedures and can also be combined on both sides in each case.

In the case of pathological changes, we will be happy to help you obtain health insurance coverage.

A sore neck and tense shoulders or back pain, bra straps that regularly cut in, no matter how wide they are, inflammation in the underbust crease or pain during sports are just a few of the problems that accompany the everyday lives of those affected. to reduce the size of their breasts. They suffer from the burden of their too large and heavy breasts. Often they have already gone through a long ordeal before they decide to have a breast reduction. Unfortunately, health insurance companies only cover this procedure in rare cases.

In order to reduce the volume of the breast and make the breast appear firmer and more attractive, tissue and skin is removed from the lower part of the breast and the nipple is positioned higher and, if necessary, adjusted in size. Breast reduction is often combined with a breast lift. Therefore, there are different surgical methods for breast reduction, which we will explain to you in detail. Stitches do not need to be removed, as they dissolve themselves.

After the operation, the breasts are swollen for a longer time and change over the weeks. The absolute final result is seen after 6 months after swelling has subsided and the breasts have returned to normal. The scars mature and fade until they turn white.

Breast augmentation is the most common aesthetic procedure for women worldwide. The desire for larger breasts arises in various life situations or after major life changes.

In particular, pregnancy or weight loss may be followed by a significant reduction in breast size. Likewise, natural asymmetries, shape anomalies or a lack of development of the female breast can cause the desire for breast augmentation. This is because it helps to feel more feminine again and thus also improves one's quality of life.

There are various procedures to choose from. For example, breast augmentation with implants or with autologous fat is possible. Modern surgical techniques make it possible to build up a completely natural-looking breast. An additional breast lift may also be necessary and is offered in the same session.

We use high-quality implants filled with stable, shape-retaining silicone gel, which are produced in Germany and are guaranteed to be leak-proof due to the modern material composition.

The implants are available in many shapes and sizes, so that a breast shape harmonious with the body can always be modeled.

The ability to breastfeed is maintained and the sensations of the breast are not affected. Temporary sensory disturbances may occur after the operation, but these will return to normal after a short time.

If the patient wishes to build up with her own fat, liposuction is performed in the same operation on the desired areas (for example, riding breeches, waist shaping). A second treatment may also be necessary. Enlargement with autologous fat can only be performed by one cup size.

Implants have a limited shelf life in the human body. This varies from person to person, so there is no time limit for when an implant should be replaced. The focus here is on existing pain or the development of a higher degree of capsular fibrosis. In these cases, we perform an implant exchange in our clinic. For this purpose, the breast implant is completely removed with its capsule and, if necessary, a new bearing is created under the breast muscle, if this was not already present.

In rare cases there is a wish to remove the implant completely. The breast is then empty. By means of a tightening operation, our physicians restore a natural shape. Filling can also be done additionally with the patient's own fat tissue.

The various methods of breast lift aim to optimize the shape, firmness and size of the breast. Adjusting asymmetries is also possible. By removing excess and sagging skin and reshaping the breast, by moving your nipples to a higher position, your breast will have the desired shape.

All surgical methods are designed to achieve the least scarring possible. Depending on your wishes, an implant is inserted during a breast lift to regain missing volume. After the operation, the breasts are swollen for longer and change over the weeks. The absolute final result is seen after six months, after the breast swells and sinks to a normal level. The scars mature and fade until they turn white.

Just like women, men have mammary glands. These are developed in different sizes in men as well as in women, and asymmetries are also possible. While a large breast is usually a beauty ideal for women, this is considered "unmanly" for a man. Accordingly, these men desire a surgical reduction of the breast shape.

A distinction must be made during an examination as to whether the gland itself is too strongly developed ("gynaekomastia vera") or whether rather the fatty tissue located around the breast is too pronounced ("gynaekomastia falsa"). Depending on the findings, the required surgical steps vary. Of course, there are also mixed forms.

Before the operation, the patient should see a urologist to rule out any pathological causes. The urologist examines the hormone level, performs an ultrasound and, if necessary, checks medications to be taken, since some trigger an enlargement of the gland.

While pure fatty tissue can be treated well with liposuction, an excessively large mammary gland must be surgically removed via a crescent-shaped incision at the edge of the areola. Usually this is done in combination. Whenever glandular tissue is removed via an incision, this tissue is sent for histological examination.

Overall, the skin still contracts after the operation, so that the final result is only fully visible after about three months.

Tightening

Marking before the operation is done in the standing position.

After a skin incision, running above the pubic hair, larger fat deposits and sagging tissue are removed from the front abdominal region.

In addition, if necessary, the fascia between the "six pack" abdominal wall (rectus) muscles can be tightened, which is often stretched after pregnancies and cannot retract (rectus diastasis). This results in a firmer abdominal wall and a narrower waist. Umbilical or incisional hernias are also treated at the same time. In addition, liposuction of the waist, for example, can be combined as desired. The navel, which is usually hidden, is reshaped and repositioned so that the scar is barely visible.

The classic procedure creates a scar in the bikini area and also a small circumferential scar on the navel by moving it. Often, annoying stretch marks can be removed at the same time, as the excess skin tissue below the belly button is removed.

If weight loss is planned, it is advisable to wait with the tummy tuck until the desired weight has been reached. In case of pronounced obesity (adiposity), abdominoplasty is not possible.

Women who wish to have children should also postpone the operation, as the connective tissue between the straight abdominal muscles, which are tightened during the operation, is particularly susceptible to damage.muscles, which are tightened during the operation, can separate again during pregnancy.

Brief overview
Duration of the procedure: 2 to 3.5 hours
Type of anesthesia: general anesthesia
Length of stay: inpatient
Special feature: a compression girdle should be worn for 6 weeks
Preparation of expert opinions on cost absorption by health insurance companies
Self-payers: from 6,500 euros

Brief overview
Duration of the procedure: 1 to 2 hours
Type of anesthesia: general or local anesthesia
Stay: outpatient or inpatient
Special feature: a compression girdle should be worn for 6 weeks
Price: from 3.600 Euro

When the skin and subcutaneous layers lose elasticity, sagging areas develop that are perceived as unpleasant. Causes of sagging include the natural aging process, excess weight as well as weight fluctuations or a connective tissue structure that is only weakly developed. If exercise and appropriate nutrition as well as simple liposuction cannot remedy the situation, an upper arm lift is the possible alternative. Lifting operations are often combined with liposuction of local fat deposits to achieve an optimal, aesthetic result.

In an upper arm lift, the incision can be guided in various ways. In most cases, the thin remaining scar on the inner side of the upper arm runs underneath the biceps so that they conceal the scar. Here, the excess fatty tissue and skin is removed.

The amount of tissue to be removed during the upper arm lift and the type of incision used will be discussed with you by the attending physician in a detailed preliminary consultation, as this depends on various factors, especially the condition of the skin and the extent.

Brief overview
Duration of the procedure: 2 hours
Type of anesthesia: general anesthesia
Stay: outpatient or inpatient
Special feature: 4 until 6 weeks of wearing compression bolero
Price: from 4.300 Euro

With age, the skin loses elasticity. Once the elasticity limit is reached, excess skin first appears in the inner thigh area, which cannot be eliminated by diet or exercise. This natural aging process has no disease value. The effect is particularly pronounced after excessive weight reduction or XXL lipedema.

Lifting operations are often combined with liposuction of local fat deposits to achieve an optimal, aesthetic result. The result of thigh lift depends on your individual general condition, and the state of skin elasticity.

In the case of an upperthighThe incision can be made in different ways. Almost alwayswe try to avoid the longitudinal long (vertical) incision on the inside of the thigh up to the knee, even in patients who have lost a lot of weight.

The incision is always made from the groin through the inner thighs in the crease to the genital/perineal area..JDepending on the extent of the problem, the patient may even be repositioned during the operation in order to remove the excess weight from the back of the thighs as well. In this case, the later scar runs exactly in the buttock fold and is hidden by it.

What amount of tissue is to be removed and what type of mostly horizontal The surgeon will discuss the amount of tissue to be removed and the type of incision, which is usually horizontal, in a detailed preliminary consultation, as this depends on various factors, in particular the condition of the skin and the extent of the scar..

Brief overview
Duration of the procedure: 2 to 3 hours
Type of anesthesia: general anesthesia
Length of stay: inpatient
Special feature: compression pants should be worn for 5 to 6 weeks
Price: from 4,900 euros

Most often, a pronounced weight loss causes the skin to sag - and that includes the buttocks. Only a part can be tightened by sport. For this reason, tissue can either be removed from the buttock fold in a "banana" shape or it can be folded inwards in order to achieve a volume effect for a shapely buttock. Of course, shaping can also be combined with lipofilling using the patient's own fatty tissue, especially in the upper parts where flattening is often found.

The amount of tissue to be removed and the type of additional volume redistribution to be applied will be discussed with you by the attending physician in a detailed preliminary consultation, as this depends on various factors, especially the condition of the skin, the fatty tissue as well as the extent.

Brief overview
Duration of the procedure: 2 to 3 hours
Type of anesthesia: general anesthesia
Length of stay: inpatient
Price: from 4,900 euros

After pronounced weight loss, the skin mantle may not completely recover despite intensive exercise. Depending on weight loss and functional disorders, but also soreness in the respective folds with appropriate proof by a dermatologist, the body lift can be covered by health insurance.

We will be happy to advise you on this, take the necessary photos and prepare corresponding letters with which you can present yourself to your health insurance company and apply for cost coverage. Even after stomach reduction or equivalent operations, a body lift is not automatically approved by the health insurance.

Prior to a body lift, a detailed discussion of the individual wishes, the existing conditions and how to proceed in detail takes place. We often perform several operations in one session, of course only if there are no or few pre-existing conditions, as the operation times are then very long.

Thus, we often start with the mostly complete front. Here the abdominoplasty is performed, depending on the findings only with a horizontal incision or in combination of a vertical incision in the midline. With this additional incision, more waist can be created than without. The navel is always moved and repositioned. In addition, breast and upper arm lift are performed. These costs are often not covered by health insurance, you can add them as a self-pay service. This way, you only need anesthesia and have a more beautiful overall appearance.

After the operation, the compression garment ordered by us for you is put on in the operating room, so that as few bandages as possible have to be fixed with plasters.

These operations are always supervised as in-patients, as there may be significant circulatory problems. After a recovery period of at least four to six months, depending on the combined operations and the overall situation, the operation of your back side is performed according to your wishes.

Back surgery is performed in the prone position and includes tightening of the back as well as a slight buttock lift and tightening of the lateral thighs. In addition, a thigh lift may be performed, which we often perform in a circular (horizontal) fashion to avoid large vertical incisions in the inner thighs. The circular incision allows the buttock crease to be redefined and lifted very well. In this case, the patient must then be turned around in the supine position in the operating room in order to complete the thigh lift by continuing the incision in the pubic and inguinal area.

The following applies to all operations: in the morning before the operation, while standing, all the steps of the operation are marked and photo-documented.

During the operation, drains (Redon bottles) are placed. The wound water flows through these tubes. Removal is done in the course, depending on the amount of filling and mobility after the operation. These major operations are performed by Ästhetik Hellersen on an inpatient basis. The average length of stay is five days. Compression garments must be worn for six weeks. Patients are also provided with a second set.

Since flanking operations of the body lift are often not paid by health insurance, there is the possibility of financing. In the first year we can offer zero percent financing. The office of Ästhetik Hellersen will advise you on the conditions and necessary documents.

The term "Mommy Makeover" comes from the United States and refers to the combination of different procedures in one operation to restore the remaining change due to pregnancies and births that disturb women.

Depending on the individual woman's wishes, two to three of the following procedures may be combined: Abdominoplasty and breast reduction/tightening or breast augmentation, liposuction, intimate surgery up to adjustment of the mons pubis.

You can read the individual information about the respective surgical procedures under the corresponding keyword here.

In general, it is important for such combined operations that there are no significant previous illnesses, as the operation times add up and a longer recovery time is necessary.

The attending physician will discuss all possibilities and particularities with you in a detailed preliminary consultation.

Facial surgery

Eyelid lift is used to optimize both the upper and lower eyelids. The skin around the eye area is significantly thinner than in other areas and therefore particularly susceptible to early aging. Thus, an upper eyelid lift is a relatively minor procedure with a major effect. It is one of the most common aesthetic operations and is usually performed on an outpatient basis. Under local anesthesia, the excess skin is also removed from the sides and, if necessary, disturbing fatty tissue is also removed. Cooling during and after the operation counteracts swelling. Although the patient can open his eyes again after the operation, he still has to be picked up. Stitches are removed after eight to nine days.

Lower eyelid blepharoplasty primarily involves the removal of fatty tissue from the bags under the eyes with corresponding moderate removal of skin under the eye. The attending physician makes the incision just below the lash line. In rare cases, the incision can also be made from the inside in the area of the conjunctiva to perform only targeted fat removal. Since the eye is more likely to be irritated during a lower eyelid lift than during an upper eyelid lift, the patient is given eye drops. Often, if a lower eyelid lift is necessary, the upper eyelids are also lifted directly at the same time, for a more comprehensive result. In addition, only one anesthetic is necessary.

Brief overview of upper eyelid lifting
Duration of the procedure: 45 to 60 minutes
Type of anesthesia: local
Hospital stay: outpatient
Fit for social life: after five to nine days
Price approx. 1800 euros Upper eyelid lifting on both sides with fat removal

Brief overview Lower eyelid lift
Duration of the procedure: 60 to 90 minutes
Type of anesthesia: general anesthesia
Stay: outpatient
Fit for society: after nine to 14 days
Price approx. 2300 Euro Lower eyelid lift on both sides with fat removal

When analyzing the eye, some people notice that they have a relative lowering of the eyebrows - especially in the lateral part. This is often combined with drooping eyelids, but can also occur in isolation. Our doctors will give you a comprehensive explanation, which includes an eyebrow lift.

In an eyebrow lift, an incision is made in the hairy portion of the forehead or directly at the hairline to lift and anchor the entire portion of the lateral forehead with the eyebrows. This is achieved by appropriately deep sutures. After the operation, there is swelling and slight bruising. After two to three weeks, the doctor removes the stitches. The result is long-lasting and usually does not need to be repeated.

Brief overview Brow lift
Duration of the procedure: 60 minutes
Type of anesthesia: local with twilight sleep or general anesthesia
Hospital stay: outpatient
Fit for social life: after five to nine days
Price approx. 2600 euros Brow lift on both sides

The forehead lift includes a complete eyebrow lift and is also called an upper facelift. A sunken forehead with frown lines and eyebrows that are too low always gives the face a tired and sullen expression. We therefore perform a forehead lift alone or in addition to a facelift.

Through a skin incision that runs in the hair or is placed at the hairline, it is possible to smooth out pronounced mimic forehead and frown lines and to loosen the connections to the muscles that lie under the skin. Subsequently, the forehead skin is tightened and shortened accordingly. The entire forehead area, including the eyebrows, is effectively lifted as a result. A fresh, smooth and relaxed forehead is the permanent result.

Overall, there is significant swelling and the formation of bruises postoperatively, but these disappear completely.

Brief overview
Duration of the procedure: 60 to 90 minutes
Type of anesthesia: general anesthesia
Hospital stay: outpatient
Fit for social life: after two to three weeks
Price approx. 4300 Euro

To make the lips look fresher and fuller, there are several options. A temporary effect - for about nine months - can be achieved with hyaluronic acid. Depending on the dosage of the amount, it does not have a noticeable effect. In addition, hyaluronic acid attracts water, so the lip skin is no longer dry and brittle.

For a final result, instead of hyaluronic acid, the patient's own fat can be injected as a filler. Fat tissue is taken from elsewhere in the body - under local or general anesthesia, washed and prepared for the planned transplant. The doctor works the fat into the lips in a fan shape so that it is evenly distributed. The effect does not wear off. Therefore, a touch-up is not necessary.

In order to significantly enlarge lips or to compensate for asymmetries, various surgical techniques can also be applied to the oral mucosa to widen the lips. In this case, small scars are created, for example, on the lower edge of the nose (bullhorn excision) or on the lower edge of the lower lip.

Brief overview
Duration: approx. 20 minutes Hyaluronic acid
Stay: outpatient
Fit for society: immediately
Price: 1ml from 300 Euro / 2ml from 500 Euro

With age, the elasticity and resilience of the skin decrease. The tissue in the midface sinks. Other means such as thread lift, autologous blood or hyaluronic acid have perhaps already been exhausted? Then you are optimally advised with a facelift (face lift). With a facelift, whether a large one with a combined neck lift or just a minilift, the skin should not just be "simply" pulled. This can not only widen the scars, it also does not give a long-term result.

The standard procedure is the SMAS lift. SMAS stands for Superficial Muscular Aponeurotic System and refers to the supporting sub-tissue of the facial skin. The actual procedure in the SMAS lift consists of the complex preparation of this tissue under the skin. In this way, the SMAS lift differs from a simple tightening of the skin as it was done in the past. Only at the end, the excess skin in the tightened position is shortened and sutured without tension.

Mini facelift: MACS lift - the smaller version

The MACS (Minimal-Access-Cranial-Suspension-Lift) is a gentle technique whose application is not possible in all cases. The advantage of the MACS lift is that it leaves only small scars, which is why the patient is able to return to social life relatively quickly. It can lead to good results in cases of sagging cheeks and at the same time quite tight neck area, among others. SMAS lifting is also performed in this case.

Brief overview

Duration of the procedure: three to four hours
Type of anesthesia: local or general
Stay: outpatient or inpatient
Fit for social life: after two to three weeks
Price: 3600 Euro to 5900 Euro

The best known ear correction is the creation of protruding ears. Sick ears are a blemish that can be easily corrected with an ear correction. Of course, even at a young age, a surgical procedure can help to create protruding ears or to reduce particularly large ears, but ear correction is also possible in adulthood.

During this procedure, the attending physician exposes the ear cartilage and works on it in such a way that the ear fits without tension. By skillfully shaping the cartilage, the outer contour of the ear is remodeled and then treated with a cosmetic suture. Unsightly asymmetries can also be corrected during surgery.

Correction is also possible for congenital or acquired problems of the ear - such as a lack of protrusion of the lower part of the ear, a lack of folding of the pinna, large earlobes or defective conditions after an injury or tunnel.

Brief overview Creation of protruding ears
Duration of the procedure: 90 to 120 minutes
Type of anesthesia: local or general
Stay: outpatient
Fit for society: after two to five days
Wear a headband for two weeks
Price: complete correction from 3600 euros, partial correction from 2600 euros

Brief overview of reconstruction after tunnel/tear
Duration of the procedure: 30 to 45 minutes
Type of anesthesia: local
Stay: outpatient
Fit for socializing: after one to two days
Price: per earlobe from 450 euros

A neck lift does not always have to be performed directly with a major surgical neck lift. It is also possible to achieve a certain tightening effect only in the area of the middle of the neck by means of liposuction alone.

Also, there is often the problem that the platysma - the superficial skin muscle of the neck has moved apart. This should then be rejoined and sutured via a small access under the chin. This restores good stability and significantly improves the contour. A combination of both techniques is also possible. To clearly define the chin-neck contour, a pressure bandage is then fixed by sutures. This is removed after four to five days.

Brief overview
Duration of the procedure: two hours
Type of anesthesia: local or general
Stay: outpatient
Fit for social life: after two to three weeks
Price: 3600 to 4300 euros

Sweat gland treatment

Botulinum toxin can be injected at defined points in the armpit area, on the hands or feet. It temporarily blocks certain nerve fibers involved in sweat production.

As a result, sweating is reduced to a minimum. Since the effect wears off over time, the injections must be repeated every four to six months. Usually, one or two injection treatments per year are sufficient.

Brief overview
Duration: approx. 20 minutes
Type of anesthesia: local anesthesia with Emla ointment if necessary
Stay: outpatient
Fit for society: immediately
Price: 100 IU from 450 euros

Under local anesthesia or anesthesia, the sweat glands located under the skin are removed using a special suction technique. This is a very gentle method that achieves a permanent result. After that, the doctor applies a pressure bandage for a week. After about two weeks, the stitches are removed from the puncture sites. There is a significant reduction in sweat production, as the proportion of sweat glands is significantly minimized and they do not form again.

Brief overview
Duration: approx. 60 minutes
Type of anesthesia: local or general
Stay: outpatient
Fit for society: after two days
Price: from 2600 euros

Intimate surgery

Too large or too long labia minora and flaccid labia majora are considered disturbing, as they are visible in the external genital area. With considerable impairment and pain, these changes can also affect sexual intercourse and the performance of certain sports (e.g. horseback riding, cycling).

In a labia minora reduction (labiaplasty), the labia minora are minimized by plastic surgery using a proprietary scar-saving technique by removing the excess tissue. This is followed by a harmonious reshaping of the labia minora.

At the end of the operation, the labia minora are ideally enclosed by the labia majora.

Of course, the labia minora can also be reshaped accordingly.

Brief overview
Duration of the procedure: 45 to 60 minutes
Type of anesthesia: local anesthesia, sedation if necessary, general anesthesia if desired
Length of stay: outpatient
Price: from 2,600 euros

Due to pronounced weight loss or the remaining change due to pregnancy, some women desire a firmer mons pubis.

Depending on the individual wishes of the woman, a pure tightening can be performed or this can be combined with a removal of fatty tissue. A retracted painful scar after a caesarean section can also be perceived as very disturbing. In this case, this is also removed in the deep layers and the level of the mons veneris is restored. Depending on the findings, filling with the patient's own fatty tissue may be necessary. Depending on the extent, this may be a health insurance benefit.

We will be happy to advise you on this!

Brief overview
Duration of the procedure: 60 minutes
Type of anesthesia: local anesthesia, sedation if necessary, general anesthesia if desired
Length of stay: outpatient
Price: from 2,600 euros, if purely aesthetic