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Fleur De Lis Tummy Tuck, Do I Have Necrosis?

asked 11 months ago by icebaby in Stafford, VA
Latest answer by Alan Engler, MD
Question viewed 865 times
Tags: 2 weeks post-op, black, fleur de lis, necrosis, treatment

I had a FDL TT 16 days ago and I am concerned I have necrosis. First let me say, I am not a smoker, never have been, nor am I around smokers. At the T intersection, I have one area that turned black and bubbled up, after the bubble up area popped and that skin came off it turned into a hard black scab that is sunken. The skin around that area is also hard. It doesn't hurt and it is not weeping but I am concerned that when that black scab comes off there will be no skin there. Treatment???

14 answers to Fleur De Lis Tummy Tuck, Do I Have Necrosis?

Skin necrosis aftermtummy tuck

You have an area of skin loss where the skin lost it's blood supply. This is more of a risk after a fleur de lys type of tummy tuck as the blood supply in the lower tummy is lessened by the vertical scar. The proper treatment is to let it heal on it's own, and I usually only remove the scab if it becomes "mushy" and there is a fluid collection beneath it. There will be a depressed wound but it will heal in and can always be revised later, so don't despair.

Robert M. Grenley, MD
Seattle Plastic Surgeon

Tummy Tuck Complication

Unfortunately, it appears that you do have necrosis of tissue. There are elements of both skin and fat loss. Conservative wound care will heal the wound. Management of this wound should be under the care of the surgeon who performed the surgery. You should heal and if necessary, a revision or touch up I editton this involved area can be performed. It is not unreasonable to believe that you will have the tummy tuck results that you wanted. It... more

Jonathan Berman, MD
Palm Beach Plastic Surgeon

www.drberman.com

Skin Necrosis after Tummy Tuck / Abdominoplasty

Thanks for posting pictures - it makes it much more informative for other patients and easier for us to answer your question. Yes, it does look like you have a small area of necrosis. If you post a before pictures, it may be even more informative to see how extensive of surgery you had. From looking at your pictures, there does not appear to be any surrounding erythema or signs of infection. My advice would be to follow closely with your surgeon. While it will... more

David Shafer, MD
New York Plastic Surgeon

www.ShaferPlasticSurgery.com

You DO have necrosis at lower edge of fleur-de-lis tummy tuck.

I'm glad you are not a smoker or are around anybody that smokes, as this area of dead skin would likely have been significantly larger and more difficult to manage. Poor circulation can occur in tummy tuck flaps even in non-smokers, which is why it is so important to avoid all tobacco products when doing this procedure for the "casual" smoker or non-smoker exposed to nicotine gum, patch, spray, or even second-hand smoke! You do have dead skin--that's the black area.... more

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon

www.mpsmn.com

Possible necrosis after Fleur de Lis Tummy Tuck

You do have some necrosis, which can happen in non-smokers but is much more common in smokers. The area should heal surprisingly well with time and may not even need a scar revision. You will need serial debasements until clean and can use a wound vac but that is expensive and hard to lug around everywhere with that noisy machine. It is just as effective to use good wound care with daily betadine wet to dry dressing changes. After there is healing, the area can be assessed for a possible... more

Richard Dale Reynolds, MD
El Paso Plastic Surgeon

Necrosis following tummy tuck

Yes you do have necrosis and this involves the skin and a degree of the underlying fatty tissue. When this complication occurs it is related to circulation issues and you do not need to be a smoker to have this happen. Fortunately, with good care, this can heal and sometimes patients will need a revision and other times it heals well enough not to. Let your plastic surgeon take care of this for you.

Albert Dabbah, MD
Boca Raton Plastic Surgeon

Fleur De Lis Tummy Tuck Necrosis

RE : "had a FDL TT 16 days ago and I am concerned I have necrosis. First let me say, I am not a smoker, never have been, nor am I around smokers. At the T intersection, I have one area that turned black and bubbled up, after the bubble up area popped and that skin came off it turned into a hard black scab that is sunken. The skin around that area is also hard. It doesn't hurt and it is not weeping but I am concerned that when that black scab comes off there will be no skin there.... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

Tummy Tuck - Fleur De Lis Tummy Tuck, Do I Have Necrosis?

It looks like you do have necrosis, but it's not that much - and it also looks like this will heal well. Of course, you need your own plastic surgeon to assess this, and to oversee the wound care, and to help guide you through the recovery. It is very difficult to make an absolute assessment via this forum. That being said, I think that you will heal well and have a nice result. You will probably go through at least a few weeks of local wound care (dressing changes to... more

Alan Engler, MD
New York Plastic Surgeon

Do I have necrosis?

Yes you do. take the tape off, start wound care. your surgeon will get you through it. the ultimate result may require a revision to be maximized. for now it is important to not let an infection extend the area of necrosis. good luck

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon

It looks like it....

Hello, From what I see you have likely a little bit of necrosis at the junction of the Fleur De Lis where you would expect it might form after such a tummy tuck. You need to have your surgeon see you frequently. These can heal over weeks or months. I would not disrupt it but do what your surgeon advises. Good luck. Best Regards, John Di Saia MD

John P. Di Saia, MD
Orange Plastic Surgeon

Fleur de lis tummy tuck

It looks like you may have an area of necrosis at the "T". More than likely this can heal in on its own but may take several weeks. Smoking certainly can increase the risk, but it can happen to non-smokers as well.

Steven Wallach, MD
Manhattan Plastic Surgeon

Wound necrosis after a tummy tuck

I agree with the others that you do have an element of necrosis at the "T" junction of the wound. Debridement and dressing changes plus a wound vac will help this heal. Please stay extremely close to your doctor through this healing process.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Looks like you have necrosis on T junction

From the picture, looks like you have necrosis. I would debride the necrotic tissue, and start wound VAC therapy to facilitate the closure.

Adil Ceydeli, MD
Panama City Plastic Surgeon

Treatment of skin necrosis after tummy tuck

It does appear by this photo that there is a small area of at least partial skin necrosis. This can occur at the T incision area even if you are not a smoker because this is the tip of the skin flaps to close the incision. The best treatment is careful observation as the depth and extent of skin loss will become more apparent within a couple weeks. Need to watch for redness or drainage and treat as needed. This may require some debridement and dressing changes. This may heal with minimal... more