Reverse abdominoplasty & surprise implant swap due to rupture

Content warning: The following photos document a full-thickness surgical wound dehiscence and may be graphic. I am including them for accuracy and transparency.
It has now been just over two years since my reverse abdominoplasty and implant exchange in late January 2024. I waited intentionally before writing this update so that I could assess the long-term durability of the surgical correction rather than temporary postoperative changes.
My early posts here reflect how genuinely happy I was at first. The immediate postoperative appearance looked excellent. I had every reason to believe the procedure was a success.
Approximately three weeks after surgery, the inframammary incision line developed significant dehiscence. Prior to outside referral, the wound was managed exclusively in office with silver nitrate applications and a manually operated vacuum device that required suction every 30 minutes during the day.
I requested referral to a wound care specialist more than once. During one phone conversation I was told, “I am a wound care specialist.” Later in that same conversation I was told that seeing a wound care specialist would probably benefit me but that it would take a long time to get in.
After seeing my primary care physician, whom I sought out on my own, I was evaluated and began treatment at an independent wound care clinic within two days.
At the initial wound care evaluation on March 6, 2024, the midline surgical dehiscence was documented as a full thickness defect measuring 3 cm in length, 1 cm in width, and 2.6 cm in depth. In addition, there were lateral breakdown areas on both breasts that required mechanical debridement.
A defect measuring 2.6 cm in depth occurred during the early postoperative healing period of a procedure that depends on stable tissue re-adhesion.
Although the wound ultimately closed, the prolonged open tissue during the critical early healing phase appears to have affected the long-term durability of the surgical correction. Sagging began returning within months.
At approximately six months post op, I returned to discuss these concerns. I was reassured that it would take many years, even up to a decade, for my abdomen to return to its preoperative appearance and that by then I likely would not care.
It has now been just over two years. A substantial portion of the original correction has regressed, and I still care.
One month prior to surgery I underwent a mammogram reporting both implants intact. After the procedure, I was informed that a ruptured implant had been identified intraoperatively and both implants were replaced.
The original implants were under manufacturer warranty. I later learned that because the explanted devices were discarded, I was unable to pursue a warranty claim and incurred out-of-pocket expense for the replacement implants.
More recently, after recognizing the long-term regression, I attempted to address these concerns directly through written communication, including email and certified letter. I have not received substantive engagement regarding resolution.
I share this two-year update so that anyone researching reverse abdominoplasty understands that long-term outcomes are influenced not only by the surgery itself but also by the management of postoperative complications.
My early optimism was real. So is this outcome.

One of the biggest complaints with my stomach was how my navel looked before surgery. After surgery it looked incredible. Everything did. But it's all slowly going back to the way it was. The doctor assured me it would take a LONG time to ever get as bad as it was, but I no longer believe that given how quickly everything is happening. I'm about a year and a half post op and so sad with the results. I would never have gone through what I went through and paid that much for this had I known I would look like this so soon.

Things all healed up around June, which was the 5 month mark. I noticed a little bit of sagging returning and went to see Dr. Nichols. He assured me that this happens, but it will not return to the way it was any time soon. I did some research and found that the return sagging DOES happen with this procedure, no matter who does it. However, looking at my latest "after" photo, I still say it was worth it. The only thing I would say to anyone deciding on whether or not to get this done is to weigh whether it is worth it to you, knowing it can and most likely will, return to some extent. Like I said, for me, the improvement is still worth it.