Revision tummy tuck five years later - what is the risk of necrosis? (Photo)

Question

I had a TT in 2021. I was left with a firm bulge in my lower abdomen. I also had Lipo on my back and arms. My arms were overly done and left me with saggy skin on my upper arm. I am scheduled for a TT revision and a mini arm lift in a month. I know that there is a greater risk for necrosis and infection with revisions since there has already been trauma on those areas. Given that it’s been 5 years, I am in good health and not a smoker, what can I do to further Reduce risks? How worried should I be?

George Marosan, MD · Answer

Thank you for your question and photo. While skin necrosis is a known potential risk in any abdominoplasty, careful preoperative planning and surgical technique are designed to minimize this possibility. As a Total Definer surgeon, I routinely use VASER liposuction with revision abdominoplasties and incorporate hyperbaric oxygen therapy postoperatively to optimize healing. Because every patient's tissue and vascularity are unique, I encourage you to thoroughly discuss your specific risk factors and concerns with your board-certified plastic surgeon. Good luck with your scheduled surgery.

Frank Agullo, MD · Answer

I want to put the fear of this revision down for you, because a revision in the five year window is safe. Your skin already regained its blood flow from the sides, the scar is healed, and the flap that felt fragile back in 2021 is not fragile anymore because it has regrown blood supply from all around. That is the delay phenomenon, and it works to your advantage. What threatens a flap is not reopening the tummy tuck, it is aggressively liposuctioning fat out of the same flap you are tightening, having even a little nicotine in your system from a vape, patch, or gum, unmanaged blood sugar, or simply closing too tight. You are healthy and you do not smoke, so you are already in the safest group for this. I would stay off nicotine for several weeks before surgery, follow the protein-heavy diet your doctor recommends, avoid gaining weight between now and surgery, and ask your surgeon not to undermine or lipo that flap heavily all at once. Your arm lift has its own blood supply separate from the tummy tuck, so combining them is usually fine. That firm lower bulge I would want to feel standing up, since fat, fascia, or a small hernia each lead to a different repair.

#StayBeautiful,

@RealDrWorldWide

#StayBeautiful,

@RealDrWorldWide

Revision tummy tuck five years later - what is the risk of necrosis? (Photo)

Answers (2)

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