Belly button issue, 3 weeks post-op from mommy makeover (Photo)

Question

I am 3 Weeks PO from MM. A portion of my B.B. scab fell of last night after I showered. It doesn’t appear to be fully healed underneath. It is not malodorous and not painful. Any idea on what is happening? Isn’t typical healing 2-3 Weeks for BB? I’m a non smoker and all other areas are healing well. Worries that my BB will not heal nicely due to this complication.

Richard H. Tholen, MD, FACS · Answer

Wow, 5 answers thus far, and other than Dr. Wald, everybody has "answered" by saying you should see your surgeon because they can't see beyond the crusts and scabs. At least Dr. Morgan told you your belly button "doesn't look as it should."
The good news is that it is not malodorous or painful, and the surrounding healthy tissues do not appear to have a cellulitis either.
However, I see no evidence from your single photograph that the umbilicus is alive. Perhaps there might be small remnants of living tissue, but this needs to be considered a nonviable belly button, and treated as such. This means local wound debridement, topical agents that penetrate dead tissue and minimize the risk of warm, wet, dead tissues becoming a nidus for bacteria that could destroy any residual living belly button remnants or cause infection in the surrounding healthy abdominal skin, and oral antibiotics for the same reasons--minimize bacterial invasion of healthy surrounding tissue and more tissue loss.
Further good news is that once the dead stuff is gone, healing can resume, and the scarring that contracts and replaces what used to be your belly button actually becomes a pretty convincing and normal-appearing "new" belly button.
But you can't just let this go and hope all will be well.
Forewarned is forearmed--telling you to just go see your surgeon to "clean up crusts and scabs" is not letting you know that your surgeon will need to make you aware of your dead belly button, and giving you a framework for what needs to be done by your surgeon.
 Let's face it, this is a known complication of tummy tuck. Most plastic surgeons who have done lots of tummy tucks will see this complication, and usually it is not because they did something "wrong." Often umbilical hernias can compromise circulation to the belly button after an incision is made around it. Sometimes a thick abdominal flap can stretch the blood supply to the umbilicus. Sometimes it just has minimal circulation and doesn't heal.
And, some patients will always seek to "blame" something or their surgeon when things don't go perfectly. Even when there is no surgical error, and even when patient compliance is perfect, and even when there is no smoking involved, belly buttons can die. Please re-read the fourth paragraph above--the one that starts with "Further good news . . ."
Now I believe it is appropriate to tell you to go see your surgeon so this can be put on the path to best healing going forward. You have a very good chance that your result will not be harmed by this occurrence--it will just take a bit more work and time. More good news: and probably no additional surgery, either. Best wishes! Dr. Tholen

Camille Cash, MD · Answer

It will take several weeks for your swelling to subside and the swelling will impact the appearance of your belly button.  I encourage you to discuss your concerns with your surgeon.  He/She will update you on appropriate wound care for optimal healing.

Kenneth Hughes, MD · Answer

Hello. Great question. I am sorry for your post op difficulties. At 3 weeks you are still early in your recovery process. It is not uncommon for wound dehiscence to occur post op. You have yet to see your final results. Keep following your surgeon's post op instructions.

Robert M. Wald, Jr., MD · Answer

It is not uncommon to develop some bleeding around the edges of the belly button following surgery. This will appear as a dry black crust or scab. Occasionally, some necrosis of the edges of the umbilicus can also occur causing this appearance. Please see your surgeon and he will be able to explain in more detail.

Daniel Barrett, MD · Answer

Dear Alifedesigned,I understand your concern. However, without a proper assessment it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment. Only after thorough examination you can get proper recommendations and advice.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Belly button issue, 3 weeks post-op from mommy makeover (Photo)

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Belly button issue, 3 weeks post-op from mommy makeover (Photo)

Answers (8)

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