Black Spot Along Tummy Tuck Incision Necrosis or Just a Burn?

It looks like you have skin necrosis to the flap.  Being a diabetic puts you at a higher risk for necrosis.  It also places you at a higher risk for infection with necrotic skin.  I would be very conservative in your treatment and would see you quite regularly.  I would also have you check your blood glucose regularly to make sure you aren't running higher than normal.  If this is necrosis, you should be prepared for a somewhat lengthy recovery with wound care treatments.  Good luck and I wish you the best during your recovery. 

Thank you for your post. Diabetes is a disease that should demand a healthy respect from both surgeon and patient in plastic surgery. It is a disease that affects the immune system and can increase the risk of infection, a disease that affects the healing potential of a wound and can cause opening of a wound, and is a disease of the circulation that can lower the blood flow to the operated tissue and cause necrosis or tissue death. This needs to be managed as follows:1. Tight blood glucose control with diet, exercise, and medication. You need to see your internal medicine doctor regularly and make sure your diabetes is well controlled. 2. If you are overweight, then losing weight decreases your risk in tummy tuck surgery or any other surgery for that matter.3. If you have high blood pressure, this needs to be managed and well controlled by your internal medicine doctor as well.4. ABSOLUTELY NO SMOKING!5. Consider with your surgeon HyperBaric Oxygen therapy pre- and post-op.6. Make sure you understand from your surgeon and anesthisiologist what medications you should take or not take prior to surgery.It is very possible to have a great outcome as a diabetic following tummy tuck surgery, but minimizing the risk is the most rational way of accomplishing this.Best Wishes, Pablo Prichard, MD

This appears to be an area of full thickness skin loss.  An area of marginal necrosis in the middle is not uncommon. This is the area that is the furthest away from the blood supply and under the most tension. These areas generally take about 4 - 6 weeks to fully heal. Many times the scar will look just fine and other times you may require a relatively simple scar revision. If it is a large area such as yours a revision may be more complicated.  Treatment with antibiotics is only needed if you show signs of an invasive infection.  Simple wound care is all that is required at this time.