Umbilical stalk skin necrosis means that the barrier between these permanent sutures and the outside world may be breached, creating the possibility of internal suture infection. Antibacterial ointment will not only reduce the likelihood of an infection, but will also promote the healing of the umbilical stalk if some of the stalk is still viable (i.e. it has enough blood flow to survive).
The best course of action is local wound care as mentioned above and frequent visits to your plastic surgeon. Regarding the long–term appearance of your new umbilicus: the sutures through the skin adjacent to your belly button will create permanent suture marks if they are not removed soon. Ask your surgeon if that can be done in order to avoid a pattern of dot-like scars around your new umbilicus which will make it look like a surgicalbelly button, not a natural belly button. It is possible to place umbilical skin sutures so that they pass through the dermis only (and not the epidermis) on the abdominoplasty skin flap side of the umbilical closure.
You may ultimately require some form of revisional surgery once the belly button wound has healed, but in most cases a definitive secondary procedure cannot be done for at least 6 months or so. So you will need to be patient, take good care of the wound, and see your doctor frequently as this issue evolves.
Silicone gel will not help necrosis. Sulvadene cream may help control infection until healing .
I have had a look at your tummy button and
it doesn’t look to me as if it has got necrosis, although it is difficult to
see from the photograph.
A necrotic tummy button is black and we
normally treat these with applications of antibiotic ointment and regular
dressings and washing. For the vast
majority of patients the tummy button recovers very well.
If you are concerned about your tummy button
I would suggest however that you do go and see your plastic surgeon to suggest
the best way forward for you.
I am not seeing the necrosis on your belly button, at least in the photo you enclosed. If you have delayed healing, I would continue to use an antibiotic ointment such as Bacitracin or Polysporin until the belly button is well healed with no open areas or scabs. At that point it would be safe to use a silicone based scar gel if you would like, but this should not in my opinion be used on open wounds.
If you were to develop necrosis you would see a dark black scab or escar. I see no evidence of wound healing problems. I would continue to follow the advice of your plastic surgeon . If there are questions I would begin by e mailing him a close up photo of the area.
The circulation to the belly button can be compromised with a tummy tuck, especially if a hernia is present, which can lead to necrosis. Usually when there is necrosis, there is black tissue present which is difficult to see in your photo. Often times, if there is a small are of necrosis it will scar in and not be very noticeable. As long as there is no infection, I would recommend keeping the area clean and placing some ointment on the wound. If there are any concerns about the appearance, I would see a plastic surgeon for follow up.
"Necrosis" means death of tissue. In your photo I do not see andy blackened areas, which is typically how dead tissue looks. What I see looks like normal wound healing and scar formation. Surgeons all have different recommendations for treatment of the scars, ranging from silicone strips or gel to Vitamin E oil to massage. All are acceptable. If you have further concerns, I encourage you to contact your surgeon. Or, if an exam is required to figure out what is going on, hook up with a local Plastic Surgeon certified by the American Board of Plastic Surgery.
You should see a plastic surgeon near you. I agree that it is difficult to see your belly button on the photo and I can not tell if there is necrosis of it. Also, in order to diagnose a seroma you need to be seen in person, that can not be done over the internet. I do not recommend vitamin E cream as it will weaken the scar and widen it. the best scar therapy is silicone gel sheets, but you need to wait to use those. The best thing to do in your situation is see a plastic surgeon near you and follow their advise. Best of luck.
Thank you for your question and photo. I do not see any tissue death in the belly button on this photo. You might have some separation and this should heal just fine. The concern I have with your surgery is the lack of follow up, since you had surgery abroad. Your lower abdomen looks "full". Either you have a large fluid collection which would need to be aspirated or you did not have adequate liposuction done during your surgery. you do have excess fat on the hips and it is not possible to evaluate the contours of your back from this photo. Good luck with your healing.
Since it may be hard for you see your doctor your best bet is to pay to see a plastic surgeon in the area you live. He or she will charge you based on the time and level of complexity of what you need. If you need treatment such as aspiration of a seroma you may find that you are going to spend a good bit of additional money. When having surgery out of the country you should know that it can be risky and cost more then you think in the end if things like this pop up since the USA doctor you see has no idea what was done to you and will charge you for treatment. In fact many plastic surgeons you call will not want to see you since they do not want to assume the risk. Good Luck!