How do you prevent your tummy tuck incision from opening?

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:

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

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.