Plastic surgeon consultation before rhinoplasty in University Hospital of Ludwig Maximilian University of Munich

About the department

The Department of Plastic, Aesthetic and Reconstructive Surgery, Hand Surgery at the University Hospital of Ludwig Maximilian University of Munich is among the leading plastic surgery clinics in Germany and throughout Europe, offering its patients a comprehensive spectrum of services in its areas of specialization. The department's team of skilled surgeons performs reconstructive plastic surgery to repair defects caused by injuries, cancer, and infectious diseases, restoring both function and patients' self-esteem and confidence. Patients who want to make some improvements in their appearance without a medical indication are provided with excellent aesthetic plastic surgery services, including facelifts, otoplasties, rhinoplasties, body lifts, breast augmentations, and anti-aging procedures with Botox and fillers. Another important clinical focus for the department is hand surgery, dealing with finger, hand, and arm replantation, reconstructive surgery for congenital malformations and severe hand injuries, treatment of nerve compression syndromes, such as carpal tunnel syndrome and ulnar nerve compression syndrome, and many other clinical conditions. A team of 17 highly qualified surgeons is available here to provide top-tier medical care in two state-of-the-art operating rooms. The specialists prefer to use modern surgical techniques and high-quality materials in their daily clinical practice, which contributes to outstanding therapeutic and aesthetic results. Another important fact is that the department has been accredited by the German Trauma Society as a Center for Severe Hand Injuries – this accreditation underscores the department's expertise in treating serious hand injuries sustained in the workplace.

The Head Physician of the department is Prof. Dr. med. Riccardo Giunta, who has a wealth of clinical experience and consistently achieves high treatment success rates. Notably, Prof. Giunta was part of a renowned team of plastic surgeons who were the first in the world to perform a bilateral full-arm transplant. This event marked a significant breakthrough in medicine, opening a new era of reconstructive plastic surgery. Prof. Riccardo Giunta became the president of the European Society for Plastic, Reconstructive and Aesthetic Surgery (ESPRAS) in 2023, which is also a remarkable accomplishment.

Reconstructive plastic surgery is one of the department's priority areas of specialization. The most in-demand procedure in this field is breast reconstruction surgery for women who have undergone a mastectomy for breast cancer. For most patients, a mastectomy represents a profound loss that affects their sense of femininity. The department's surgeons' mission is to restore breast aesthetics alongside a woman's self-esteem. Plastic surgeons work in close cooperation with the Breast Center and the Department of Gynecology and Obstetrics, offering comprehensive medical care. The department's doctors use silicone implants or autologous tissue to perform breast reconstruction surgery. A common autologous option is DIEP flap surgery that involves removing a skin flap from the lower abdomen (other flaps can be taken from the buttocks or thighs) along with the underlying subcutaneous adipose tissue, nerves, and blood vessels. These tissues are then transplanted to the site of the removed breast. Using microsurgical techniques and specialized instruments, plastic surgeons can suture blood vessels together to provide a blood supply to a reconstructed breast. Although DIEP flap surgery is considered complex, the department's specialists regularly perform these operations and achieve excellent outcomes.

For many years, the department's plastic surgeons have been providing effective lymphedema treatment. This condition is characterized by chronic swelling of the legs or arms, often with a feeling of heaviness. It develops due to impaired lymphatic drainage, resulting in the accumulation of lymph in the intercellular space and an increase in the volume of the lower or upper limbs. The mainstay of treatment for lymphedema is conservative therapy. However, in some clinical cases, a microsurgical procedure may be required. The department's surgical options include vascularized lymph node transfer, lymphatic vessel transplantation, and lymphovenous bypass surgery. The purpose of these interventions is to create new pathways for lymphatic fluid to flow out of the affected limb. The optimal procedure is selected based on preoperative diagnostic tests. After surgery, patients stay under constant medical supervision. Doctors also apply compression bandages and perform manual lymphatic drainage. It will take several months after the operation to assess the final results of the surgical treatment.

The department offers many plastic surgery options for patients after bariatric surgery or massive weight loss through diet and exercise. Significant weight loss can affect the body's appearance, leading to sagging skin. In addition to these aesthetic issues, functional disorders may also occur, including limited mobility and recurrent inflammatory processes in the groin and armpits. The department's plastic surgeons assess the extent of skin sagging, identify the areas of the body that are most problematic, and take full-body images of the patient. These images are processed using a special 3D visualization program that allows doctors to simulate the expected result from different angles before surgery. The following types of plastic surgery can be performed by the specialists, based on the most problematic areas of the body following weight loss: abdominoplasty (tummy tuck), torsoplasty (back lift), mastopexy (breast lift), femoroplasty (thigh lift), brachioplasty (arm lift), or several of these surgical procedures at the same time. The department's plastic surgeons are highly professional specialists who routinely perform these procedures, and therefore patients can expect results of the highest professional standard.

Aesthetic plastic surgery is also an integral part of the department's medical services. These operations are performed at a patient's request, not based on medical indications. The most requested surgical procedures for the head and face include facelifts, neck lifts, forehead lifts, blepharoplasties, rhinoplasties, and otoplasties. Patients also benefit from effective injection procedures using Botox, fillers, and autologous adipose tissue to treat wrinkles. The most frequent requests from patients for body aesthetic plastic surgery are breast augmentations, breast lifts, abdominoplasties, liposuctions, body contouring, and body lifts. A computer-assisted simulation of the expected outcome of aesthetic plastic surgery can be performed whenever necessary before the procedure – this approach aims to ensure each patient is fully satisfied with their new appearance.

The department also has decades of successful experience in the treatment of hand diseases and injuries. The clinical focus of surgeons in this field is on finger, hand, and arm replantation surgery, reconstructive procedures for congenital malformations and severe hand injuries, as well as treatment of nerve compression syndromes, Dupuytren’s contracture, and rheumatic hand conditions. The department's specialists prefer conservative therapy whenever possible. However, many cases still require surgery. The department is equipped with state-of-the-art operating rooms capable of performing hand surgeries of any complexity, including challenging finger and hand replantations.

The department's range of surgical services includes:

• Reconstructive plastic surgery
  • Reconstructive surgery after mastectomy: silicone implants and DIEP flap surgery 
  • Reconstructive surgery for breast and nipple malformations and asymmetries
  • Reconstructive surgery after injuries
  • Reconstructive surgery after soft tissue tumor removal
  • Reconstructive surgery after skin and mucous membrane tumor removal
  • Reconstructive surgery after head and neck tumor removal
  • Reconstructive surgery after bone tumor removal
  • Reconstructive surgery for pressure ulcers
  • Reconstructive surgery for burns in all areas of the body
  • Reconstructive surgery for facial paralysis
  • Reconstructive surgery on the brachial plexus
  • Reconstructive surgery for lymphedema: vascularized lymph node transfer, transposition of the lymphatic vessels, and lymphovenous bypass surgery
• Aesthetic plastic surgery
  • Head and neck aesthetic plastic surgery
    • Facelift
    • Neck lift
    • Forehead lift (endoscopic techniques)
    • Eyelid lift
    • Nose reshaping (rhinoplasty)
    • Ear reshaping (otoplasty)
    • Anti-aging Botox, filler, and autologous adipose tissue injections for treating wrinkles
    • Scar revision: laser and surgical techniques
  • Aesthetic body plastic surgery
    • Breast augmentation, reduction and lift, including gynecomastia treatment in men
    • Abdominoplasty
    • Liposuction
    • Body contouring
    • Body lift
    • Scar revision: laser and surgical techniques
• Hand surgery
  • Finger, hand and arm replantation
  • Reconstructive surgery for congenital malformations
  • Reconstructive surgery for severe hand injuries
  • Surgical and conservative treatment for compression syndromes: carpal tunnel syndrome, cubital tunnel syndrome, etc.
  • Surgical and conservative treatment for hand fractures
  • Surgical and conservative treatment for hand nerve injuries
  • Surgical and conservative treatment for Dupuytren's contracture
  • Surgical and conservative treatment for ganglion cysts of the wrist and hand
  • Surgical and conservative treatment for wrist osteoarthritis
  • Surgical and conservative treatment for wrist pain
  • Surgical and conservative treatment for hand tendon injuries
  • Surgical and conservative treatment for trigger fingers and inflammatory processes in the hand
  • Hand tumor resections
• Other medical services