Scab 9 Weeks After Tummy Tuck?

     If this area has not healed after 9 weeks, make an appointment with a local plastic surgeon for an assessment.  Wound care by itself may not help the area heal and some dead tissue or foreign bodies may be hindering healing.  Kenneth Hughes, MD Los Angeles, CA

If you thought it was a good idea to have elective surgery in Mexico, why didn't you stay there long enough to make sure there was no problem, or return to your surgeon when you found out later that you did have a problem. Talking to your surgeon over the phone has certainly proved to be inadequate post-op care, yet it is he you paid for the surgery (and whatever post-op care you received).

Seeing a family doctor near your home in Canada has proved equally fruitless. So now you're trying for "free" assistance online, yet this answer is costing me time and unfortunately won't do you much good, since what you need is a board-certified, properly trained, experienced plastic surgeon to deal with your complication in person and get you out of this 11-week-old mess.

I'm not saying that having your cosmetic surgery closer to home would have prevented having a problem with wound healing--but then again, maybe it would have, since you would have had regular recheck visits to determine if there were any problems developing, and received expert advice on how to treat such concerns before they became bigger, longer-lasting, and potentially very dangerous or even fatal consequences of this "scab." I'd say you've been lucky thus far treating this on your own, because there are plenty of disasters that started with "superficial openings" that now are "quite deep and about one inch in length" nearly 3 months post-op!

Your wound requires examination in person by a qualified plastic surgeon, probably surgical debridement, appropriate open surgical wound dressings on an ongoing basis (this almost certainly can't be simply re-closed--it will get infected and fall apart), allow the wound to granulate and heal, and then, after proper scar maturation, re-excision and reclosure. Not possible online, or by a family doc, and in reality, the proper follow-up care of the surgeon you chose to do your surgery.

But you're in Edmonton, and he's in Mexico, so you will have to beg mercy of a local plastic surgeon (equally or more qualified than your Mexican surgeon who likely charged less for a reason) who you initially spurned in favor of surgical tourism. S/he will not likely be happy taking care of someone else's problem, and should not be expected to do so "for free."

I'd consider charging double, but then again, we don't really charge a "stupid tax," so I'd smile, take care of someone else's mess (hope they are a worthy surgeon who just had bad luck) and quietly seethe about another patient who thought it would be a "fine idea" to have a surgical "vacation" or save a buck at my expense.

Sorry about the tone of this response, but online anonymity does allow me to be more pointed than I would be in person. You're probably a nice person who didn't really think this out very well, and now you're in a pickle of your own making. So fo those prospective patients who think "cheap surgery" by "well-qualified surgeons" elsewhere is a good idea, please consider that this could have been a portal for serious infection that destroyed the entire abdominal skin, or a large portion of it, leaving horrific scarring or a dead patient.

Please be honest about your problem as you seek someone kind enough to tackle this wound. We do unfortunately see this all too often. Best wishes. Dr. Tholen

suggests you experienced some tissue loss.  I believe moist wounds heal faster than dry wounds and if you were my patient, you would be using saline moistened gauze in the wound (packing it) 1-2 times a day and if you have a lot of compromised tissue, they would have office debridements  as needed to facilitate the process.  Unfortunately, going abroad has its shortcomings and you are experiencing one of the.  If it isn't getting better, you should see our local plastic surgeon for further advice, and yes, it will likely incur fees.