How to Care for Beginning Stage of Necrosis on Non Smoker Mid TT Incision? (photo)

Im 17 days PO and I think I have necrosis on my mid TT incision. Im 35, 5'3 158 lbs, nonsmoker, non-diabetic. full TT w/MR and lipo including inner thighs. My mons & thighs have had alot of swelling, better, but mons is still very large and not I am noticing one big bad spot in middle of incision and a few others. It's the weekend, what should I do to care for this the next 2.5 days until my office is open? Am I possibly doing something wrong during the healing faze? I am very nervous. Thanks.

Doctor Answers 9

Possible wound healing problems after an abdominoplasty

It would be unusual for ischemia or necrosis to present so late in your post operative course.  I you begin to notice blistering or separation of the wound with redness, drainage and swelling then notify you surgeon immediately.  There should be an on call physician to answer your questions and concerns.  

Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

17 days post-op tummy tuck and lipo--necrosis worries.

At 17 days post-op you are not showing clear evidence of skin necrosis, but there is ample reason for swelling at this point, including not only the tummy tuck itself, but the lipo you had. Subcutaneous fat necrosis could be present, but this is not evident by looking at the wound or photographs, and takes time and physical examination to determine. Seems unlikely in a non-smoker, non-diabetic whose wounds are healing like yours are appearing to!

You have some (normal) incisional irregularities due to swelling, but this does not look worrisome in the photographs you included (thanks). You are much more likely to be in the beginning phase of healing rather than the beginning stages of necrosis. ("Too much" online research only begets excessive worry!)

I'd keep your compression binder on (secure, but not overly tight), follow your doctor's restrictions, and perhaps give him/her or the answering service a call if you are still worried. This actually looks pretty normal for now, and will continue to improve  as the weeks go by! Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

How to Care for Beginning Stage of Necrosis on Non Smoker Mid TT Incision?

    You have bruising and swelling, but necrosis does not appear to be present.  If there are any fluid collections, they will have to be addressed.  Kenneth Hughes,  MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

How to Care for Beginning Stage of Necrosis on Non Smoker Mid TT Incision

From the pictures no obvious signs of necrosis. You do have swelling that is normal at this stage. It is hard to tell with out proper exam and previous pictures during recovery. Contact your surgeon and send him the pictures by email or cell phone to insure he is comfortable with your healing.

How to Care for Beginning Stage of Necrosis on Non Smoker Mid TT Incision?

No I see no necrosis after 17 days! Best to discuss wound edge healing with your chosen surgeon. Appears very normal healing to me. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Skin Necrosis after Tummy Tuck?

Based on the pictures and information you submitted it does not look like there is any necrosis developing. Rather, it looks like the normal healing process with a few scabs.

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 71 reviews

How to Care for Beginning Stage of Necrosis on Non Smoker Mid TT Incision

You should have a number to reach your surgeon or whomever is covering for your surgeon. I really don't see anything particularly alarming. If you are not able to get in touch over the phone, try to keep the area in question moist using an over the counter antibiotic ointment covered with a non-stick guaze-xerofrom, adaptic, telfa, or any similar product. 

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Treating wound necrosis

I agree that this may not represent wound necrosis. However, you should not self-treat before speaking to your plastic surgeon.  Regardless of whether the office is closed over the weekend, there should be an emergency contact number and, given your concern, you should page your doctor or the covering surgeon and comply with the instructions given.  Best of luck.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 42 reviews

Small Healing Issues

Thanks for the photo and question.  I would cover it with dry gauze daily until you can see your PS.  I would also call your PS's office even though it may be closed you can have the PS paged to return your call so than you can ask him/her directly as to what should be done.

Dr. ES

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.