Necrosis after 5 weeks post op tummy tuck. Options for healthy healing? (photos)

Question

Had a tummy tuck 5 weeks ago my skin suffered from necrosis my surgeon did a surgical cleaning. Now I was left with a huge wound. Not sure if I’m in the right path for a healthy healing wold like to hear other opinions. I know I don’t have an infection he also did some vac therapy sessions. Thank you for all your help.

Daniel Barrett, MD · Answer

Dear marysolrangel,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

Farbod Esmailian, MD · Answer

Thank you for the photos.  You appear to be on the right path and everything that is happening is pretty much on par with what should be.  The wound bed looks good and the wound vac is a great idea.  This will take some time to heal, you just have to be patient.Once everything has healed, in about 1 year you can revisit with your surgeon and see if there is anything that can be done to re-advance the abdominal flap to get rid of the resulting scar from the wound.  It is always good do keep up on your vitamins/minerals and protein intake to make certain the wound can close as fast as possible.  You can discuss with your wound care team which vitamins and minerals are recommended.Hope that helps.

Curtis Wong, MD · Answer

involve costly and minimal costs... depending on your budget and needs.  Wound VAC's are great but costly as is hyperbaric oxygen.  Saline dressings are cheap but wound healing may take a little longer.  I always employ saline dressings and good wound care and all wounds heal with this regimen.  Once the debris is removed, the wound fills in quite quickly then the skin creeps in from the edges to get it fully healed.

Steven M. Lynch, MD · Answer

Hi...So this complication is one that occurs because the area of the redraped tissue that has the least blood supply is just above the center of the pubic hair.  It is more common to see this in a smoker but it can occur in anyone.  The tissue needs more blood supply than it is left with after  pulling the upper abdominal tissue down and it necroses.  You have a reasonable loss but I am always impressed at how all of this heals.  Your belly button is very viable and this is important.  Also, you have good granulation tissue (the red tissue your body is making) and you have the red rim around the wound and this will produce new cells to surface the granulation tissue after it fills the open wound.  This is not an infection going on.  It is tissue loss followed by good healing and it will progressively heal the wound (the wound vac has helped it close quicker.  So, now to the final cosmetic result.  There are some advancement techniques that will make this surprisingly better but you have to be very patient.  The revision procedure is not a big thing but it has to be at a predictable time.  That will probably be at 6 months to one year and I am in the camp of the one year time frame.    Be patient...your doctor is doing all of the right things to get this healed and to the point of the revision.  Your should be quite impressed at how the healing process  and the revision surgery works to make you happier

Necrosis after 5 weeks post op tummy tuck. Options for healthy healing? (photos)

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