How can I heal necrosis after my tummy tuck?

Necrosis from tummy tuck unfortunately can occur.  If this occurs there is usually  a time period allowed to determine the extent of the necrosis to declare itself.  Once this has occurred the unhealthy tissues is removed. This should reveal healthy tissue beneath.  The resultant wound is dressed and allowed to heal over time.  

Dr. ES

This will likely heal on its own without surgical intervention and with wound care. However, if the scar is excessively wide it may benefit from scar revision.

 Unfortunately this complication is a risk of tummy tuck surgery, especially in patients with a history of smoking. Your plastic surgeon will advise you on the best wound care, which typically involves a morning and night routine. It is important to achieve healthy tissue edges on all sides before any shrinkage in the dimensions will be apparent. This may involve debridements (removing any unhealthy tissue). Once the entire wound is free of necrotic or unhealthy tissue, then over time you will see shrinkage and healing of the area. Be patient! If a widened or depressed scar results, it can easily be revised later once the tissue is soft and supple to restore a good result. Sometimes the body heals so well, that over time scar revision isn't even necessary. 

necrosis usually occurs in the midline and can lead to separation of the wound. you  have the typical findings of black, hard, dry shoe-leather skin.  my concern is the drainage and greenish color. it is time to debride (remove dead skin) and wash out.  even colonization (not quire infection but bacteria present) can extend the zone of necrosis and lead to more tissue loss. intervention generally speeds recovery and allows the loss of tissue to be minimized. see you doctor. good luck 

This looks like a small area of skin necrosis which can happen because of numerous reasons.  It will probably heal on its own and may need a scar revision down the road.

Your photograph demonstrates tissue death (necrosis) along the lowest portion of the tummy flap near the incision. This is a known complication of tummy tuck and is related to a great decrease or loss of a healthy blood supply to and from that area which can be seen in smokers, diabetics, people with autoimmune diseases, obesity, undue compression of the area (bending over for prolonged periods or tight garment) among others.
This tissue needs to be removed (debrided) to healthy bleeding tissue which would heal. This surgical cleaning (debridement), depending on the size can either be done in the doctor's office or in the operating room. The resulting wound would then be treated with either dressing changes or, in larger cases with a wound suction device (such as the VAC) and in all cases would heal by itself. The scar would be wider but could be revised to a narrower scar 8-12 months after the surgery.

You need to discuss all of this with your surgeon.

Dr. Peter Aldea

Skin necrosis after tummy tuck occurs because of inadequate blood flow to the skin. This can occur for several reasons. Fortunately the majority heal uneventfully with good local care directed by your surgeon.  If the scar that results is bothersome, a scar revision can improve it easily.

It appears that you have some skin necrosis with possible underlying fat necrosis (lack of blood flow to the fatty tissue).   It is important to maintain close contact and followup with your plastic surgeon through this wound healing process.    Plastic surgeons are trained on the best methods in wound care.  The most important consideration is to determine why your wound is failing to heal.   This could be due to lack of blood supply to the skin or fat (necrosis), infection, or wound dehiscence (mechanical breakdown).   Once the cause is determined, the optimal wound care solution can be selected.   This will depend on the source of the problem.   It will most likely involve serial clean ups/debridements, frequent dressing changes, antibiotics to treat any infection, and frequent follow up with your plastic surgeon.  In addition, optimal nutrition and compliance with wound care recommendations are a must  to ensure quick resolution of your wound.

Skin necrosis is a recognized possible risk following a tummy tuck.  It is most commonly seen in smokers but can occur also less frequently in nonsmokers.  The area of discoloration in your photo is relatively small and should go ahead and heal secondarily.  A revision of your scar in the future may or may not be appropriate.

Hi.

You certainly have an open unhealthy wound that requires intensive care with debridement (trimming dead tissue) and frequent dressing changes.

The wound may eventually heal on its own and then you will need a scar revision later. Another option may be to re-operate on you now, cut out all the dead (necrotic) tissue, and close the new wound.

If in doubt, get another opinion.