Why did my tummy incision opened above the pubic area four weeks after my mommy makeover? (photos)

These small areas of incision breakdown are not completely uncommon. They can be caused by small areas of ischemia, fat necrosis, spitting sutures, or underlying seroma fluid. Your latest photo appears to show some fatty tissue that doesn't appear to have a very good blood supply. It will heal with time, but the healing process might be stimulated by completing a very minimal debridement of the wound base. This can be done in the office by your surgeon. 

Fat, which has poor blood supply, can die in areas of poor circulation after a tummy tuck. As the body tries to rid itself of the dead fat it may push this material through the skin.

Thank you for your question and photos.  I am sorry that you are having trouble with wound healing delay.  It appears that you have a small separation in the  middle portion of your incision.  This is not uncommon after tummy tuck and frequently happens in the middle of the incision because this is the area of highest tension and poorest blood supply.  Occasionally you may have some inflammation related to the disappearance of the dissovable sutures and this can cause a mild abscess.  As long as you do not have signs of a significant infection (pus, redness, fever), then local wound care with some antibiotic ointment is all that you will need.  Your scar in this area may end up being a little wide, but this is easily fixed under local anesthesia in the office 8-12 months after your procedure.  Follow up with  your plastic surgeon as often as needed to make sure the wound stays clean and your questions are answered.  Good luck. 

Dear blessedlife,The incision opening up 4 weeks after your tummy tuck is most likely an indication of a slow healing process in that area.  The dissolvable sutures have started to weaken and dissolve as they should and your body has not developed the strength that it needed to  by that time.  This could be the result of low blood supply, high tension, too much suture material, or some combination of all.  The good news is that the wound appears to be superficial and fairly clean of non-viable tissue.  This will continue to repair itself over the next handful of weeks.All the best,Dr. Remus Repta

It is not uncommon for patients to have small superficial separation of the wound edges after tummy tuck  surgery. Often the separation of the wound edges is associated with serous  (yellow) fluid drainage. Generally, these superficial separations heal spontaneously.  You should be concerned if there are any signs of infection such as fevers,  chills,  redness of the skin, thicker  drainage etc. Continue close follow-up with your plastic surgeon with any questions or concerns. He/she may be able to help with removal of offending sutures or unhealthy tissue that may delay wound healing.Best wishes.