3 Weeks Post Op TT, Desperate? (photo)

i developed necrosis the very next day of surgery. I stopped smoking two weeks prior and haven't smoke since. Im very frustrated as I decided to do the surgery 4 hours away from home, I feel that I am not getting treated appropriately. I do keep in touch with my ps and send him pics of the progress almost every other day. I'm taking TWO antibiotics (they make me really sick) cipro & zulphameto... But I feel that is just getting worse and worse! Please help.

Doctor Answers 16

Necrosis after Tummy Tuck

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         The necrosis at the incision line looks superficial, and it has not progressed.  However, your last picture shows more redness and swelling, and I would be concerned about fluid collection and developing infectionCiprofloxacin and Trimethoprim-Sulfamethoxazole is a good combination, but you may need a fluid collection drained.  If you have a drain or two still in place, are they still functioning and draining or are they clogged?  At any rate, these things happen after tummy tuck, and I would recommend returning to your plastic surgeon or find one closer to you for an examination.  Even though a plastic surgeon in your area did not operate on you, a plastic surgeon in your area may be willing to see you given the circumstances.  

Complication after tummy tuck

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Thanks for your question and pictures.  I am sorry that you have developed a complication after your surgery.  When you have developed a complication like this, close follow up with your surgeon is necessary.  This means having in person examinations every few days.  In your last picture, there appears to be some more redness around the eschar.  You may have a more significant infection than just cellulitis and you should be seen by a board-certified plastic surgeon soon.

Naveen Setty, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 78 reviews

Tummy Tuck Complication

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Hi JanMar,

I am very sorry you have had this complication. Based on your history and photos:

  • You need to have an "in-person" exam by your PS or someone nearby right away.
  • A direct examination is needed to determine whether there is blood (hematoma) or fluid (seroma) in addition to the skin healing problem(necrosis) and infection.
  • A smoking history (even if you've stopped before surgery) increases the risk for these complications.
  • These problems can take months to resolve. Frequent in-office follow-ups are important to monitor your progress until things have stabilized.

Good luck!

Stephen M. Lazarus, MD
Knoxville Plastic Surgeon

Management of Necrosis Along Tummy Tuck Incision Line

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As you know, you have developed some areas of tissue necrosis along your tummy tuck incision line. What you are not aware of, however, is that the progression of full demarcation of the zone of necrosis takes time... often weeks to see the full extent. Such necrotic wounds will look worse three weeks after surgery than at just one week after surgery...which is understandably disconcerting to patients.The management of the eschar (dead tissue) and the subsequent healing will take another 4 to 6 weeks until it gets to a point of being a closed wound. This is a long process to get to where you want to be, usually 8 to 10 weeks after surgery. There is nothing your plastic surgeon can do to hurry this process along to make it heal faster. All he/she can do is to prevent cellulitis through antibiotics and debride the eschar as needed. Topical wound dressings will be needed throughout the course of this prolonged healing process.

Necrosis After Tummy Tuck

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I understand your concern. I think you need to be seen by your surgeon or someone that he/she can refer you to. You have an infection that is not responding to the antibiotics. You need to have cultures taken of the drainage and drainage of any fluid collection if it is present.

Tummy Tuck Complication

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The swelling and redness at/above incision line indicate that your should be seen by your surgeon immediately.  Your surgeon should be able to decide if antibiotics remain sufficient, or if the wound should be opened.

Michael Kreidstein, MD
Toronto Plastic Surgeon
4.6 out of 5 stars 33 reviews

Necrosis of flap after TT

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Although you are four hours from your surgeon, it appears you live in a big city. If you can't regularly make the trip to be seen by your surgeon, perhaps either the surgeon or your primary doc could make a local referral. This wound really needs to be seen and evaluated regularly until the worst is over. At some point all of the dark tissue (which is non-viable skin over non-viable fat) will need to be removed, and the timing can't be decided from photos alone.

Sorry for the problems you have had. Thanks for the question and for the photos. Best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Skin necrosis after tummy tuck

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Thank you for your question and for providing the photos. I am sorry to hear of your difficulties after the surgery. While complications are uncommon, they can occur and close follow up with your plastic surgeon is needed. Only during an examination can the extent of the problem be adequately assessed. 

In your photos it looks like there is a zone of skin loss around the incision. It is essential to determine if there is any underlying issue, such as infection or fat necrosis, that is adding to the problem. This requires an examination by your plastic surgeon, and I would recommend contacting him/her immediately.

With proper care and enough time, you can still have a nice result. It may take longer to get there than you had anticipated, but you can still get where you want to be.

Best of luck.

Jeff Rockmore

3 Weeks Post Op TT, Desperate?

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Even with you stopping smoking 2 weeks prior you have skin edge necrosis + cellulitis. You should be seeing the PS in person every few days! You need minor debridement of the necrotic areas and aggressive wound care. 

Smoking increases risk of complications after tummy tuck.

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The photo demonstrateds dead skin and fat along the bottom of the abdominal fat.  Surgical removal and wound toilet will be part of the final solution.  Smoking increases the risk of this complication.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.