Why is my dehiscence getting bigger every week? 5 wks post thigh lift. (photos)

Question

I had a thigh lift approx 5 weeks ago and a week later, I had wound dehiscence. It’s got bigger despite continued care from my surgeon. It is being treated with inadine dressings changed daily. It is undermining in every direction despite other small areas which also opened, granulating and epithelialising. I feel like I make one step forward and 10 steps back. At this rate I feel it’s goijg to be open at Christmas! Why is it getting bigger? There is no infection. What am I doing wrong?

J. Timothy Katzen, MD, FACS · Answer

Hello, and thank you for asking why your thigh lift dehiscence is getting larger 5 weeks after your thigh lift.  Thank you for your history in your thigh lift dehiscence pictures.  I am sorry you're having wound healing issues with your thigh lift or thighplasty.  Unfortunately, dehiscence is very common after a thigh lift or thighplasty procedure.   The plastic surgery literature cites up to 70% wound healing problems with thighplasty procedures.  If you have other comorbidities like smoking or diabetes, the risk of dehiscence is higher.
There are multiple reasons for poor wound healing, including anemia, low hemoglobin, poor nutrition, infection, tension on the incision line, rejection of sutures, too much activity, excessive compression on the incision due to the garment,  excess swelling, etc.  All these factors must be addressed and handled to minimize thigh lift wound dehiscence.  
During a thigh lift, there is tension during the surgical closure.  Normal post-operative swelling can also increase swelling.  When a thigh lift dehiscence occurs, a thigh lift incision opens at the point of maximum tension.  The thigh lift wound continues to open until there is no more tension in the wound.  Then, once the tension in the wound has stabilized, the thigh lift wound stabilizes.  Therefore, most wounds get larger before they get smaller.
Unfortunately, there is still tension in your thigh lift wound.  At your stage, your thigh lift dehiscence will continue to open until the tension decreases and eventually stabilizes.    
Fortunately, you can do things to accelerate your thigh lift healing.  First, you need to contact your plastic surgeon for appropriate wound care.  You should strive to eat or drink about 100 g of protein daily.   You should also increase your daily vitamin C, zinc, magnesium, and collagen intake.  In addition, it's very important not to strain the incision by doing too much walking or running.  Also, be sure the garment is not digging into the thigh lift incision.
Regarding wound care, every plastic surgeon has their different technique.  Techniques include wet-to-dry dressings with various solutions, like saline and Dakin's.  Other plastic surgeons use the wound VAC.  The wound VAC applies negative pressure to the incision, removes excess fluid, and stabilizes the wound.  The wound VAC is changed every two days.  Some plastic surgeons would suggest daily or every other day hyperbaric treatment.  Hyperbaric treatment forces oxygen into the wound and accelerates wound healing.  Either way, fortunately, all thigh lift wounds like this heal.  These thigh lift wounds heal by secondary intention, which means they heal from the bottom upward.  Once the wound's depth is filled, the skin edges close.  It is highly doubtful that you will need any thigh lift scar revision once the wound is healed.
Most plastic surgeons suggest you stick with your plastic surgeon and see them frequently.  Consider the other modalities suggested in this post.  Good luck.  I've answered your question regarding why your thigh lift dehiscence is getting larger 5 weeks after your thigh lift.  If you have any questions regarding thigh lift, thigh reduction, vertical thigh lift, medial thigh lift, spiral thigh lift, crescent thigh lift, or thigh lipo, please get in touch with a thigh reduction expert's office.   Thighplasty surgery is difficult.  Thighplasty revisions are even more difficult.  Please seek an experienced, board-certified plastic surgeon with significant experience performing thigh lifts.  Do your research.  Make sure your chosen plastic surgeon has performed at least 100 thigh lifts.  Make sure they have the before and after pictures to prove it.  Carefully examine their before and after pictures and check their reviews on RealSelf.   Sincerely, Dr. Katzen.  (Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, Certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Yannis Alexandrides, MD, FACS · Answer

The most likely explanation is that there is too much tension at the end of the wound. Thigh lift is one operation that requires proper planning, and too much tensions at the edge of the wound can create a dehiscence and delayed healing.

Nick Masri, MD, FACS · Answer

First of all, congratulations on your thigh lift, sasharo0o.
As long as you continue following the instructions of your reputable and board-certified plastic surgeon, your wound will eventually heal. Sometimes, it has to get worse before it can get better, but trust the process that’s usually how wound dehiscence heals.
If you experience any other problems, please don’t hesitate to consult your plastic surgeon.
Best of luck!

Peter Fisher, MD (retired) · Answer

Hello and thank you for your question. Unfortunately that is the nature of the beast. It gets worse for a while then stabilizes and then starts to close (contract).I think the wound looks a lot better. The beefy red look (granulation tissue) is what you are looking for and looks to be increasing. I know this is difficult for you but hang in there. It will get better even if it takes another 6 weeks, which it may well do.Peter Fisher M.D

Why is my dehiscence getting bigger every week? 5 wks post thigh lift. (photos)

Answers (4)

Answer: Dehiscence getting bigger

Answer: Dehiscence getting bigger

Recommended reading

Everything you need to know about Thigh Lift

Our mission is to create a world where every investment in modern beauty is Worth It.

Why is my dehiscence getting bigger every week? 5 wks post thigh lift. (photos)

Answers (4)

Answer: Dehiscence getting bigger

Answer: Dehiscence getting bigger

Browse related questions

Recommended reading

Everything you need to know about Thigh Lift

Our mission is to create a world where every investment in modern beauty is Worth It.