TT post op 10 days, may have an area of necrosis (Photo)

When I saw the Dr 5 days post op he said "looks like an area with little blood supply. It should be fine." I spoke to his nurse and asked what it was, she stated it's a breakdown of the skin. We need to see you in a week. It doesn't appear to have changed any. Still just muttled area of reddish purple streaks. If this is necrosis, will it always definitively turn black, ooze and decay into a huge problem? Should I be doing something now?

Doctor Answers 4

Tummy Tuck Wound Healing Concerns

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Tummy tuck surgery often produces amazing outcomes, with corresponding improvements in self-esteem.  However, it's actually a pretty big operation and with that come some risks.  There is more than one way to perform a tummy tuck, but in the most common type of tummy tuck much of the abdominal skin is lifted off of the underlying musculature.  This maneuver results in a decrease in blood flow to that skin/tissue which in turn increases the risk of problems with healing.  The most common site for problems healing is in the central abdomen below the belly button, along the low scar.  That's the area under greatest tension, and tension is not good for wound healing.  In most cases problems show up initially as a purplish/pinkish color of the skin within a few days.  Sometimes that resolves, but in some cases it progresses to darker color skin and then areas of black firm scabs.  There are two really important things to do during this time.  First, if a patient has used any type of nicotine product (cigarettes, gum, patches, e-cigarettes), those should be absolutely and completely stopped (hopefully they were stopped long before surgery, but they should also be stopped for many weeks after surgery).  Second, visit frequently with the surgeon who did the procedure.  Applying something topically may help, but the surgeon should be actively involved in helping the patient progress through the process.  In my experience, even if some breakdown/necrosis occurs, with good wound care the final result is still usually very good.  On occasion a small revision of the scar may be performed a few months later, but that's fairly uncommon.

Fort Worth Plastic Surgeon

Abdominoplasty complications

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I am sorry to hear of your problems following abdominoplasty. It is possible that all may heal well, but it is possible that you may have some delayed healing. I have only two pieces of advice. Work closely with your plastic surgeon. They are the ultimate wound specialists and will help you achieve your best result. The second is don't smoke. Don't allow the people near you to smoke. Don't take nicotine in any form. It will lead to tissue loss. Best of luck.

Peter D. Geldner, MD
Chicago Plastic Surgeon
4.6 out of 5 stars 34 reviews

TT post op 10 days, may have an area of necrosis

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Thank you for sharing your question and photographs.  It does appear that a segment of your skin has limited blood supply and may go on to have some superficial blistering.  I would recommend keeping the area well-moisturized and maintain close follow up with your surgeon.  Best wishes on a speedy recovery.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

Blood supply to the lower area skin is tenuous..

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Hello--- the blood supply to the lower skin flap is tenuous-- the blood vessels that normally feed these areas are cut and so the lowest area has the greatest risk.. 

The color of the skin does look indicative of impending skin necrosis-- but it is always hard to say how much will actually occur-- it can be partial and so you should follow the advice of your plastic surgeon!

Anne Taylor, MD
Columbus Plastic Surgeon
4.9 out of 5 stars 49 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.