3 weeks post op Tummy tuck. The incision seems swollen and white tissue . Are these signs of necrosis? (photos)

This does not look like "necrosis" that you are fearing. Necrosis is a term which generally is reserved for significant portions of skin which have died off. It looks like you have very slight separation of some of the wound edges which is not the same as significant tissue death. This should heal over well with time. The only outcome which might occur is a slight thickening of the scar as opposed to finer areas where there is no wound healing issues. This can be addressed with silicone stickers, laser treatments, or a small office revision to make the scar finer. However, the scar is going to mature and fade and soften over several months, so I would wait at least 6-9 months before you start entertaining these ideas. Keep in close contact with your plastic surgeon.Best of luck!Dr. SubbioBoard-Certified Plastic SurgeonNewtown Square/Philadelphia, PA

You look like you might have some areas of minor wound healing issues. Often local wound are is all that is required. Best to review with your surgeon.

From your photo it would seem that you do not have necrosis. The wound has separated a little and will heal slowly with proper care. It may take several weeks so you will have to be patient. Your surgeon can advise you on his/her preferred wound care regimen. Without proper care infection may occur and the wound become deeper so best be attentive to the care of it. If you are given saline dressings you can put a drop of bleach in the saline which will help keep the wound clean. Bacteria hang out in the hair follicles so it is typical to see this problem at the top of the pubic hair. The hairs can also become ingrown and small "pimples" will appear along an intact scar so watch for those, too.