Risk of Necrosis After Tummy Tuck?

Necrosis is when tissue of the surgical site dies (become necrotic) following surgery. Tissue may change colour, begin to fall off and become infected. Corrective surgery is necessary to resolve this. Skin or fat (usually when it is transferred) necrosis is more common in people who smoke or are diabetic, when blood circulation.

Hello! Thank you for your question! The issue with nicotine is that it
also acts as a vasoconstrictor, clamping down of blood vessels. Blood
supply is always of great concern during any surgical procedure, but
especially in such a procedure as a breast augmentation where the viability of the
skin/tissue, and nipple-areolar complex is obviously important. Since the vascularity to
the area is already tenuous since it will be raised by cutting around
the area, maximizing blood flow to the tissue is critical. Typically,

we recommend at least 6 weeks of smoking cessation prior to and at
least 6 weeks after any surgical procedure. The longer, the better.
Nicotine always increases the risk for infection, nipple necrosis, poor
scarring, and
wound complications, as well as other health consequences including blood clots. The
anesthesia risk is greater with general anesthesia as well as pulmonary
issues/lung infections postoperatively. I would
discuss this with your surgeon prior to your procedure. Hope that this
helps! Best wishes!

Dead tissue after tummy tuck occurs when there is inadequate blood supply to the healing tissues, causing the affected tissues to die. This requires more healing over longer time, causes more scarring, and can require more surgery, skin grafts, and in rare cases, major reconstructive surgery. This can also, in extremely rare cases, even progress to severe infection and death. This is, when you think about it, true about virtually anything in life, such as a car trip, a slip and fall, etc. What is important is to keep things in proper perspective.

The risk of any kind of skin or umbilical necrosis for most experienced, board-certified plastic surgeons is below 1%, but only if the patient is a non-smoker, avoids all nicotine products (including spray, gum, or patches), and also avoids second-hand smoke. Nicotine is a major vasoconstrictor, and once the skin dies it's too late to say "I won't smoke any more!"

In a smoker, statistics vary, but the risk in some studies is as high as 15-20%. For this reason, I will not perform tummy tucks on smokers, nicotine users, or those exposed to second-hand smoke. It's just not worth the risk, in my opinion. I have cancelled paid-for surgery if I smell smoke on my patient as they report for surgery. They get their money back, minus a cancellation fee.

So, if you are NOT a smoker, this is a minimal risk well-understood by your surgeon. He or she will take all appropriate surgical precautions to minimize this and all the other risks you may or may not be aware of. Trust me, we ARE aware of them, and no surgeon wants or allows complications in their patients; when they occur, they do so despite our best efforts. Our reputation and livelihood depend on your good outcome.