What can be done next? I feel like there is no hope (Photos)

I feel like my doctor keeps telling me it will get better eventually & it's not. I have had 2 surgeries already the first TT WAS 8/29 & he had to go back in and remove 2 more inches due to wound necrosis. Now I'm 3 weeks out of my 2nd surgery & it's been reopening again & just getting worse! I need to know what other options there are because I feel like I'm never going to be able to work again & now I have horrible pain.

Doctor Answers 5

Wound healing problems and tissue necrosis after tt

Hi jayden

Let me first say that I am so sorry that you are experiencing these problems.  Let me also tell you a few things to help your emotional situation.  

This type of complication sadly, will happen no matter how goo the surgeon is, and no matter how "good" the patient is.  You have a fairly long area of tissue necrosis, and it will take many weeks to heal, so strap in, have a talk with yourself, and muster all the patience you can- impatience will only make this worse.  Know that you WILL heal and likely still have your excellent result with a nice scar.

My recommendation to you is to visit with your doctor, and make him aware that you are having pain and that is new.  He should be able to prescribe pain pills.

Next is the question about wound management.  Discuss this with him.  It is my opinion that you have an accumulation of more fat necrosis, and some inflammation.  Without any knowledge about your case or medical conditions, I will make some suggestions that obviously must be taken with a pinch of salt, and take a back seat to what your doctor says.

I think that antibiotics (oral) may be appropriate, either to treat or prevent infection.  There is a chance that this will heal without additional surgery, however I think that will be a longer period of healing.

I think additional surgery should be considered.  New onset of pain may be an indicator of infection.  Still, I think it may be beneficial to clean out aggressively all necrotic and unhealthy tissue.

The next decision is what to do with the wound at this point.  You may decide to close it again with a drain, or, you may decide to leave the wound open to heal in a delayed fashion.  The latter would likely be the safer and surer bet.  The open would could be treated with packing or VAC wound closure.  Both are acceptable, but he VAC requires less input from you and will help the wound heal faster.

Discuss this with your doctor and decide on a next step.

Most importantly to you. keep your chin up, you will get through this and be fine.

One final thing- if you smoke, stop.  If you are around second hand smoke-get away from it. If you have medical conditions like diabetes, high BP, etc, get them under control right now.  Be sure that you eat plenty of proteins, and calories so that you can heal.

All the best.

sek

What can be done next? I feel like there is no hope (Photos)

Thank you for sharing your question and photographs and I am sorry to see your wound healing difficulties. Unfortunately whether due to issues with skin tension, swelling, blood supply, or sutures your incision line has areas of separation.  These will need to heal on their own from the inside out to avoid a possible infection.  I would counsel you to be in touch with your surgeon so that they can give you appropriate wound care recommendations to speed the healing process.  Best wishes.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

What can be done next? I feel like there is no hope

While it is not appropriate to make a diagnosis and treatment plan based on pictures, you can see another plastic surgeon if concerned about your care. However, first have a discussion about your concerns with your plastic surgeon.

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 65 reviews

What can be done next?

Hello dear, thanks for your post and provided information and pictures as well. I am sorry to hear about the complication.  Superficial separation of the incision line is a known complication after tummy tuck surgery.   Close follow up with your plastic surgeon will be the best thing you can do now; this can have multiple causes including poor nutrition post-op,  smoking and increased tension. Please keep in total comunication with your surgeon and make sure that he or her is a board certified plastic surgeon~!

Good luck :)

Tania Medina de Garcia, MD
Dominican Republic Plastic Surgeon
4.6 out of 5 stars 358 reviews

Wound healing issues after a tummy tuck

Thanks for the question.  I am sorry to hear about your issues with your tummy tuck.  It appears based on the photos that your wound healing issues may be related to an underlying infection.  It also appears the wound is under some tension which will result in compromised healing.  At this point, if no evidence of ongoing infection exists; draining pus, dead tissue, or extensive redness around the wound, local wound care is the only option.  This involves frequent dressing changes and possibly placement of a wound vac to encourage healing.  Make sure to followup with your plastic surgeon often to check that the wound is trending in the right direction.  If you are unhappy with your care, a second opinion may be in order.  In any event, you are looking at a prolonged healing course.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.