Necrosis tummy tuck causes

People are usually ready to recover as quickly as possible after surgery so they can get back to their normal routine. While they often follow their doctor’s instructions for healing, they sometimes do not recover as quickly as they should. Skin flap surgery is no different. While there are many reasons people may not heal quickly and correctly after this surgery, one of them is due to skin flap necrosis.

WHAT IS SKIN FLAP NECROSIS AND HOW DO YOU KNOW IF YOU HAVE IT?

Skin flap surgery is done to treat large wounds that cannot be closed by other treatments. Skin flap necrosis is caused by a lack of blood and oxygen to the tissue and may be evident by the 2nd to 4th day following surgery. It often shows as an area of darkness or blood-stained blister on the leading edge of the flap. A doctor or wound care specialist evaluation is required to identify it.

WHAT CAUSES IT?

Skin flap necrosis is caused by skin flap ischemia. Skin flap ischemia is caused by the inadequate blood supply to the skin flap leading to hypoxic tissue. Hypoxia is a condition in a region of the body which indicates a lower-than-normal oxygen level and pressure in the cells of the tissue.

HOW CAN NECROSIS BE TREATED AND BY WHOM?

Surgeons, in conjunction with a Hyperbaric Oxygen Therapy (HBOT) and wound care clinic, can treat this type of necrosis. HBOT can help prevent the progression of skin flap ischemia to skin flap necrosis. Surgical debridement of necrotic tissue may be necessary. Debridement used in conjunction with Hyperbaric Oxygen Therapy in these wounds includes increasing wound oxygen levels, stimulating healing, and improving blood vessel growth and circulation.

HOW CAN YOU PREVENT OR REDUCE YOUR RISK OF SKIN FLAP NECROSIS AFTER SURGERY?

Unfortunately, there is not a lot you can do to prevent it. Although, if you are a smoker, quitting smoking may reduce the risk. We recommend that you be evaluated by a wound care specialist to see what advanced treatment options may be best for you if you believe you have skip flap necrosis.

Necrosis tummy tuck causes

Abdominoplasty is also known as a ‘tummy tuck’ or as an ‘abdominal resection’. An abdominoplasty operation is a major operation that involves removing an area of skin and fat from your abdomen and repositioning your umbilicus (tummy button). An abdominoplasty operation will leave a scar from hip to hip and around your umbilicus. It is an operation that is performed under a general anaesthetic. During the operation the surgeon may also tighten your abdominal muscles. Please visit the BAPRAS link here for further information:

Why am I having an Abdominoplasty?

Are there any alternatives?

There are no alternative treatments which the surgeons can offer you.

Are the risks associated with an Abdominoplasty?

In the majority of cases this operation is carried out very successfully with good cosmetic results.

During the operation cuts are made through the skin and fat of your abdomen. This tissue always requires a very good blood supply. Sometimes the blood supply to the skin is disrupted and becomes inadequate. This means some of your skin may not be viable causing another wound on the surface of your abdomen; (This is called skin necrosis). Should this happen healing to your wound will be delayed and extra scarring may occur. A further implication of skin loss may be the need for further surgery to correct the problem. This may include a skin graft operation at a later date.

Your abdomen contains large amounts of fatty tissue beneath the skin which can have a reduced blood supply after the operation and cause long term lumpiness and distortion.

A chest infection can occur following any general anaesthetic. You can help to reduce the risk of this happening by taking regular deep breaths following surgery and getting up and sitting out of bed as soon as you are well enough.

Anaesthetic risks and complications

Your operation will be carried under a general anaesthetic.

During the operation your umbilicus (belly button) will need to be repositioned. There is a small risk that by repositioning the belly button all or part of the skin of your belly button to die. If this happens healing will be delayed and you may need another operation to correct the problem.

There is a risk that fluid may pool beneath your stitch line after surgery (this is called a seroma). A seroma can occur at any time after the operation. This fluid is usually re-absorbed by the body over a period of time. There are situations in which a doctor may need to remove the fluid using a small needle and syringe if the seroma causes pain and discomfort. In some cases the fluid can collect again so this procedure may need to be done more than once. This happens on occasions to other patients and the surgeon will discuss the risks of a seroma with you before your operation.

A wound infection can occur at any time following surgery. If your wound becomes infected you may need treatment with antibiotics or you may require hospital admission for further surgery to drain and treat the infection. Signs and symptoms of wound infection can include increased swelling, redness, fluid leakage and increased pain in your abdomen.

Wound breakdown can occur following surgery. Often there is some delay in healing of the stitch line. However; in rare cases the stitch line may not heal properly and the wound may breakdown or gape open. As a result, dressings will be required for prolonged periods and a further operation maybe needed to hasten healing and/or minimise the distortion that this complication can sometimes cause.

You will have a permanent, scar on your skin. Your scar can be concealed by clothing, however this cannot be guaranteed by the types of clothing you decide to wear. Your scar can sometimes improve over a period of 18 months following surgery however; some people for unknown reasons, develop raised, red and lumpy scars. Unfortunately this is largely beyond the control of the surgeon. The chances of this occurring are greater if you have already developed thickened scars following accidents or operations elsewhere. Scars sometimes stretch as they mature and this is also largely beyond surgical control.

During an abdominoplasty operation your surgeon will need to reposition your umbilicus (belly button). There is a risk that your umbilicus may not be placed centrally on your abdomen (as it was before your operation). Some degree of asymmetry of your scar may also be evident. If you are concerned about asymmetry after your scars have had at least 12 months to settle you should discuss this with your surgeon.

Once your wounds are healed you may notice an excess of skin at either end of the stitch line, these are known as dog-ears. If these have not settled down after 12 months, it is best to discuss further management with your surgeon. A further operation may be necessary to correct this.

You may experience some numbness in the lower part of your abdomen and thighs after this operation. In the majority of people this numbness reduces over a period of 12 months following surgery. Sometimes a small number of people may experience permanent numbness of their skin following abdominoplasty.

This is a blood clot that arises in the deep veins of the leg or pelvis. A deep vein thrombosis can happen if your mobility is restricted or you are inactive for a time following your operation. You may be given injections that help to prevent this from happening. You can reduce the risk of deep vein thrombosis by wearing the elastic stockings supplied during and after your operation and moving your legs about whilst you are in bed. Getting up and walking as soon as you are well enough may also reduce the risk of a DVT.

This is a portion of blood clot that has become lodged in a small blood vessel in your lung. It can cut off some of the blood supply to your lung causing shortness of breath or pain when you breathe in deeply. PE is a serious complication of surgery. You can reduce the risk of PE by following the advice for the prevention of DVT listed above. Patients are offered injections which help thin the blood after their operation as mobility may be limited and this can sometimes predispose to a PE or DVT. If you take the oral contraceptive pill or HRT you may be contacted by the hospital and asked to stop taking them. If you do stop taking the contraceptive pill remember to use some other method of contraception to avoid pregnancy. If you do not hear from the hospital, then continue to take your medication as normal. You will be asked to attend a pre assessment clinic at Frimley Park Hospital. These investigations will include a blood test. Photographs may be taken of your abdomen for your medical records and you will be asked for permission for the photographs to be taken.

There may be other risks specific to your individual case. The surgeon or ward nurse will discuss any further risks with you.

How do I prepare for my operation?

If you are overweight you will be asked to reduce your weight to within normal limits for your height. You will need to achieve this weight reduction before admission to hospital. If you need help to reach your target weight your GP may be able to refer you to a dietician.

If your GP prescribes aspirin, ibuprofen or other medications which may cause

bruising or bleeding such as clopidogrel or Vioxx, you may be asked to stop taking these for a period of 7 days before your operation. These medications may increase the risk of bleeding during and after your operation. Your surgeon will advise you about this when you see him / her in clinic. If you do not hear from the hospital, then continue to take your medication as normal.

If you normally take warfarin tablets you may be asked to stop taking these 5 days before your operation. You may also be asked to have a blood test on the day of your operation.

During your operation cuts will be made through this tissue. Rarely the blood supply to this area becomes disrupted, causing this tissue to become non viable. Should this happen the fatty tissue can become liquified and start to leak out of the wound (fat necrosis). This may mean having another operation to correct the cause and correct any deformities.

What happens after the operation?

The operation will take about 1-2 hours to complete however; you will be in the operating department for longer than this to allow time for recovery. When you wake up from your operation you will be lying in a ‘jack-knifed’ position; this means that you will have pillows under your knees, keeping your hips and knees bent to reduce the tension on your abdomen. You will be asked to sleep with your hips and knees in this position for several days following your operation to reduce the strain on your stitches.

how to avoid necrosis after tummy tuck

What Is Tummy Tuck Surgery?

The official word for tummy tuck is abdominoplasty. This type of surgery is performed to remove the excess skin and fat in this particular part of the body. It will restore the weakened muscles so that a person will have a much firmer and smoother abdominal physique. Most people get this done to look and feel better but there are also medical reasons that someone may need to have tummy tuck surgery completed. For whatever reason they decide to do it, it is meant to firm and tighten up the abdominal area of the body.

Fat Necrosis May Have Happened After Tummy Tuck Surgery

After a tummy tuck surgery, you will usually see about 7 – 10 days of changing dressings and checking for other issues that can occur. The signs of fat necrosis appear around 5 – 7 days after the tummy tuck surgery has been completed. It can take as long as 2 weeks to appear. Fat necrosis after tummy tuck surgery is the breakdown and eventual death of the fat cells in the body underneath the skin in the abdominal area. It is due to the lack of blood flow to the area. Here are some ways that you will be able to tell that you have fat necrosis after your tummy tuck surgery:

The skin next to the incision site can be scabby. It may also have a bluish-black color to it or in some other way look discolored. Just the sight of it may be disturbing and you may feel self-conscious about the way that it looks.

The site of the incision will feel warm and firm. There may also be lumps that are very obvious in that part of your body. Since you know your body the best, be sure that you are paying attention to any of the ways that it feels different.

There may be red patchy areas around the site. It will also have other types of skin breakdowns that will occur and it may become very sensitive to the touch.

It is quite common to have a reddish-yellow discharge. The discharge will come from the scar. and the wound site. You will likely want to call the doctor right away if this should occur to find out what you can do about it. In most cases, they will suggest a foam dressing with a soft surgical tape closure over it.

How To Treat Fat Necrosis After Tummy Tuck Surgery?

If you have fat necrosis after your tummy tuck surgery, you will want to know that it will heal but it will take some time in order to do so. You will want to use a wound dressing to help alleviate the pain or discomfort that you may be feeling. The wound dressing is important. You should talk to the surgeon that did your tummy tuck for good suggestions on the wound dressing that will work the best for you. In all cases, you will want to use soft surgical tape for your wound dressing. Many people use a foam dressing and use the soft surgical tape to secure it to the affected area. It can make a huge difference when you are dealing with the after effects of your tummy tuck surgery.

Treatments For Fat Necrosis After Tummy Tuck Surgery

If you have fat necrosis after your tummy tuck surgery, you will want to know that it will heal but it will take some time in order to do so. You will want to use a wound dressing to help alleviate the pain or discomfort that you may be feeling. The wound dressing is important. You should talk to the surgeon that did your tummy tuck for good suggestions on the wound dressing that will work the best for you. In all cases, you will want to use soft surgical tape for your wound dressing. Many people use a foam dressing and use the soft surgical tape to secure it to the affected area. It can make a huge difference when you are dealing with the after effects of your tummy tuck surgery.

Cutting Out The Fat Necrosis

In this instance, the surgeon will perform an operation that will Before you are operated on, you will be given a local anesthetic so that you do not have to feel it. The surgeon will remove or cut out the dead cells. After you are healed, you may have a small scar where the surgeon made the incision. Make sure that you do any of the follow up advice that the surgeon gives to you. If you have to write it down, be sure to keep it somewhere where you will be able to find it quickly.

With liposuction to treat fat necrosis after tummy tuck surgery, the surgeon will also give you an anesthetic. They will make an incision and insert a vacuum like tube to suck out the dead cells. You will also need to use a foam dressing with the soft surgical tape closure. This will assist in healing the incision area in the quickest and best way possible. Notice if anything doesn’t look or feel right so that you can keep your surgeon and doctor updated on your condition until you are totally fine.

Wound VAC is also known as vacuum-assisted help for closing up a wound. During wound VAC, a special device will decrease the air pressure on the wound. This will assist in allowing the wound to heal in a quicker way. Be sure that you consider wound VAC if your surgeon should suggest this to you. You might want to talk it over with a loved one also. Since there will be a time for healing, you may need their assistance in some ways. Be sure that they understand what you can be going through and they will be there for you at all times.

tummy tuck necrosis treatment

Abdominoplasty is the medical term we use to describe the procedure performed to improve the appearance of the abdomen by eliminating excess skin. During abdominoplasty, the plastic surgeon will strengthen the loose abdominal muscles with sutures, correct umbilical hernia, and remove the skin folds that are present on the lower part of the tummy. This type of procedure is usually recommended for people who have lost a lot of weight either after bariatric surgery or as a result of another weight loss program, but it is also a good option for patients who had multiple pregnancies or have been affected by weight fluctuations.

Abdominoplasty is the procedure we use to improve the appearance of the tummy when the skin has lost elasticity and there is considerable sagginess. This is also the main difference between enhancing the tummy with liposuction versus abdominoplasty. Liposuction only addresses the layer of fat that is under the skin in the abdominal area while abdominoplasty eliminates the excess skin that is saggy.

The tummy tuck is a more complex and invasive procedure compared to abdominal liposuction. The procedure should always be performed by a board-certified and experienced plastic surgeon in a hospital or accredited medical facility. When performed following a strict surgical protocol and with all the safety measures in place, the tummy tuck often delivers impressive results and is associated with few potential complications. However, more than the skills of the plastic surgeon, the patient’s post-op behavior can make all the difference in terms of avoiding the complications that can occur after the tummy tuck.

The complications that can be associated with abdominoplasty are common to all surgeries such as the development of blood clots, excessive bleeding, seromas, hematomas, infections, and complications related to the use of general anesthesia. Aside from these, there is also the risk of skin necrosis after abdominoplasty.

Skin necrosis can occur during the healing stage and is a rare complication. If it happens, sometimes another surgical procedure might be recommended. However, in a vast majority of cases, the skin necrosis that occurs are small in size and can be treated with the patient under a local anesthetic.

Another type of necrosis that can occur after the tummy tuck surgery is umbilical necrosis. This is a more severe complication and additional surgical interventions might be required for the reconstruction of the navel.

The risk of skin necrosis can be minimized if the patient is committed to following the indications of the plastic surgeon, especially the ones related to smoking and post-op care. Smoking is to be avoided for at least three to six weeks before the procedure is performed and for the same amount of time after the intervention. This indication is important as smoking can interfere with the healing process and can cause skin necrosis.


how common is necrosis after tummy tuck

Skin necrosis is a rare side effect of any surgical procedure, including cosmetic surgery. Skin necrosis occurs when the blood supply to the skin is interrupted or damaged. This limits the delivery of oxygen and nutrients and results in the death of skin tissue.

In this blog post we’ll discuss skin necrosis including symptoms, risk of occurrence, preventive measures, and treatment options.

How Does Skin Necrosis Occur?

Your skin is kept healthy and alive via a network of small capillaries which deliver oxygen and other nutrients to the skin’s surface.

Any type of trauma, including that which occurs during surgery, can disrupt this network of small blood vessels, resulting in ischemia, decreased blood supply, or hypoxia, lack of oxygen.

Trauma may include the severing of blood vessels, tightening of the skin via sutures, or pressure from post-surgery blood clots. Sometimes, skin necrosis is the result of bacterial or fungal infections. It can also occur if dermal filler is mistakenly injected into a blood vessel, blocking the flow of blood.

Can Plastic Surgery Cause Skin Necrosis?

Any and all types of surgery injure blood vessels. Once a surgeon cuts into your skin, some blood vessel damage will occur. Typically, the body is quick to adjust and the blood supply is rerouted.

Excessive injury to an area or risk factors such as smoking, diabetes or obesity, however, make it difficult for the body to heal. When an area is cut off from its blood supply, skin necrosis is the result.

How Common Is Skin Necrosis After Plastic Surgery?

Skin necrosis is a rare complication of cosmetic surgery. While studies have yet to be done to determine the exact rates of skin necrosis for each type of plastic surgery, the following are best estimates of the risk.

Generally, the more complicated the surgery, the higher the risk of skin necrosis. Still, for each of the studies above, smoking was the most common risk factor among those who developed necrosis.

What Are the Signs of Skin Necrosis?

The symptoms of skin necrosis can appear as early as 2-4 days after surgery and may progress hourly. It’s important to closely monitor your healing, as early identification offers the best chance for recovery. Contact your doctor immediately if you notice any of the following:

If you’re unsure, err on the side of caution and report your symptoms. The earlier skin necrosis is diagnosed, the better your chances of healing.

Can Skin Necrosis Be Prevented?

With any surgery, skin necrosis is a risk. However, this minimal risk can be reduced even further by selecting a skilled plastic surgeon, and by refraining from smoking.

Non-Smoking: Smoking is the biggest risk factor for skin necrosis. Nicotine is a vasoconstrictor, meaning it shrinks your blood vessels. This impedes the flow of oxygen and nutrients to the skin. It also slows the healing process, which puts you at risk for infection.

If you smoke, quit at least 2-4 weeks before your surgery. Refrain from the use of all nicotine products until you are fully healed.

Choosing a Skilled Surgeon: A skilled, experienced, board-certified cosmetic surgeon will perform your surgery more efficiently, damaging fewer blood vessels in the process. This can reduce the risk of skin necrosis by minimizing trauma.

How Is Necrosis Treated in The Event of an Occurrence?

To be effective, treatment for necrosis must begin as early as possible. In some cases, necrosis of a small area may resolve on its own, but can still leave scarring that negatively affects cosmetic outcomes.

Depending on the cause, size, area and appearance of the skin necrosis, your doctor may treat it in any of the following ways

Wet to Dry Dressings: Using saline-treated dressings and changing them frequently can speed the process of wound healing, preventing the progress of skin necrosis.

Antibiotics: If a bacterial or fungal infection is the cause of the necrosis, it may be treated with the use of antibiotics or antifungal medications.

Negative Pressure Wound Therapy: NPWT helps wounds heal faster by drawing fluid from the area, stimulating the circulation of blood.

Hyperbaric Oxygen Therapy: HBOT exposes skin cells to oxygen, promoting healing in otherwise oxygen-deprived tissues.

Debridement: In severe cases, the affected tissue must be removed through surgical or other means. This triggers the healing process anew, but can leave permanent scarring or disfigurement.

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