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Fat Necrosis After Tummy Tuck What to Do? Update (photo)

asked 6 months ago by Sue1948 in Wichita, KS
Latest answer by Tom J. Pousti, MD
Question viewed 527 times
Tags: necrosis, odor, worried, wound

Thank you for the answers to a question about fat necrosis after TT I posted 15 days ago. Now I am worry again. My PS cut part of a scar making one big wound instead 2 smaller; cleaned the wound with instruments, and told me to wet a gauze with tap water and pack a wound twice a day. A couple of days ago I noticed bad odor from a would. I have no fever or pain. Is it a new complication or a normal step in treatment?

Previous Question

10 answers to Fat Necrosis After Tummy Tuck What to Do? Update (photo)

Fat Necrosis Treatment?

Thank you for the question and updated photos. I think you and your plastic surgeon are treating the fat process appropriately. It may be that, given the new onset odor, that further debridement will be beneficial. Your plastic surgeon will be in the best position to determine the need for debridement once he examines you. Generally speaking, it is best to allow for the unhealthy tissues to “declare themselves” ( as yours has done). This will prevent unnecessary... more

Tom J. Pousti, MD
San Diego Plastic Surgeon

www.poustiplasticsurgery.com

Necrosis after tummy tuck

Time and local care are what you need right now. Frequent moist to dry dressings are beneficial. You can use either saline or Dakin's solution ( roughly 1 part Chlorox to 19 parts sterile water). Oral antibiotics are not necessary unless you are running a hig fever, have increased redness or a positive culture.Then at least 6 months after the wound has filled in the widened scar can be reexcised and closed. I know this looks very bad to you. Stick with your surgeon and... more

Ann F. Reilley, MD
Baton Rouge Plastic Surgeon

www.plasticsurgerybr.com

Necrosis of skin of lower abdomen following a tummy tuck

Your healing issue is not a rare phenomenon with tummy tucks and should ultimately heal. You may need more aggressive treatment of the wound such as debridements by your plastic surgeon who may need to follow you twice a week. An antibacterial dressing may be more effect such as silvadene. Make sure that you are on a well balanced but high protein diet. Finally, if you are smoking or exposed to smoke: STOP! This is very detrimental to healing.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon

www.turkeltaub.com

Fat Necrosis After Tummy Tuck What to Do? Update (photo)

Thanks for the photos. Aggressive deep wound care is the initial course to proceed. Are you following with your surgeon on a 3 times a week visits? Other options are operative debridement, oxygen therapy, wound vac. The odor is due to the necrofication and bacteria of the necrotic tissue.

Darryl J. Blinski, MD
Miami Plastic Surgeon

Abdominoplasty wound from fat necrosis now smells. What to do?

Odor relates to bacteria residing in warm, wet, dead tissue. Better cleansing will eliminate this. To accomplish better wound care, you should perform more dressing changes per day, let the dried "stuff" stick to the gauze as you pull it away (in other words, do not moisten the dressing so it comes out easily), and feel free to gently scrub the wound with a soft-bristle toothbrush! This accomplishes what your surgeon did when he "cleaned the wound with instruments."... more

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon

www.mpsmn.com

Fat necrosis after tt

When there is fat necrosis it means a strip of fat is dead. Your ps has debrided or cleaned the dead fat out which is good. But there is always still a little patchy bit of fat necrosis left which will take time to separate and come out on the dressings. This is the reason for the packing. If you change the packs often it will lessen the odor which will diminish over time anyway. You are being well and appropriately managed all the right things are happening but it's a slow and... more

Howard Webster, MBBS, MBA
Melbourne Plastic Surgeon

www.arcplasticsurgery.com.au

Odor is likely the residual fat necrosis

Hello, With an open wound and with the dressing changes you describe your body will be able to get rid of the dead fat/tissue and form healing tissue (granulation) behind it, essentially filling the wound in from the inside out. What you are likely detecting in terms of odor is residual fat necrosis and the bacteria that wants to grow in it. Sometimes when this happens changing your dressing regiment to add a solution that kills some of the bacteria may be helpful.... more

Remus Repta, MD
Phoenix Plastic Surgeon

You will be ok

This is a rare complication of the tummy tuck that will heal. You will to follow your surgeons recommendations. The wound looks bad now,but it will heal fine and you will need local scar revision in 6 months. The other option to expedite the healing is wound vac. This may cost you extra ,but will shorten the healing time.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

Wound Healing Problem

You need to see the doctor and get either more debridement or change your dressing routine. Usually a bad odor reflects dead tissue.

Steven Holzman, MD
Austin Plastic Surgeon

Open wounds and tummy tucks

Yes you appear to have had a complication resulting in an open wound that is being treated appropriately. If you are noting an increase in odor of discharge you should see your PS. You may need to change your dressings more frequently.