What can I expect to happen yet before I recover completely? (photos)

I had a Full tummy tuck 31/2 weeks ago. I have some Necrosis and also currently being treated for infection. The redness has improved a lot . 1. How much long can I expect to have drainage along my incision? 2. Will the black scabs come off and will my skin be raw underneath. 3. Based on on it looks will I have to have additional surgery? Thanks you

Doctor Answers 3

Necrosis after tummy tuck.

I am sorry you suffered this rare but devastating complication. This 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 hassle.

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

Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

Tummy tuck necrosis & infection

Thank you for your question and photograph.The necrosis, which is skin that has died due to lack of oxygenated blood supply should be removed by debridement to prevent further infection from occurring, it is hard to determine the duration of your drainage but as long as it is getting less over time then that is a good sign that you are healing. It is important that you get the necrosis and present infection treated immediately.
Best of luck in your recovery.
Sincerely, James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science

James Fernau, MD, FACS
Pittsburgh Plastic Surgeon
4.9 out of 5 stars 75 reviews

Wound healing comlications

To answer your questions:  Yes, the black scab will fall off eventually and leave raw tissue underneath.  If left to heal alone it will take about 2 months,and leave an unsightly scar.  Yes, my recommendation is to have your surgeon excise the non healed area and re suture it.  This will give you the best result in terms of more rapid healing and acceptable scar.  If you are a smoker---STOP -nicotine prevents good woundhealing

Paul Silverstein, MD (retired)
Oklahoma City Plastic Surgeon

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.