Do I Have Necrosis?! My Incision is Not Normal I Know It. (photo)

My dr says I'm healing beautifully but I just have this feeling that I'm not. I'm 8 days post and I have black areas, I'm swollen and budging out of the scar, I'm red, and even oozy in the front as well. What is the black stuff? Is it necrosis I'm very concerned and my dr won't really listen he just says it's fine. I'm really sad and scared by this, this cannot be normal right? I apologize in advance for the blurry pictures.

Doctor Answers 6

Do I Have Necrosis after Tummy Tuck Surgery?

The small black areas along the incision line are areas where oxygenation is subpar. Just so you are prepared, sometimes the incision lines may look worse before they look better. In other words, in the next few weeks you may experience some drainage and/or  superficial separation along these areas as well. Keep an eye on the areas of redness and drainage: make sure you let your plastic surgeon know if the redness and/or drainage increases.

 Otherwise, it is likely that you will go on to heal without long-term sequelae.

 Best wishes.

San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

The "black stuff" are areas of necrosis

Unfortunately, you do have areas of necrosis. Hopefully, this is limited to the skin surface and does not extend to the deeper tissues. Good wound care is important for optimal healing and prevention of infection. So, follow up closely with your plastic surgeon. Thank you for sharing your photos and concerns. Best wishes.

Gregory Park, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 164 reviews

Incision healing looks normal

The photos you posted show a fairly normal scar appearance for someone one week after surgery.  The black areas are technically tiny areas of necrosis but are very normal.  There often is some drainage and separation of the incision at these areas, but ultimately they tend to heal with a normal appearing scar.  Nothing in your description or photos suggests a problem.  Continue to follow up regularly with your surgeon and call if you have ongoing concerns.

Michael S. Hopkins, MD
Albuquerque Plastic Surgeon
4.9 out of 5 stars 83 reviews

Do I Have Necrosis?

The black areas are non-viable skin, but only a trivial amount, and should not be of concern to you or your surgeon, and should not interfere with the course of normal wound healing. As you note the photos are not quite distinct enough, but the area just adjacent to the blackened areas looks completely normal. The photos are too close up to comment on shape or bulge of the scar, but it looks ok.

Best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Do I Have Necrosis?! My Incision is Not Normal I Know It. (photo)

The area that is dark black, most likely is full thickness skin necrosis with possible deeper tissue involvement. Avoid any direct pressure over these areas with compression garment and minimize tension across the incision. Check with your PS, may apply antibiotic ointment (e.g Neosporin, Bacitracin or triple, chose one that you have not had a history of allergy) 2-3 times a day. Keep the area clean at all times (avoid any contamination). Some of the areas of your wound would improve with time but the area with full thickness necrosis may have drainage and will eventually demarcate itself; the dead tissue will have to be removed by your PS followed by local wound care. It is important to follow up closely with your PS and follow his/her instructions. Wish yuo luck.

B. Kalantarian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 32 reviews

You have some isolated area of skin necrosis

I would say you have spotty areas of skin necrosis.  The level of necrosis will define itself with time.  If you have necrosis do not place the abdominal skin under a lot of pressure such as with a tight binder.  The rest of the incision appears to be healing well but the sewing technique is really sloppy. 

Benjamin Chu, MD, FACS
Honolulu Plastic Surgeon
4.8 out of 5 stars 91 reviews

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.