2 weeks post-op. I have TT incision dehiscence. Advice? (photos)

Question

Well I feel so horrible by my wound opening up. I am 5’4” and when I when into surgery I was at my heaviest at 217. I had a BBL in December. So I decided I wanted to a breast lift and tummy tuck. I am 14 days post op. I did have a Hx of smoking but I quit last October. My abdomen looks round a swollen and I feel like my skin is so tight in my abdomen I will never be able to stand straight. I am feeling defeated as depressed. Tomorrow I have a follow up with my doctor

Kenneth Hughes, MD · Answer

Hello Adrienne,Great question. Thank you for your pictures. You are still very early in your recovery process. Wound dehiscence is not uncommon. Follow your surgeon's post op instructions. Congratulations on your procedure.

Ira H. Rex III, MD · Answer

There are a number of reasons why you may have slow healing in this area. Your doctor is the best person to give you advice. Often, the patient would just need simple care to this incision until healing improves. Sometimes, antibiotics are added if a local infection is a concern.

Daniel Barrett, MD · Answer

Dear Adrienne2012,
this type of wound is not uncommon after tummy tuck. It is usually caused by poor blood flow and increased tension. I would suggest you to consult your plastic surgeon, follow your surgeon's instructions and keep your wound clean and covered. It can take few weeks or months for wound to fully heal. 
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

I'm sorry you are having a rough start to your recovery.  The best thing you can do is keep in contact with your surgeon and closely follow all post operative instructions.  She/He will help you through issues as you recover from your procedures.  It will improve!

Michael Zarrabi, MD · Answer

I am so sorry to hear that you are having this problem.  Relatively speaking I would say this is a small wound seperation.  It is however serious and should be treated correctly.  I would hope that your surgeon is already aware of the situation.  At this point the treatment includes local wound care and some debridement (cleaning up) of any tissue that doesn't look healthy.  Please see your plastic surgeon ASAP.

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum!
I am
sorry that you have experienced a complication of the abdominoplasty procedure.
During the procedure, the abdominal skin and soft tissues are separated
from the underlying musculature from the ribs to the pubic area. If there is
impairment of the blood supply to the abdominal skin, the segment of the flap
the greatest distance from its blood supply may not survive (above the
mid-pubis). The cause of the blood supply impairment can range from effects
of smoking, diabetes mellitus, vascular disease, previous surgery in the
area (disrupting the normal blood supply), infection, or may totally
inapparent.  
From your photographs, I do not see significant infection, but
there is minimal residual unhealthy tissue in the wound.. Treatment consists of removal
of the unhealthy tissue, followed by intensive wound care. One looks for the
development of granulation tissue, a beefy red vascular tissue, to develop,
after which time the wound will begin to shrink. Many wounds of this size will
seal over a span of several months. In our practice, we consider application of a
temporary skin graft over the granulations if the wound does not seal within
3 months. Some advocate the use of a suction apparatus (wound vac) to
accelerate the process of wound shrinkage. Various enzymatic topical
creams are available. Some advocate hyperbaric oxygen treatments.
Each
plastic surgeon has his / her own wound care regimen based upon years of
experience. Follow the advice of your surgeon and maintain close followup
care. After the wound seals, and after the scars mature and the
inflammation subsides, one would then consider revisional surgery if
necessary (usually 6-12 months). I am often surprised how well these scars heal
on their own!
Best
wishes...

2 weeks post-op. I have TT incision dehiscence. Advice? (photos)

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