What could have caused my tummy tuck incision to heal this way and can this be revised? 1 year post op (photos)

Question

Had tummy tuck over a year ago. My incision never healed. I spent 9 months packing and cleaning a wound that was 4 inches around and deep. It eventually healed but I am left with an awful scar that is pink, probably still 4 inches round and looks awful. What is it that happened and why? I was told a revision could be done but at a price. Is this normal? Thank you - very nervous to go back to same doctor.

Fernando Ovalle Jr., MD · Answer

Hello and thank you for your question. Wound healing issues are one of the risks of any surgery and are certainly very distressing and frustrating. Small wound healing issues such as spitting sutures can be very common, while larger ones such as yours are more rare but can happen. It is very hard to say based on the limited information but the causes can be multi-factorial including infectious, technical issues/excess tension, pre-existing or undiscovered genetic/medical conditions, and sometimes just bad luck. Revisions are possible and are best considered when the scar tissue is fully mature, or around 1 year after healing. I recommend an in-person consultation with a board certified plastic surgeon. Thank you again for sharing your journey.

Stephen T. Greenberg, MD, FACS · Answer

Thank you for your question.  Sorry to hear that you had some complications after surgery.  With that being said it can happen.  There are numerous things that could cause this to happen.  A few could be infection, a patient that is or was a smoker, rejection of sutures are a few.  This area can be revised and yes there is typically some form of a cost that is associated with it.  I would suggest speaking with your Surgeon and discussing a plan.  Best of luck to you.

Christopher Pannucci, MD, MS · Answer

Hi Vickilynnp,
I am sorry that you had this problem, and I am glad to see that it has finally healed.
In a tummy tuck, the lower abdominal skin and fat (from bellybutton to with in the pubic hairline) is removed. In order to close that the vertical defect, the remaining upper abdominal skin is undermined to the level of the ribs, and the combination of this undermining, stretch, and bed flexion allows the wound to close primarily. This extent of undermining by definition marginalized is the blood supply to the upper abdominal flap. Unfortunately for you, it appears that a portion of the upper abdominal flap, where it was closed most tightly in the midline, did not survive the transfer. As such, you ended up with an open wound, which healed in on its own.
While it is possible to remake your tummy tuck scar, re undermine the adjacent healthy tissue, and close in a similar fashion to your first surgery, it is unclear whether this would be reliable and whether it would achieve your goals of getting the scar out completely. An exam by a qualified board certified plastic surgeon would help to answer both of these questions.
I am very happy for you that you are completely closed and healed. You may also choose to take some time with her scar as is, expecting that it should fade to a more white scar over time. This scar may be an acceptable alternative to surgery for you, but ultimately you and your surgeon will decide.
Hope this helps.
Best,Christopher Pannucci MDBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, Washington

Daniel Barrett, MD · Answer

Dear vickilynnp,
in most cases wound necrosis occurs due to a lack of blood supply. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

I'm sorry to hear of the wound healing issues you had.  Your scar looks typical for the size and depth of wound that you had.  Scar revision should improve the result.  If you're not comfortable with your prior surgeon you can visit with another board certified plastic surgeon near you.  I've included a video about scar revision that I hope you find helpful.

What could have caused my tummy tuck incision to heal this way and can this be revised? 1 year post op (photos)

Answers (10)

Answer: Wound necrosis

Answer: Wound necrosis

Answer: Scar revision

Answer: Scar revision

Recommended reading

Everything you need to know about Tummy Tuck

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

What could have caused my tummy tuck incision to heal this way and can this be revised? 1 year post op (photos)

Answers (10)

Answer: Wound necrosis

Answer: Wound necrosis

Answer: Scar revision

Answer: Scar revision

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Recommended reading

Everything you need to know about Tummy Tuck

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