Is this necrosis? Or normal? 6 days post op and surgeon is on (I didn't know) now a 2 week vacation (Photo)

I'm 6 days post op tummy tuck and liposuction. My incision is troubling me. His prn said today it looked okay, I'm not so convinced. Should I report to er? I also have black on my Tt incision

Doctor Answers 11

Healing After Tummy Tuck

A tummy tuck is a pretty big operation.  A large amount of tissue is removed and, in the process, some stress is placed on the circulation of the tissue that remains behind.  One potential result is that some of the wound edges may take some extra time to heal.  I tell our patients that this is really about a 120 day process.  The result that is seen on day 7 is different than the result that will be seen on day 120.  Tissues are really swollen early during the healing and this adds some stress to the circulation.  Swelling decreases quite a bit over the first 3 weeks, but often patients feel a bit bloated in the lower abdomen for about 3 or even 4 months.  We see our patients frequently during this time of healing, even more frequently if there are any signs of wound healing problems.  We encourage our patients to call any time of the day, night, or weekend if they have questions.  

It's natural to go to the internet to look for answers to questions after surgery.  Ultimately, though, the best place to go for answers is to the surgeon who performed the surgery.  All surgeons want great outcomes for their patients.  It's okay to be persistent in asking questions, and it's okay to require a few more office visits than the "typical" patient, especially if there are specific issues that need to be addressed.  


Fort Worth Plastic Surgeon
4.8 out of 5 stars 24 reviews

Belly button

It appears you have some scabbing around your belly button but everything else looks like it is healing ok. It is common to have some areas of scanning early on after surgery. This should improve with more time 

David R. Alfonso, MD, FACS
Grand Rapids Plastic Surgeon
4.9 out of 5 stars 36 reviews

Necrosis?

Thank you for your question and providing photos. Based on the photos I do not believe you have skin necrosis. It appears you are healing normally. Best of luck

Healing after TT

Thanks for your post. No, I don't get the sense from this photo that you are having significant necrosis or death of the tissues. It looks like some scabbing that occurs normally. Most of the belly button tissues look pink and healthy. I don't see photos of your actual incision. If you are concerned, please have your surgeon (or assistant) take another look today. It will likely resolve on its own. Best wishes.

Paul J. Leahy, MD
Leawood Plastic Surgeon
5.0 out of 5 stars 7 reviews

Concerns with Incision Post-Op

It may take several months for a tummy tuck patient’s scars to soften, for sensation to return, and for relaxing of the tight sensation in the abdomen. In the case of extensive surgery, abdominoplasty recovery can be uncomfortable and may take longer. Scars may stay red, become thick or widen. It can take 12-18 months for the scars to settle.

These can be improved with topical treatments such as BioCorneum, Scar Guard, Scar Fade and Mederma. Redness can be improved with laser treatments and the scars can be kept narrow with products such as Embrace.  On occasion, keloids or hypertrophic scars can develop and will need treatment including Kenalog, 5FU and laser.

It is unfortunate that you find yourself concerned with your incision and your plastic surgeon is not personally available right now. With the PRN not providing and answer with which you are comfortable, there should be the number for an answering service to which you can refer while your surgeon is out of town. If you find yourself completely uncomfortable and without anyone else to turn it would likely be a good idea to visit the ER or your general practitioner to have the area examined to make sure that healing is progressing well. Good luck!

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

Doesn't look like skin necrosis

Based solely on your photos, you don't appear to have skin necrosis. Things look to be healing normally. However, if you symptoms worsen or change then yes, get in to see your surgeon or whoever it is that he or she has covering his patients while on vacation. 

Kindly,

Kouros Azar

Kouros Azar, MD
Thousand Oaks Plastic Surgeon
4.8 out of 5 stars 21 reviews

Rim of discoloration around belly button following tummy tuck

From the pictures you provided it is difficult to say for certain.  The dark ring of discoloration at the margin of the belly button represents either some superficial crusting and/or some superficial ischemia.  The circular incision around the belly button can stress the circulation to it.  So the discoloration you see could be some superficial marginal skin edge ischemia/necrosis.  Even if it is, I don't think it will affect the overall healing significantly, and in the end, I believe it will be of little significance.  With the exception of this ring of discoloration, the rest of the belly button has a normal color and appears healthy.  If this is a little marginal skin edge necrosis, since you already 6 days out from surgery, I don't think it is likely to get any worse. 

I don't know if he will given any specific instructions to care for this incision.  I usually have patients wash it gently, blot dry, and apply a thin layer of Polysporin antibiotic ointment to the suture line.  

If you have additional concerns you can always send the same photographs to your surgeon. Best wishes.

Kenneth Dembny, II, MD
Milwaukee Plastic Surgeon
4.9 out of 5 stars 34 reviews

Crusting?

There appears to be some crusting around the incision.  This may or may not be normal.  But usually if there is some minor issues at the incision edges, it often goes on to heal without significant issues.  Best to follow closely with your surgeon.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Necrosis after tummy tuck?

Thank you for your question.  The provided photo appears to show some superficial ischemia vs scab formation at the incision line where the belly button was inset.  This does occur time to time after a tummy tuck.  I personally have patients treat the belly button with triple antibiotic ointment for a week following surgery.  At the one week follow-up, I evaluate all surgical sites and decide whether any incision sites/surgical sites need further care.  I would discuss concerns with your surgeon.  If your surgeon is out of town, they should have a physician covering their practice that can see you.


Best of luck,


Dr. Mooty

R. Clark Mooty, MD
Lubbock Plastic Surgeon
5.0 out of 5 stars 18 reviews

Is this necrosis? Or normal? 6 days post op and surgeon is on (I didn't know) now a 2 week vacation

Based on the pictures, this looks normal. If concerned, ask to send this picture to your surgeon for review and advice. 

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 65 reviews

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.