How do you prevent your tummy tuck incision from opening?

Question

I find that so many people have issues with their tummy tuck incisions reopening post op. Is this an issue of not following physican instruction on discharge or poor surgical technique?

R. Brannon Claytor, MD, FACS · Answer

Optimally following surgery there are clear instructions that have been going over with a patient by the surgeon and or the office nurse to help guide the patient through this unfamiliar territory. It is not uncommon for an abdominal binder to be worn for upwards of a month. Some surgeons  use drains in the postoperative period and this adds to the care maintenance in the recovery period. Following post surgical instructions and following up with the surgeon for the postop visits are in the central part of the entire surgical treatment. Nutrition is also important in the postoperative period to ensure maximum wound healing and this is important leading up to the surgery as well. In terms of smoking if a patient is smoking in the postoperative. This will dramatically increase wound complications and worsen the quality of the scars.

Christian Subbio, MD · Answer

Tummy tuck opening should be a rare occurrence.  In a properly selected patient, with excellent technique, that should not happen very frequently at all.Best of luck!
Dr. SubbioBoard-Certified Plastic SurgeonNewtown Square/Philadelphia, PA

Leila Kasrai, MD, FRCSC · Answer

Causes contributing to opening incisions include straining too much and too early after surgery, preexisting health conditions and poor lifestyle habits (smoking). It is not a common complication for my patients.

Amy Simon, MD, FACS · Answer

Thank you for your
question regarding the incision after a tummy tuck.  There are numerous
factors that can contribute to or prevent this.  Be sure and follow the
postop instructions of your board-certified plastic surgeon.  Also note
that such issues are much more common in people who are diabetic and people who
smoke and patients who are obese.  However, it can certainly occur in
anyone, particularly if you are doing too much in terms of physical
activity.  Be sure and discuss with your board-certified plastic
surgeon.  Hope this information is helpful to you.  Best of luck!

Arthur W. Perry, MD, FACS · Answer

If your incision was closed properly and you refrain from exercise and sex for three weeks postop, you should not have issues with your incision.  Of course, that means you do not have diabetes, or smoke, or have other healing issues.  Your surgeon should not remove so much skin that the wound would be in danger of opening.

Andre Levesque, MD · Answer

Thank you for your question.
Tummy tuck incisions open due to many factors.
Things that increase risk are "traditional tummy tuck" techniques with wide undermining of the skin flaps.
Not closing scarpa's fascia with good technique and suture.
Not addressing fluid collection (seroma)
Large BMI patients, smokers, massive weight loss patients, diabetics, very aggressive removal of the skin.
It is rarely due to patient non compliance
Seeing a board certified plastic surgeon that focuses on up to date techniques and patient safety will be the best way to avoid this common issue.
Best Dr. L

Steven Wallach, MD · Answer

I do not find tummy tuck incisions routinely opening up.  It is more likely to occur in diabetics, smokers, and obese patients to name a few.

Brooke R. Seckel, MD, FACS (retired) · Answer

It is not uncommon for there to be a small amount of superficial skin loss at the point of maximal tension in the middle of the lower abdominal incision.  This is caused by the tightening or tension  of the skin at the closure which reduces blood supply to the skin.  Normally this is a very small area of superficial skin loss which heals quickly and does not represent a problem.
When abdominoplasty incision is actually open it can be caused by too much skin tension due to removal of excess amounts of skin which is a surgical technical problem.  Another major problem or risk to proper wound healing after tummy tuck is one aggressive liposuction is done in conjunction with the tummy tuck.   The combination of liposuction to the middle portion of the abdomen with tummy tuck damages blood vessels to the skin, reduces blood flow to the skin and can result in a failure of wound healing and an open wound.Another potential problem is the use of a tight abdominal binder after tummy tuck.   Placing a tight abdominal binder at the end of the operation also can restrict blood supply to the skin and result in skin loss.   I use a binder only  to hold dressings in place and given specific instructions that it should not be tightened until a week to 10 days after surgery when I have examined the patient and determined that blood flow to the skin is adequate.
My recommendation is that only the flanks be treated with liposuction and not the middle portion of the abdomen when a tummy tuck is done.  In my opinion the best tummy tuck results occur after weight loss or liposuction has resulted in loose skin with only three quarters of an inch of fat beneath the skin.   If there is significant fat underneath the abdominal skin, weight loss or liposuction should be done before tummy tuck is done.  To learn more please read below:

How do you prevent your tummy tuck incision from opening?

Answers (8)

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