Is my tummy tuck incision opening?

The picture you provided us with is one of an inflamed, non healing wound.  The appropriate treatment at this time would be:  (1) culture the wound; (2) place on topical antibiotics; (3) place on culture specific oral antibiotics.  I would leave the wound open sufficiently to drain any bacteria present, but would judiciously place a few staples to keep the wound from complete dehiscence (completely opening up).  

That having been said, your plastic surgeon is the one person who knows exactly what went on inside your abdominoplasty.  You trusted him or her with your life and appearance.  Trust your plastic surgeon to get you past this bump in the road to recovery. 

The most important thing is to address the possibility of infection. The skin looks a bit irritated which could be a result of infection, tape sensitivity, or just inflammation from recent removal of the drains. If there is any purulent drainage, then it should be treated with antibiotics and possibly have the drainage cultured. It also needs to be determined if there is too much internal pressure that is causing the incision to open. Seroma accumulation should be ruled out. If there is clear fluid leaking from the wound, I would want to have your surgeon to evaluate for seroma formation. If this is just a skin issue, then it will heal with just some antibiotic ointment or a few weeks of small dressing changes. If the scar is not acceptable, it can be revised several months after everything has healed. 

I am sorry to hear about the complication you have experienced.  These types of superficial separations can occur, and sometimes may “look worse, before it looks better”. In my opinion, the most important “factor” involved  with successful treatment of the complication will be close follow-up with your plastic surgeon. He/she will be in the best position to monitor situation carefully. Infections should be ruled out and “foreign bodies” such as sutures that may prevent quick healing may be removed.   The open wound  should go on to heal over the course of the next several weeks,  hopefully without long-term sequelae. Concentrate on a well-balanced ( good protein source) diet.  Best wishes.

With local care this should heal. However, the scar may end up less than ideal and a revision under local anesthesia when the tissue has softened up may be needed. This will take anywhere from 4 months to 8 months to happen.

Hello,

The most reason for a tummy tuck incision to open at this point is secondary to non-healing.  Healing could be delayed or prevented if there is an infection or if there is not sufficient blood supply to the area.  The antibiotics may help with the infection but will not help with the blood supply issue if that is the case.  Keep your waist somewhat flexed, drink plenty of water, take your multi vitamins and see your plastic surgeon regularly.  You may need to return to the operating room to clean out the non-viable tissue and re-suture the incision if it does not improve on its own with conservative care.

All the best,

Dr Remus Repta