Tummy Tuck Skin Necrosis Healing Process. (photos)

This can happen after tummy tuck but it is the most problematic of the potential complications.   You will need surgery to remove the dead tissue, and prolonged wound care.  You will also lily need revision surgery and the outcome will not be as you expected.  A wound VAC is a useful tool to help in this situation.  This is a long process.   It will take up to 6 months to heal, 1 year before the revision and several years  before things are settled.

Thank you for your pictures. This is a significant loss of skin. A VAC witll help. In my opinion this will take at least two months to close

Although the VAC system has some wound healing benefits, in my opinion- it's totally not applicable in your condition. The black tissue is dead- and must be removed. However, as long as it is dry- it could be left in place and it may assist the underlying tissue to heal. In my opinion, the best thing to do is to leave it alone until it is very wet and almost sliding off by itself. 

This is an unusually large area of full thickness skin loss, rarely seen in cosmetic surgery. The reason is poor vascular flow to this area, whatever the cause. Your surgeon is right, that this large area to be healed in fairly short time (weeks) would require a wound vac system. This means, that your surgeon needs to totally excise the black eschar or necrotic tissue (can be done without anesthesia) and place a foam pad into the defect which is sealed and connected to a small portable vacuum machine. This will help shrink down the defect and help granulation tissue (red vascular healing tissue) fill in the defect. Once a clean vascular bed is attained, your surgeon will need to skin graft the wound. Depending on the size of the final wound with the skin graft, at a later date (1-2 years) this might be possible to be excised and end up with a better scar. Good luck, stay close to your treting surgeon.

You have an unusual pattern of skin necrosis. The necrotic tissue that you see on your lower abdomen will have to be removed surgically. This can often be done in the office under local anesthesia. A wound VAC is a device that will speed the healing time of the wound. The VAC dressing will need to be changed three times a week. Sometimes arrangements can be made for a home health nurse to do this for you.  This process typically takes a few months.  As for as the long-term outcome goes, only time will tell. These wounds will sometimes heal surprisingly well, and revision is not undertaken.  Sometimes it is necessary to excise the scar that forms which is often depressed compared to the surrounding tissue.  Your priorities now are to manage the current complication and achieve a healed wound.  Any revisions if necessary can be discussed in a year.