Fat Necrosis After Tummy Tuck. What to Do? (photo)

Hi there

This is a minor but annoying problem.  I've seen it many times in my practice.  The problem is not that it will compromise your result, but that it just takes a long time to settle down so it gets a bit frustrating.

The wound will heal, but it will take it's time.  Just use local wound cleaning measures to keep it clean and avoid infection.  Talk to the practice nurse at your surgeons office for advice about this.

Once healed, there will be a thick hard lump under the scar for up to a year.  Sometimes it is better after a few months for the surgeon to excise the scar itself in a few months, just to get rid of the hard lump underneath it.

The lump will not give you a poor result, it just feels like an annoying lump that's all.  It's easily fixed if it doesn't seem to be going away.

Any surgeon doing a large volume of abdominoplasty (tt) surgery will see this reasonably often. Don't feel too bad about it, it's easily dealt with.

Good luck!

Hello,

Its possible that it may be fat necrosis.  The overlying skin is alive and appears healthy so we know that there is some blood supply that is getting to that area.  The second issue is that there is no way to tell how much fat necrosis there is if any.  It might only be a few percent and the body may be able to clean this up on its own.  What you are likely feeling is essentially the extra edema that the body is creating in that area to help clean up the fat issue.  At this time I would continue doing what you are doing.  Stay well hydrated, avoid smoking or nicotine, and keep the area protected.  It will continue to get smaller and better on its own.

All the best,

Dr Repta

Sounds like your chosen PSs is treating you correctly. It takes time to heal this area, about 2 months on average. 

Thank you for the question and picture.

Fat necrosis will usually resolve by liquefaction ( will liquefy and drain or be absorbed). You may find that the area of firmness will gradually decrease in size and soft you may find that you will have drainage for a period of time from the incision line.

You should follow up closely with your plastic surgeon to look for signs of infection in the area given that the blood supply is (by definition) limited in this area.

I hope this helps.

The good news is that fat necrosis will generally improve over time. What should happen is that the area of firmness will slowly get smaller and softer. At about 6 months postop you will be able to see what is left. At that point, if the area is still large, a revision/excision may be necessary. Good Luck!