8 weeks post-op. Why isn't my incision fully healing? (photos)

Question

Why isn’t my incision fully healing? At 6 weeks PO It Started out as swelling than the doctor squeezed it to drain said no sign of infection. And now this is happening. It’s frustrating because I am a healthy person and now this is causing me to not workout.

Pejman Aflaki, MD · Answer

Hello and thank you for the question. Wound breakdown after tummy tuck can be from a variety of reasons, including excessive tension on the incision from taking too much skin, poor blood supply from aggressive liposuction, and smoking among others. I would closely follow with your surgeon. These wounds should heal spontaneously with local wound care. Once everything has healed, then a revision surgery can be done in a delayed fashion to correct the widened scar, if ever needed. I would keep the area clean and avoid any strenuous activity/lifting and smoking (if you are a smoker). Your surgeon is the best person to talk to.

Alexander Zuriarrain, MD, FACS · Answer

Hello, It looks like you have an area of wound separation which is not that uncommon after an abdominoplasty. Some patients have delayed healing which can occur due to nutritional deficiencies or their overall health status. I would suggest seeing your plastic surgeon for further insight. A stitch abscess is always a possibility.
Best of luck!
Alex Zuriarrain, MD
Cleveland Clinic Trained Plastic Surgeon

Kenneth Hughes, MD · Answer

Based on your submitted photos, this may be a little incision inflammation (or incision separation) or stitch abscess.  However, your PS has ruled out an infection related to a stitch abscess.  Continue to follow your PS's post-operative guidelines for wound care.Kenneth Hughes, MD, ABPS Board Certified Plastic SurgeonLos Angeles, CA

James H. Rogers, MD · Answer

From your photos and the information provided, you most likely are experiencing suture related problems or a process called fat necrosis. Both are not uncommon after tummy tuck and can lead to wound healing issues. Fat necrosis occurs when areas of fat tissue don't have adequate blood supply and the fat dies. This may present much like infection with swelling, redness , warmth, and have yellowish drainage . Once the area has drained or been debrided, it can go on and heal. Suture reactions typically will present with discomfort.and swelling, and may open to the surface. Removal of the offending suture will generally allow the wound to heal. In our practice we would permit you to proceed with most exercise at this point other than core exercises like situps. I recommend following your surgeons instuctions, however, for best results.

Daniel Barrett, MD · Answer

Dear danswoman85,
this type of wound is not uncommon after tummy tuck. It is usually caused by poor blood flow. I would suggest you to consult your plastic surgeon, follow your surgeon's instructions and keep your wound clean and covered. It can take few weeks or months for wound to fully heal. 
Daniel Barrett, MD

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs and I am sorry to hear of your healing difficulties.  Based on the pictures supplied it appears that you are having a suture related issue termed a stitch abscess.  These localized areas of infection can cause the incisions to separate as your body tries to push out the material.  This will heal in time with local wound care so keep in close contact with your surgeon in order to ensure no further issues.

Camille Cash, MD · Answer

An exam is needed to know for sure but you may have some suture knots that need to be addressed.  This can be done in your surgeon's office.  Once removed the area tends to heal well with minimal home care.  See your surgeon for an evaluation.

Connie Hiers, MD, FACS · Answer

Your surgeon who has examined you will be the best one to ask. However, you may be reacting to the suture material used. Once dissolved, things should hopefully settle down, unless you have an infection.

Tahira Prendergast, MD, FACS · Answer

Thank you for your question. Sometimes deep sutures 'spit' and cause little suture abscesses that result in these little open areas. I would suggest you follow the advice of your plastic surgeon and they will heal up in no time. Good Luck.

Chad Robbins, MD · Answer

Hello and thank you for your question and photo's.  It looks like you have a few stitch abscesses which aren't unusual and will heal on their own.  You may or may not need a scar revision down the road.