Severe dermatitis (rash) after tummy tuck. Has anyone seen this before? (Photo)

Question

I had a tummy tuck 1/14/19, after they removed my drains I started to get very itchy on each side of my stomach. I did not itch it and then I started to get a rash (1/22/19) which has become extremely red and now turning dark red almost purple. My surgeon has me on Methylprednisolone 4mg 21 tablets. I have about 2 left and have not seen any improvement. My surgeon and the urgent care stated it is dermatitis caused by an allergic reaction. Has anyone seen this before? What can I do to cure it?

R. Brannon Claytor, MD, FACS · Answer

Following surgery with a tummy tuck or was also known as an abdominoplasty, it is not uncommon for there to be some skin irritation.  This may be caused by tape or even the abdominal binder.  I have not used drains for tummy tuck for over 8 years and I find that this significantly cuts down on the skin rash irritation caused by chafing at the drain exit site.  In addition having no drains allows the patient to shower one day after surgery.  This early return to hygiene is beneficial and allows for the skin layers to slough off as they normally would.  The abdominal binder which is frequently used in the postoperative period to help reapproximate the abdominal flap to the abdominal wall can sometimes cause some chafing.  For this I recommend either gentle patting with gauze or a soft cotton T-shirt between the skin and the abdominal binder.  This can help soothe the irritated skin.  Should an area appear red or blistering this is an opportunity for an early intervention and conversation with your plastic surgeon to evaluate for wound healing challenges.  Topical dermatitis may be an inflammatory response to the surgical prep at the time of surgery.  While this is uncommon it is still possible.  In these limited cases close follow-up is helpful and steroid application has multiple delivery mechanisms some through topical skin application and some through oral medications.  As the major function of steroids is to decrease inflammation careful attention to its effect on primary wound healing is also important.  Close follow-up with your plastic surgeon is always the best.

Roger Tsai, MD · Answer

Great question!  This can happen to patients with sensitive skin, which is due to the tapes, bandages, and binders that are placed after surgery.  Sweat can buildup in the area and cause a rash as well as reacting to the tapes themselves.  It may take sometime but should resolve over time.  I would have your plastic surgeon continue to followup with you to make sure it is improving.  Best of luck and hope this information helps!
- Dr. Roger Tsai  @DrRogerTsai
Board Certified Plastic Surgeon

Nathan Eberle, MD, DDS, FACS · Answer

definitely seen it in a few patients, as stated below, could be the prep solution, could be the steri strips or adhesive used to keep them in place, need to discuss with your surgeon, likely need topical steroid cream +/- oral steroids.

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. I think that dermatitis is a reasonable starting diagnosis. It is likely due to an irritation from surgical garments, dressings, skin glue, etc. However, if washing the area thoroughly and a round of steroids has not shown any improvement, then it might be time to investigate further. I would recommend seeing your surgeon for an in-person exam and perhaps some lab work to rule out other causes like infection, hematoma, seroma, etc.Hope this helps!Dallas R. Buchanan, MD, FACSOwner & Board-Certified Plastic SurgeonVIVIFY plastic surgery

Aditya Sood, MD, MBA, FACS · Answer

Great question! It indeed looks like a localized dermatitis along your incision. It was likely caused by the steristrips, skin glue, or skin cleansing agent used after incision closure before application of the steristrips. These tend to disappear after a few days of removing the offending agent, but in your case it seems to be lingering. Sometimes, benadryl and topical calamine lotion can help relieve the symptoms while the rash slowly disappears. best of luck to you.

Derby Sang Caputo, MD · Answer

It is very normal to have itchy skin after surgery in the first weeks but this looks like a rash from the tape maybe, normally this can improve fast with the use of anti allergy medication like Benadryl or Zyrtec even. Best of luck

Robert E. Zaworski, MD (retired) · Answer

It is not uncommon to experience skin irritation following tummy tuck surgery.  The binder and tape can cause itching and irritation over time.  I suggest my patients wear a soft cotton shirt, such as a T shirt or camisole under the garment to avoid direct contact with the skin.  Your surgeon may recommend an allergy cream to help clear up the rash.

J. Michael Morrissey, MD (in memoriam) · Answer

Thank you for your question and photos. This is likely a reaction to adhesive tape that was likely used as it is in the distribution of where a dressing would have been. For itching, benadryl is helpful. The steroid dose pack is helpful as well. The main treatment is avoidance of  further irritation ie; adhesive tape. It will get better. It will just take some time. Best wishes,Dr. Morrissey

Severe dermatitis (rash) after tummy tuck. Has anyone seen this before? (Photo)

Answers (8)

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