How bad will necrosis this get before it gets better? (photo)
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Doctor Answers 6
Depends on management
usually occurs in smokers (even second-hand smoke or one nicotine gum,
etc.), in patients who have liposuction in areas of the blood supply to
the abdominal skin, too-tight closure, or in the random 1-2% where
everything is still done properly but inadequate circulation leads to
dead fat and/or skin. You have both, as evidenced by the black dead skin
in your photos. BTW, infection can also lead to circulation impairment
and necrosis--or necrosis (warm, wet, and dead) can lead to
infection--sort of chicken or egg, but related.
Until healing is complete (and that means the dead tissue will need to self-separate over
weeks, or surgical debridement can accelerate the removal of the dead
fat and skin), you will have drainage and a portal for infection.
Debridement is the way to go faster and with less risk, but that is
minor surgery. Letting things heal over time requires constant wound
care, vigilance about infection, and prolonged dressings, odor, and
Surgical debridement requires more surgery and scarring,
but you will have more scarring anyway--tissues died that were expected
to survive and heal. Judicious additional surgery now can minimize the
extra scarring and perhaps even get you back to your life more rapidly.
Talk to your surgeon, and no smoking if that is an issue with you or
those around you. Best wishes! Dr. Tholen
Necrosis after abdominoplasty
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Thanks for the question. At 3 1/2 weeks post-surgery, any potential tissue loss has probably been well demarcated and will not extend beyond the areas of eschar (black). Those areas of black tissue will require debridement before the areas can heal. The sooner the black tissue is removed the faster the healing process will be. I would recommend following up with your surgeon to get that process started.
Necrosis following tummy tuck
Thank you for your question.I am sorry to hear that you are having this issue. Unfortunately this can happen during tummy tuck procedures. By 3 1/2 weeks the areas involved should be well demarcated as it appears on the photo. The scab will fall off and there will be healthy tissue underneath as the body repairs itself. The scab however will unfortunately have drainage and an odor to it for some time yet. The best thing to do in these situations is to be patient, follow your plastic surgeons advice. A touch up can be performed later if necessary.Best Dr. L
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