Do blood vessels regrow or is the blood supply permanently diminished?

Question

What happens to the blood supply after abdominoplasty? I know that the abdomen is undermined down to the fascia overlying the abdominal muscles. I know blood vessels, lymphatic vessels, and nerves are severed, running vertically from the muscle to the skin. I also know that this restriction of the blood supply is one reason why it is dangerous to combine abdominoplasty with liposuction of the upper abdomen. Do these regrow in the new skin flap? If so, do they regrow to the same extent of coverage as prior to surgery? Over what period of time?

Fouad V. Atalla, MD · Answer

The existing blood vessels in the skin flap will grow to establish a new network of blood vessels. Nerves will also, to an extent, regenerate and return sensation to much of the remaining skin flap. Although this takes a much longer period of time and may never restore complete and normal sensation, especially in the midline immediately above the incision. Lymphatics will also grow in the existing skin flap. Nerves and lymphatics are much slower than the blood vessels so it is hard to declare a specific period of time in which these things will occur.

Kenneth Hughes, MD · Answer

You do have some advantage in performing surgery in a previous area as long as you have waited enough time for creation of more robust vasculature in the areas that have not been transected.

Nelson Castillo, MD · Answer

Thank you for sharing your excellent question.  The majority of the blood supply that remains comes from both named arteries as well as arborization of others to maintain the viability of the skin.  Over time there is some angiogenesis and new vessel creation between the muscle fascia and tummy tuck flap of skin but the vessels are not to the same size as the original ones.  Hope this helps.

Camille Cash, MD · Answer

Yes blood vessels will regrow after surgery.  Due to blood supply concerns it is not recommended to have liposuction of the abdomen at the same time as a tummy tuck.  However it is safe to do so once fully healed from surgery.  Generally you will want to wait 6-12 months after surgery to have liposuction.

Charles Nduka, MD · Answer

Some studies have shown that blood vessels can regrow into the abdominal area after surgery. However, there are limited information as to how much they can regrow and how fast. Usually, blood supply into the abdomen after surgery does not cause complications and is of little concern post op depending on the skills and techniques used by your surgeon. Be sure to select a board certified plastic surgeon with ample experience in these kind of surgeries to make sure you are properly cared for.

Matthew A. DelMauro, MD, FACS · Answer

Hello! Thank you for your question. (Keep in mind that an in-person consultation is necessary for the best advice.) Studies have demonstrated that arteries, veins, nerves, and lymphatics can regrow into the abdominal flap. Unfortunately not enough of these studies have been done for us to know the extent and the speed of this regrowth. 
If you decide to pursue surgery it’s very important that you find a surgeon whom you are comfortable with and trust and who evaluates you in-person and tailors an individualized treatment plan for you and your aesthetic goals. Best of luck
Matthew A. DelMauro, M.D

Do blood vessels regrow or is the blood supply permanently diminished?

Answers (6)