Cosmetic Surgery Tips

When Does Necrosis Occur After Tummy Tuck

Skin necrosis, also known as dermal necrosis, is a serious complication that can occur following certain cosmetic procedures such as breast lifts, breast reductions, tummy tucks, and facelifts. This condition develops when there is a lack of blood supply to a specific part of the skin, which in turn damages not only the skin itself but also the surrounding tissues. The compromised blood supply results in the affected skin turning black, as it is deprived of the necessary oxygen and nutrients needed to maintain healthy tissue.

Blood plays a crucial role in maintaining the health of our tissues by carrying oxygen and nutrients throughout the body. When there is a disruption in the blood supply to a particular area of the skin, the tissues in that area do not receive an adequate amount of oxygen, leading to tissue damage and ultimately skin necrosis. This can happen as a result of surgical procedures that involve the manipulation of the skin and underlying tissues, potentially causing damage to blood vessels and reducing blood flow to the affected area.

While skin necrosis is a rare complication, it is important for patients considering cosmetic surgery to be aware of the risks involved. Factors that can increase the likelihood of developing skin necrosis include smoking, diabetes, and certain medical conditions that affect blood circulation. It is crucial for patients to discuss their medical history and any potential risk factors with their healthcare provider before undergoing cosmetic procedures to minimize the chances of complications such as skin necrosis.

In cases where skin necrosis does occur, prompt medical attention is crucial to prevent further damage and promote healing. Treatment may involve debridement (removal of dead tissue), topical medications, and in severe cases, surgical intervention to repair the damaged skin and tissue. It is important for patients to follow their healthcare provider’s instructions carefully and attend follow-up appointments to monitor their progress and ensure proper healing.

It is worth noting that there are certain products available on Amazon that may help with wound healing and skin recovery following skin necrosis. These products include topical ointments, dressings, and wound care supplies designed to promote healing and reduce the risk of infection. Patients recovering from skin necrosis should consult with their healthcare provider before using any of these products to ensure they are safe and appropriate for their specific situation.

Overall, skin necrosis is a serious complication that can occur following cosmetic procedures, but with proper attention and care, it can be managed effectively. Patients considering cosmetic surgery should be well-informed about the potential risks involved and work closely with their healthcare provider to minimize complications and achieve a successful outcome. By taking proactive steps to protect their skin health and overall well-being, patients can minimize the risk of developing skin necrosis and other complications associated with cosmetic surgery.

When Does Necrosis Occur After Tummy Tuck

Abdominoplasty, more commonly referred to as a tummy tuck, is a popular surgical procedure aimed at improving the appearance of the abdomen by removing excess skin and, in some cases, tightening the underlying abdominal muscles. This procedure is often sought after by individuals who have experienced significant weight loss, pregnancy, or aging, which can lead to loose and sagging skin around the midsection. Oftentimes, a tummy tuck is combined with liposuction to remove stubborn areas of fat and further enhance the results of the surgery.

During a tummy tuck, the surgeon will make an incision along the lower abdomen, typically from hip to hip, to remove excess skin and fat. The abdominal muscles may also be tightened to create a more toned and defined appearance. This procedure is not a substitute for weight loss or a healthy lifestyle, but rather a way to address loose skin and muscle laxity that diet and exercise alone may not be able to correct.

Some popular products on Amazon that are relevant to the tummy tuck procedure include:
1. ScarAway Silicone Scar Sheets – These silicone sheets can help improve the appearance of scars following surgery.
2. Marena Recovery Compression Garments – Compression garments are often recommended post-surgery to aid in the healing process and reduce swelling.
3. Bio-Oil Skincare Oil – This skincare oil can help improve the appearance of scars and stretch marks, which are common concerns following a tummy tuck.

It is important for individuals considering a tummy tuck to consult with a board-certified plastic surgeon to discuss their goals and expectations for the procedure. Recovery time varies for each patient, but most individuals can expect to return to work and normal activities within a few weeks. It is important to follow post-operative instructions and attend follow-up appointments to ensure optimal results.

In conclusion, a tummy tuck can be a transformative procedure for individuals looking to improve the appearance of their abdomen and boost their self-confidence. By combining skin and fat removal with muscle tightening, patients can achieve a more sculpted and toned midsection. With proper care and attention to post-operative instructions, the results of a tummy tuck can be long-lasting and life-changing.

What Does Skin Necrosis Look Like?

In dermal necrosis, the affected area lacks adequate blood supply and nutrients. Eventually, the lack of oxygen will lead to the death of your tissues that may appear as:

  • Dark blue, tan, or black tinge in the affected skin.
  • Dry, leathery, and thick appearance that you usually see in scabs.
  • Open wound on the affected skin.

When Do I See My Surgeon?

If you have recently undergone breast surgery or a tummy tuck, it is important to be aware of the potential signs of complications. After any surgical procedure, it is normal to experience some discomfort, swelling, and bruising. However, if you notice any of the following symptoms, it is crucial to contact your surgeon immediately:




  1. Increase in pain: While some pain and discomfort are expected after surgery, a sudden increase in pain could indicate a problem such as infection or internal bleeding. It is important to address this promptly to prevent any further complications.


  2. Non-healing wounds: If you notice that your incisions are not healing properly or if you develop any signs of infection such as redness, swelling, warmth, or drainage, it is important to seek medical attention. Untreated infections can lead to serious complications.


  3. Fever: A fever is a sign that your body is fighting off an infection. If you develop a fever after surgery, it is important to contact your surgeon immediately for further evaluation and treatment.



Early detection and treatment of any complications after breast surgery or a tummy tuck are essential for optimal outcomes. Prompt medical intervention can help prevent serious complications and ensure that you achieve the best possible cosmetic results.



Products on Amazon for Post-Surgery Care:
























Product Description Price
ScarAway Silicone Scar Sheets Helps improve the appearance of scars $25.99
Mederma Advanced Scar Gel Reduces the appearance of old and new scars $14.99
Biodermis Epi-Derm Areola Circles Silicone sheets specifically for areola scars $54.95


It is important to follow your surgeon’s post-operative instructions carefully and to attend all follow-up appointments. By being vigilant about monitoring your recovery and seeking help if you notice any concerning symptoms, you can help ensure a smooth healing process and the best possible outcome from your surgery.

After Which Procedure Is Skin Necrosis Seen?

Skin necrosis is a rare complication of surgical procedures that may disrupt the vascular supply of your tissue. This is most commonly seen in;

  • Breast Reduction or Mammoplasty: Reshaping the breast by removing excess fat, tissue, and skin.
  • Lumpectomy: Surgical removal of cancerous tumours from the breast.
  • Breast biopsy: Getting a sample of breast tissues for diagnosis.
  • Mastectomy: Removal of the entire breast.
  • Breast lifting or Mastopexy: Removal of excess breast skin and tightening the breast skin.
  • Breast reconstruction surgery: Rebuilding the shape and appearance of the breast.
  • Abdominoplasty or Tummy tuck surgery: Removal of excess skin to tighten the abdominal wall and muscles
  • Nipple-sparing mastectomy: Removal of the breast tissue while preserving the nipple-areolar complex
  • Face and/or neck lift:

Risk Factors of Skin Necrosis

Certain factors can increase your chances of developing skin necrosis after surgery. You can manage these risks with the help of your surgeon’s expert care and advice.

Smoking

Smoking can increase the likelihood of many complications occurring including skin necrosis. Smokers have lower immunity, poorer wound healing, clogged blood vessels, and low blood oxygen levels. That’s a golden recipe for plastic surgery failure and skin necrosis.

Diabetes

The blood circulation in diabetic patients is usually less than ideal. Diabetes leads to the narrowing of blood vessels, which increases the risk of tissue ischaemia. Moreover, wounds in diabetics take longer to heal than average. This prolonged wound healing can increase the chances of both infection and skin necrosis.

Bacterial or Fungal Infections

Regardless of how thorough the sterility techniques in the Operating Room (OR) are, it is impossible to completely prevent all microbes from striving in some areas of the body, like the nipples. The nipples contain a rich bacterial flora. These might sometimes spill and cause post-op breast infection, and in rare cases skin necrosis.

Bacterial and fungal infections can compromise the blood supply to your skin and lead to skin necrosis after surgery. Whilst your surgeon will do everything they can to reduce the chance of infection, you can help reduce your bacterial load with thorough pre-operative body washes of your surgical area before coming to the hospital.

Obesity

Obesity can significantly increase your chances of developing skin necrosis. In obese patients, there is extra pressure on your arteries and a need for your body to work harder to pump blood. Aside from that, extra fat cells and tissues require extra blood and oxygen supply. Obesity puts your cells at a higher risk of not getting adequate nutrition and developing necrosis.

Steroid use

Steroids can lead to poor wound healing and can increase your risk of skin necrosis. If you are taking steroids, you must ensure you inform your Plastic Surgeon in your consultation so that they can formulate a specific plan for you.

Alcohol

Excessive alcohol consumption can lead to lower immunity and can reduce your body’s ability to heal itself after surgery.

Amount of Tissue removed during surgery

The more tissue you are having cut away, the higher the risk you’ll develop skin necrosis.

What Are The Complications Of Skin Necrosis?

If detected early, your surgeon can treat necrosis with a reduced chance of potential complications. If you do not undergo treatment in a timely manner, the reduced blood supply can be detrimental to the health of your tissue and your overall cosmetic result.

Dermal necrosis may lead to bacterial superinfection and the development of gangrene. Gangrene is the build-up of dead cells and tissues when the blood supply to a large area is cut off. The affected skin can turn a greenish-black colour and contain foul-smelling fluids.

The infection might extend further and pose a risk to your health. This is why we instruct our patients to seek help as soon as they suspect skin necrosis after any cosmetic surgery.

When Does Necrosis Occur After Tummy Tuck

This is always due to an insufficient blood supply. It is much more common in smokers or nicotine users. I insist all of my patients refrain from all nicotine products (including cigarettes, patches, gum etc) for 3 weeks before and after surgery. Diabetics are also more likely to have decreased circulation after a TT to the distal flaps of tissue. An extremely tight garment that interferes with the blood supply can contribute to this.

However, most of the time when it occurs, it just happens, and there is no obvious reason. I had a female patients many years ago who placed a very hot pad on her abdomen for menstrual cramps and gave herself a 3rd degree burn, which caused skin loss – but this is a very unusual case.

What Are The Treatment Options For Skin Necrosis?

If you are experiencing skin necrosis as a complication of a recent operation, it may resolve on its own if the area is small. The treatment options your surgeon may recommend will depend on the area, cause, and appearance of your skin necrosis. Treatment options for skin necrosis include the following;

Debridement

  • Debridement is the standard procedure for treating post-surgical skin necrosis.
  • It involves the removal of the dead or necrotic tissue through surgical or non-surgical means.
  • Removal of the dead tissues is necessary to induce your healing process and tissue regeneration.
  • Once these tissues are removed, you may be placed under advanced wound care treatment, including antibiotic medication, for faster healing.
  • Depending on the severity of your case, debridement can range from removing small patches of necrotic skin to total amputation.
  • This applies to necrosis after breast reduction, breast lift, tummy tuck, or any other kind of post-surgical skin necrosis.

Daily Dressing Change and Improved Sterility

  • Changing the dressing daily promotes hygiene and faster healing of your skin necrosis.
  • Your surgeon will give you instructions on how to clean the wound with povidone-iodine and dab it dry with gauze.
  • Daily dressing change combined with surgical debridement and antibiotics promote quicker healing of skin necrosis.

Antibiotics

  • Necrosis can leave your skin damaged and vulnerable to further injury and infection.
  • Your surgeon is likely to prescribe antibiotics to prevent the risk of infection.

Negative Pressure Wound Therapy (NPWT)

  • Negative pressure wound therapy (NPWT) is a method of drawing out fluid and infection from a wound to help it heal.
  • A special dressing (bandage) is sealed over the wound and a gentle vacuum pump is attached.
  • The device can drag fluid, debris, and dead tissue from the wound and reduce swelling.
  • It keeps the wound clean and helps to prevent bacterial infection.
  • NPWT also helps to bring the edges of your wounds together. It can stimulate the growth of new tissue that helps seal the wound.

Hyperbaric Oxygen Therapy (HBOT)

  • Hyperbaric oxygen therapy (HBOT) is used to treat infections in oxygen-deprived tissues.
  • Your doctor asks you to inhale oxygen from a chamber that has above average pressure levels.
  • It increases the oxygen-carrying capacity of your blood and subsequently the healing tissue.
  • It might halt the necrosis in some cases and lead to better outcomes.
  • HBOT is not for everyone.
  • There are other risks with the use of hyperbaric oxygen therapy including;
  • Temporary short-sightedness
  • Damage to the middle ear
  • Barotrauma injury from a change in air pressure
  • Seizures from too much oxygen
  • And more.

Larval (Maggot) Therapy

  • In some cases of skin necrosis, a specific species of maggots raised in sterile environments can be used to debride wounds. We call this process biological debridement.
  • These maggots secrete enzymes that break down dead tissue and digest it.
  • They remove infected tissue and do not affect any of your healthy tissue.

Nipple Tattooing to re-colour lost skin

  • After breast reduction surgery or breast lift, breast necrosis may develop. Although it is rare, it may affect your nipple-areola complex and will lead to the loss of the nipple.
  • After treating the necrosis, nipple tattooing may be an option.
  • Patients can undergo nipple tattooing after debridement, daily dressing, and the use of antibiotics. It can restore an acceptable appearance of the nipples.
  • Tattooing can be carried out with or without a skin graft to recreate both the shape and colour of your nipple and areola.
  • Over time, the tattoo can fade but you can have a touch up to restore the look you desire.

Before undergoing any tattooing to the area, please check with your Plastic Surgeon to ensure the wound has completely healed.

Avoiding Skin Necrosis

Regular visits with your plastic surgeon and nursing team after your cosmetic procedure are necessary to detect any wound changes in a timely fashion. 

The treatment of skin necrosis depends entirely on its early diagnosis. Identifying the development of skin necrosis, the type of necrosis, and the underlying cause of your necrosis is essential for determining appropriate treatment.

Dermal necrosis can leave the affected skin vulnerable to further damage and injury. When treated correctly, it allows for quick healing and speedy recovery.

So, if you suspect that you might have skin necrosis, please contact us to schedule a visit with your surgeon to receive proper assessment and treatment.

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