Necrosis after TT. Should the yellow inside my wound be debride and removed? Or is it viable living fat? Using Santyl. (photos)

Question

I had a tummy tuck. It was all black and now all of that is removed and bright yellow fat remains. My question is, will the granulation tissue cover this yellow fat? Is it alive or does it need to be removed? PS said if/when the granulation tissue grows over the yellow part, my new skin will start to grow pretty quick A wound care doctor told me when it was black that everything needed to be cut out I was told by a Wound Care group, That yellow has to come out in order for me to heal.

Daniel Barrett, MD · Answer

Dear Yvonnehendrix86,this type of wound is not uncommon after tummy tuck. It is usually caused by poor blood flow. I would suggest you to consult your plastic surgeon, follow your surgeon's instructions and keep your wound clean and covered. It can take few weeks or months for wound to fully heal. Daniel Barrett, MD

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Vishnu Rumalla, MD · Answer

Thanks for your inquiry,  sorry for your struggles,  the wound is clean and healing, it is really up to your surgeon how aggressive to be with sharp debridement, good luck.

Deborah Sillins, MD · Answer

You do need some debridement of the yellow tissue and this an bee done a little at a time in the office. Santyl is a great debridement cream as well. Follow up with your surgeon closely.

Daniel Zeichner, MD · Answer

Hi and welcome to our forum!
I am sorry that you are experiencing a complication of abdominoplasty. Tissue loss occurs infrequently but does add significantly to recovery time. It occurs if blood supply to the area was diminished or if infection developed. The risk is increased in smokers, obese patients, diabetics, and in patients with other circulatory disturbances. 
The vast majority will heal with a regimen of intensive local wound care. Various successful regimens are employed by different surgeons. Debridement of the yellow necrotic fat will accelerate the process and prevent secondary infection. Most will seal within 90 days. Larger defects may require temporary skin grafting. It will take a year for scars to mature. If revision is required, it can be performed after that time. 
It's a long road but most often ends with a satisfactory result. Be patient and follow your doctor's instructions.
Best wishes...

Connie Hiers, MD, FACS · Answer

The yellow tissue will slowly need to be debrided until all is pink healthy granulating tissue. The yellow is fat, and skin will not grow over the fat. Please follow with your surgeon and/or wound care doctor closely. Once all is healed, your surgeon should be able to improve the scar.

Necrosis after TT. Should the yellow inside my wound be debride and removed? Or is it viable living fat? Using Santyl. (photos)

Answers (6)

Answer: Tissue loss after abdominoplasty

Answer: Tissue loss after abdominoplasty

Answer: Wound

Answer: Wound

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Necrosis after TT. Should the yellow inside my wound be debride and removed? Or is it viable living fat? Using Santyl. (photos)

Answers (6)

Answer: Tissue loss after abdominoplasty

Answer: Tissue loss after abdominoplasty

Answer: Wound

Answer: Wound

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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.