Is this skin necrosis?

Question

I had a tummy tuck on February 9th. As soon as I got out of surgery my skin started turning black right around my belly button all the way down to my incision line. Doc says he is not worried about it at all anymore and that everything looks better. I feel like as the days go by the lower part of the wound keeps getting deeper and deeper. I need a second opinion please!

Martin Jugenburg, MD · Answer

Hello Thank you for your question and pictures. It's unfortunate that you are experiencing this. You do show evidence of tissue necrosis. Please be sure to follow up with your board certified plastic surgeon. Best regards

Sheila S. Nazarian, MD · Answer

Yes, you appear to have skin necrosis. Keep following your surgeon's wound care advise to the letter and you should be healed in about a month. You may need a bit of scar revision surgery down the line, but hopefully not. My best,Dr. Sheila Nazarian@drsheilanazarian on Instagram

Gerald Minniti, MD, FACS · Answer

Hello,It is necrosis, but it looks like you're healing quickly. Continue following your doctor's orders and you will be healed in about a month.  You may be a candidate for a scar revision in a year.Best of luck!

Daniel Brown, MD, FACS · Answer

Thank you for your questions and photos.  I am so sorry that you are having healing issues after your tummy tuck!  After reviewing your photos, it does appear that you have some amount of tissue necrosis.  It does appear to be improving, but without an in-person exam it is impossible to be certain.  Local wound care should be all that is require for your wound to heal reasonably well, and you may require scar revision in the future however the only person who can be certain is your surgeon. I would encourage to continue close follow up with your surgeon for wound care and potential future revision. If you continue to be concerned, you could consider a second opinion from a board certified plastic surgeon in your are to explore further treatment options. Best wishes!

Curtis Wong, MD · Answer

and technically you had necrosis.  The question is whether this is full thickness or partial thickness with the latter being much better for you.  Your surgeon seems confident it will be fine so I am hopeful he is right.

M. Sadi Erfani, MD · Answer

It is not uncommon for the skin at the "triple point" of a tummy tuck to have compromised circulation.  That is where you seem have had an area of skin "sloughing".  This happens because this area is the furthest away from the sources of blood flow and receives the least amount of oxygen during the early healing period.  Fortunately, despite your initial skin loss, the blood supply seems to have improved.  You may be left with a mark in that area, which should be amenable to scar revisions or other strategies to help improve the final appearance of your incision and skin.  Best of luck and well wishes on your continued recovery.

Joseph L. Grzeskiewicz, MD, FACS · Answer

I'm very sorry to see that you are having wound healing issues.  Unfortunately, healing problems sometimes arise in tummy tuck procedures because we do two things to the tissues which compromise blood supply:  we lift them up and separate them from large parts of their normal blood supply, forcing them to survive on only the parts left attached, and we place tension on them as we try to make things tighter and smoother.  Both of these things can further reduce blood supply leading to tissue death, or necrosis.  This can involve just the skin, or it can also involve deeper tissues, and often it is tough to tell at first just how deep the involvement extends.  Things can also evolve over time in the early going if the wound is not properly cared for, or if there is infection or fluid collection involved, which can also further injure and compromise the tissues.In the images you have shown, it appears as though there was not only an area of skin necrosis, but the underlying fat underwent some necrosis too.  This is why the wound seems to be getting deeper to you.  Until all tissue death declares itself, and the extent of the surviving tissue is known, we may have what appears to be ongoing necrosis and deepening or spreading of wounds.  In reality, most times the injury has already occurred, and unless there is something that keeps injuring the tissues further, like infection, we are just seeing the gradual exposure of the extent of the injured tissue.  From the series of images you show, it seems as though this is the case and things are stabilizing, as there does not appear to be any infection as things have progressed, and each day the bruising and redness at the periphery is getting better.Keep in close touch with your surgeon, and follow all directions closely.  Let him or her know of any changes in your condition early on.  At this point things are very early, and I know it looks terrible to you, but sometimes you would be shocked at how good things look over time once things heal.  Try not to worry about long term results or scars or things like that, and focus on getting better now.  Best of luck.

Hector Milla, MD · Answer

Hi, thanks for your question and posted photos. I´m sorry things are not going as planned, there is necrotic tissue, the good news are it looks like it is already limited and there is no sign of infection, keep in close contact with your plastic surgeon, there are different methods to eliminate this tissue, he will determine the best for you. The most imortant right now is this heals and after that revision might be necessary.Best wishes.Dr. Milla

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

You are demonstrating tissue necrosis; I would recommend that you consider a revision of this area to eliminate all necrotic tissue so that you can begin your healing process; the alternative will be dressing changes but this may be a prolonged process with variable results.

Is this skin necrosis?

Answers (9)

More Tummy Tuck Questions

How should you clean your TT incision. How soon after a tummy tuck can you start treating your scar so it can get lighter ?

I am 4 weeks post op and my belly button looks awful to me. Is this going to open and look like a normal belly button? (photo)

Do you go home the same day after Tummy Tuck ?

What the difference between a regular tummy tuck and a hour glass tummy tuck? I'm talking about a full tummy tuck!!

Pus after 30 days from inguinal hernia surgery. What's causing it? Something to worry about? (photo)

Tummy tuck after lipo: how long do I need to wait?

WE SEND PRETTY
EMAILS