Risk of Necrosis After Tummy Tuck?

Skin necrosis is a possible but fairly uncommon risk of having tummy tuck surgery. It occurs when there is not enough circulation to the tissue and the involved skin and fat can die. During tummy tuck surgery, the abdominal tissue is lifted off of the muscle layer and part of the circulation is disrupted. The area that is most at risk is the skin in the lower abdomen, just above the scar, in the midline.
Patients who smoke are at much higher risk for skin necrosis because smoking adversely affects tissue circulation. For this reason, I never perform tummy tucks on patients who are actively smoking. In the routine patient who doesn't smoke, skin necrosis is rare. If it does happen, it may be due to excessive tension on fhe suture line and is usually limited to a small area that can be revised later on for a good result.
I hope this helps you in making an informed decision!

Hello, and thank you for your question regarding necrosis after a tummy tuck.

Necrosis refers to the death of cells or tissues in the body. It can occur when there is a lack of blood flow and oxygen to the affected area, leading to tissue damage and cell death. In the context of a tummy tuck (abdominoplasty), necrosis is a potential risk, although it is relatively rare. During a tummy tuck, excess skin and fat are removed, and the abdominal muscles are tightened. This procedure involves creating incisions and lifting the skin, which can potentially affect blood supply to the tissues. When the blood flow to the skin and underlying tissues is compromised, it can lead to necrosis.

Several factors can increase the risk of necrosis after a tummy tuck, including smoking, poor circulation, large amounts of tissue removed, infection, tension on incisions, and obesity. Smoking significantly reduces blood flow and oxygenation to tissues, increasing the risk of complications like necrosis. It is strongly advised to stop smoking at least six weeks before and after surgery. Patients with underlying conditions that affect circulation, such as diabetes or vascular disease, may have a higher risk of necrosis. The more extensive the surgery and the larger the area where tissue is removed, the higher the risk of disrupting blood flow. Post-surgical infections can compromise healing and increase the risk of necrosis. Excessive tension on the surgical incisions can impede blood flow to the surrounding tissues. Excess body weight can negatively impact blood circulation and increase the risk of complications.

To minimize the risk of necrosis, it is crucial to follow your surgeon's preoperative and postoperative instructions carefully. This includes ceasing smoking, maintaining a healthy lifestyle, and following postoperative care. If you smoke, quitting well before surgery is essential to improve blood flow and oxygenation. Proper nutrition, hydration, and managing chronic conditions like diabetes can help support healing. Adhering to wound care instructions, avoiding excessive strain on the surgical area, and attending follow-up appointments with your surgeon can help identify and address any issues early. If necrosis does occur, treatment options may include debridement (removal of dead tissue), antibiotics to prevent or treat infection, and in some cases, additional surgery to repair the affected area.

Necrosis is a potential risk of tummy tuck surgery, but with careful planning, proper surgical techniques, and adherence to postoperative care, the risk can be minimized. Always consult with a board-certified plastic surgeon who has experience performing tummy tucks to discuss your specific risk factors and ensure you receive the best possible care.

I hope this helps to answer your question regarding necrosis after a tummy tuck.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS

Thank you for your question.  Necrosis is literally death of tissue - in this case I believe you are referring to skin and/or fat at the lowest part of the abdominal flap in tummy tuck.  It results from compromise of proper blood supply to the tissue.  If a tummy tuck is closed under too much tension (i.e. too much skin is removed), or significant pressure is applied to the lower portion of the healing abdomen, wound breakdown or skin necrosis can occur.  If performed properly, tummy tuck should never result in true skin necrosis.  Please ensure that you are undergoing surgery with a board-certified plastic surgeon.