Is this Necrosis? (photos)

I had a tummy tuck with lipo Sept.19th after the first week my skin on my stomach peeled completely off. I am starting to get really nervous. My womb is healing and my surgeon is concerned it may be signs of necrosis. I keep antibiotics on it and keep it covered. I am regretting my TT. This has been an emotional Rollercoaster. Will my stomach ever look better? Does this look like necrosis?...PLEASE HELP!!!!

Doctor Answers 11

Skin loss after tummy tuck with liposuction

Dear BeautynKinks,

     Thanks for submitting your pictures, though full picture of your stomach would have been helpful, as far as future corrective surgery. Unfortunately, you have full thickness skin loss of large section of your lower abdomen tissue.

  So sorry about your big trouble. Your situation is exactly the reason, why I never perform tummy tuck with liposuction at the same time. This was documented in a recent study that was based on data from cosmetic surgery insurance company, where it was demonstrated that combination of tummy tuck and liposuction increases severe complication rate x 10 in comparison to tummy tuck surgery alone.

   Sad to say, but you have a long road to recovery ahead of you. First, all the dead tissue has to be excised and now is a good time to do it since you are over 3 weeks from surgery. Once the dead tissue is cleaned up well and good granulation tissue is noticed, the reconstructive part can ensue. The best situation is if you still have loose tissue at you upper abdomen, which can allow for skin to be advanced downward and skin flaps moved in from the sides, closing the wound. If that is not possible, skin graft is the fastest way to heal, followed up, once good healing occur, by tissue expanders balloons and wound closure.

    Discuss your situation with your surgeon and find out how much experience he or she  have with such complex reconstruction. If he or she do not have enough experience, consult with your local university hospital plastic surgery department. 

          All the best and good luck,

                                             Dr Widder

Necrosis?

You do appear to  have a necrotic wound. Your Plastic Surgeon should be directly involved in caring for your wound. Eventually you will probably have a nice result, but it will take a lot of work and time to get there. It may also require additional surgery at some point. Please do not try to care for this by yourself. If your surgeon is not available then try to get in to see a board certified plastic surgeon in your area.

Thank you.

William H. Gorman, MD
Austin Plastic Surgeon
3.9 out of 5 stars 18 reviews

Wound necrosis

You have wound necrosis for sure.  It can and does happen.  It will take conservative wound care, debridement and then re-advancement of the flap at a later date.  

Necrosis

Yes from your photos you do have skin necrosis. Your surgeon needs to debride (remove) the dead tissue to help with the healing process.

Deborah Sillins, MD
Cincinnati Plastic Surgeon
5.0 out of 5 stars 10 reviews

Dr Derby

Thank you for your question and the photos. It does look like necrosis , it is very important to contact your surgeon right away to make a plan. Best of luck  

Derby Sang Caputo, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 63 reviews

Tummy tuck complication

Hello,

Thank you for sharing your story and your pictures. Unfortunately, this does appear to be necrosis, or dead tissue, which is a possible complication of a tummy tuck procedure. The most important thing at this point is to maintain close contact and frequent visits with your plastic surgeon, who should exercise very diligent wound care which will likely end up with removing the frankly dead tissue (called a debridement). If your surgeon's formal training was not in plastic surgery, you should find a plastic surgeon for further recommendations and assistance in managing your wound.

The emotional stress of having a complication from surgery can be truly overwhelming. If you don't have a strong social support network, it also help to begin speaking to someone in that regard to help manage the mental and emotional stress that comes with this.

I am very sorry to hear about your postoperative course and wish you the best of luck with your recovery.

Joseph Brown, MD
Tampa Physician
5.0 out of 5 stars 6 reviews

Tummy tuck

Thank you for your question and photographs.

I am sorry to hear that you are having complications during your recovery. This is indeed, necrosis. You should see your plastic surgeon immediately to plan a course of action to get this debrided to prevent further complications. Best of luck in your recovery.
Sincerely,

James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science

James Fernau, MD, FACS
Pittsburgh Plastic Surgeon
4.9 out of 5 stars 68 reviews

Necrotic tissue

this is without any doubt necrotic tissue. See your surgeon frequently, at some point he/she will determine when the best time is to remove some of the dead tissue and allow things to settle in. This can happen and now that it has the most important thing is seeing your surgeon to make sure you can have the best outcome as possible. 

Healing after tummy tuck

I am so sorry that you are having this experience after what is typically a very positive and happy outcome surgery.  But it is still surgery and that comes with risks, even under the best of circumstances.  There is clearly necrosis in the area below the belly button which will need to be cleaned prior to being able to have the area finally closed.  Work very closely with your surgeon, especially if you feel like you have a solid, long term relationship with him/her.  Whenever there is a complication, surgeons feel the weight of this quite deeply.  One piece of advice that I give my patients during their initial consultation is that they should choose their surgeon not only on the results that they can achieve, but also the commitment and ability to care for a patient through a complication if one should occur.  This is a difficult one, but not insurmountable.  However, it will time, patience, and trust to get this resolved.

Necrosis after tummy tuck

Sorry to hear about your complications.  This is definitely necrosis of the skin and some of the fatty tissue.  Be sure to discuss in detail with your PS how this will be managed.  The dead tissue will need to be debrided (trimmed away) and then the wound will need to be revised.  You may even want to get a second opinion if you don't feel comfortable with your current PS.

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.