Is there any way to avoid necrosis after tummy tuck surgery?

Dear NewBodi16,
The circulation is always reduced and most vulnerable in the midline just above the middle of the incision. There is always going to be risk of skin or fat necrosis. Smoking is an absolute no no because carbon monoxide displaces oxygen delivery to the tissues and the nicotine causes constriction of the blood vessels. If the tension on the flap being pulled down is too tight, this will also contribute. Patients should walk bent at the hips in order to relieve tension on the incision. Preoperative selection is important that the fat layer under the skin is not too thick.

I hope this has been helpful.

Robert D. Wilcox, MD

Yes; there is a way to minimize skin necrosis. Traditionally a tummy tuck is done by undermining / undercutting skin from the lower abdominal incision all the way to the rib cage. This disconnects all the blood vessels attached to the skin that has been undercut. I do a modified version of a tummy tuck that preserves most of these blood vessels; this technique (pending trademark) also allows me to do aggressive liposuction at the same time, something that cannot be done with the traditional technique. Although the risk is still there (especially in a smoker), it is as low as it gets. I have personally never had skin necrosis with this operation using the technique I use.This technique also helps me remove more excess skin (as the attached photo will show), and still keep the scar very low, something the traditional TT  technique cannot do.