What are the chances of getting necrosis again with second surgery?

Question

Hi I had a tummy tuck in 2015 and developed fat necrosis in the scar above pubic area (despite being healthy no diabetes smoking etc) and it left a horrible scar, I had a baby after and i believe i now have enough loose skin to get a revision now. I was considering going for full body lift to address loose skin in lower back as well, and was wondering what my chances of developing necrosis again would be , as in will it dramatically Increase risk of getting necrosis over the same area again

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding what your chances of getting necrosis again are after having problems with healing after your tummy tuck. It is possible that this area could undergo necrosis again. However, unlikely. It really depends on how tight this area is and if there is much skin laxity. Usually, this area is loose and can be revised. Since the scar is over seven years old, I would suggest that it can be revised. Since you don't have any comorbidities like diabetes or smoking, I think you could safely undergo a body lift. It will be important for your plastic surgeon to know about your past experience with necrosis so that your plastic surgeon can minimize the tension in the scar. However, since you are healthy, I would suggest you go ahead with the body lift with slight caution, but still, nonetheless, undergo the procedure. It will be important during your body lift, to maintain high protein intake for optimal healing. You may also consider hyperbaric oxygen treatment post-operatively to minimize any complications. I hope this information helps. Thank you for your question and good luck. Again, I would still suggest you undergo a lower body lift even though you have a past history of fat necrosis.

Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Zoran Potparic, MD · Answer

Fat necrosis after TT is relatively rare complication but it may happen with any surgery involving fat tissue (TT, liposuction, fat transfer, BBL, breast reduction). It is particularly the case in patients that are overweight or obese, 3-4 times more frequently than in regular population. Providing that you are within normal weight and abdominal revision does not involve too much of flap manipulation, it is unlikely that you will have similar complication. Good luck.

Daniel Barrett, MD · Answer

Dear gs998126,
it is hard to tell for sure without an examination. If you are considering a surgery, I would suggest you to 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

M. Shuja Shafqat, MD · Answer

Good afternoon,
In general, the risk of necrosis is low. Risk of necrosis in the back for a body lift is relatively lower than in the front. In the front, it is higher risk than the back, but since you already had a tummy tuck, the chances are likely lower. You would need to be seen and examined by a board certified plastic surgeon to assess what you need and discuss the risks and benefits. Best of luck!

Camille Cash, MD · Answer

I'm sorry to hear of the necrosis you experienced in your previous surgery.  As long as there is adequate skin laxity you should be able to have a revision to your tummy tuck without necrosis resulting.  An examination is always the best way to get an accurate recommendation.  I encourage you to meet with a few board certified plastic surgeons for consultations.

Jose A. Munoz, MD - Account Suspended · Answer

Hi and welcome to our forum!Necrosis of the abdominal flap is usually caused by vascular insufficiency to the tissues the farthest away from the blood supply (at anterior midline at the incision). In spite of a healthy lifestyle, necrosis occurred because of excessive swelling, coagulopathy, or if the flap was too tight. The involved tissues have healed. If there is sufficient redundant skin and soft tissue, a secondary abdominoplasty can be performed without increased risk.Best wishes....

What are the chances of getting necrosis again with second surgery?

Answers (6)

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