Dark bruise-like area around incision area of Tummy tuck. Skin necrosis Vs ecchymosis and epidermolysis. (photos)

Question

I had a tummy tuck on 11/24/15. I also had a lift, implants of 800cc and liposuction, fat transfer to butt. day 5 the Drains stopped flowing i could hear a whistling sound at end of incision. on Monday 11/30, i went for my one-week check up and my he also said he might have over-stressed the belly area. My dr said i had ecchymosis and epidermolysis where my "previous" bellybutton is now, however all the similar photos of ladies on your site are being told it looks like its skin necrosis.

Farbod Esmailian, MD · Answer

The photos are very helpful.  Ecchymosis is simply put, bruising of the skin.  Epidermolysis is superficial skin loss/slough.  Skin necrosis is full thickness skin loss.It does appear that the lower abdominal area may progress to skin necrosis, time will eventually determine how much skin loss you will have.It is important to follow your plastic surgeons recommendation as far as skin care to help prevent any future issue such as infection.Good luck.

John L. Burns Jr., MD · Answer

It appears that you may have some necrosis at the central part of your tummy tuck incision.  This can happen and your surgeon will have a protocol to help you with this.

Tania Medina de Garcia, MD · Answer

Hello dear, thanks for your post, Im so sorry about what is going on with you, but that looks like skin necrosis, the first thing that needs to be done is for all the dead tissue to be removed before an infection sets in. Tissue that does not have a blood supply will never circulate antibiotics and will serve as a large source of unbeatable bacteria. Once the debridement (dead tissue removal) was done, the remaining wound is treated to get it to clean up and form GRANULATION TISSUE - a tissue that looks like a cut strawberry surface (granular) which will pull the wound walls together. This can be done with serial gauze dressing changes or faster with the use of a suction device called the VAC. In 2-3 months, the walls of the wound will come together and heal. In 8-10 months after-wards, when the scar is soft, you may, IF you need or want to, make the scar look nicer.I suggest to follow your PS recommendations. Good luck :)

Irving Rodriguez, MD · Answer

Hello, so sorry about your issues, but it definitely looks like skin necrosis, you really want to get that skin removed because that is a good source for infection since it is no longer being protected by your own defenses, there is no blood supply to it, so it carries a big risk for infection that could go to a deeper space and create more havoc, right now it is just a matter of skin recession and flap advancement and most probably won't leave any sequelae at all.Hope this helps

William McClure, MD · Answer

Thank you for your questions and photos. I'm sorry you are having problems. Ecchymosis is bruising which is expected and which completely resolves. Epidermolysis is blistering of the skin which reflects superficial skin damage. With proper care this tends to heal completely without problem. Necrosis means full thickness skin death which would delay healing and could lead to more scarring. From the photos it appears you might have an area of necrosis. It is important to continue close follow-up with your surgeon. Necrosis in this area is a recognized complication and can be treated successfully. Good luck to you.

Paul J. Leahy, MD · Answer

I'm sorry to hear you are having troubles. This central area on the upper skin flap is the most common site to have wound issues after TT surgery. It's a little tough to tell from the pictures, but at this point, it looks relatively superficial (relatively minor). This will need to be watched closely, and I'm sure your surgeon is doing that. Hopefully, it will recover on its own. Best wishes.

Malcolm D. Paul, MD · Answer

You have some areas of superficial skin loss and some areas that are deeper. Close follow up and skin care are important and, if neglected, can lead to infection and more areas of skin loss.

Pedro M. Soler, Jr., MD · Answer

Thank you for the question and the photographs. While pictures cannot take the place of an in-person evaluation, it would appear as though you have a combination of areas of epidermolysis and skin necrosis. With good local care this should go on to resolve with little to no sequela. I would recommend to continue in close follow up with your plastic surgeon as they are in the best position to treat you in the post operative period. Best of luck.

Sugene Kim, MD, FACS · Answer

Hi, hotpaIn-person evaluation would be better to assess you.However, based on your photos, you have epidermolysis (blisters) with superficial skin necrosis.The area can potentially get worse before it gets better.Please follow up with your plastic surgeon closely.Good luck with your recovery.

Arian Mowlavi, MD, FACS (license on probation) · Answer

Duskiness following tummy tuck can be an indication of future skin and soft tissue loss. This can happen after a tummy tuck. Measures can be taken to limit area of necrosis including use of a topical vasodilator such as Nitro paste as well as aggressive hyperbaric oxygen therapy. Please follow up with your surgeon for definitive recommendations.

Dark bruise-like area around incision area of Tummy tuck. Skin necrosis Vs ecchymosis and epidermolysis. (photos)

Answers (10)

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