Skin Necrosis After a Tummy Tuck

A tummy tuck may give you the sleek, flat torso of a bikini babe, or it could result in a complication known as necrosis, or cell death. Necrosis is sometimes serious, depending on the type and the extent of the problem. Problems associated with necrosis include black, crusty skin; lumps beneath the surface of the skin; and scars that tear open and leak fluid.

About

• The FDA defines necrosis as when the "skin or underlying tissue dies and falls off." Necrosis occurs when the blood supply to the belly button, or to underlying fat or skin, sustains damage during the surgical procedure.

  According to "Skin and Aging," a publication examining issues in dermatology, this type of complication is relatively common after a tummy tuck. Thirty-two percent of non-smokers and 52 percent of smokers experience necrosis or other types of localized complications following surgery.

Types

• The three main types of necrosis are umbilical, flap, and fat necrosis. Umbilical necrosis is considered fairly common, occurring primarily in smokers. With umbilical necrosis, your belly button turns black, and eventually winds up as a scar.

  Flap necrosis is both the least common and the most serious. This type of necrosis may require consistent and careful dressing of the blackened skin until the affected area falls off, or it could result in skin grafts and surgery.

  Fat necrosis is basically a ball of dead fat under the skin. This type of necrosis will generally go away on its own, though you will probably need to keep it bandaged to absorb discharged fluids.

Symptoms

• If you've recently undergone a tummy tuck procedure, you need to watch for signs of necrosis. It takes between two and four weeks for fat necrosis to develop. You should look for lumps that develop under the affected area. These lumps are generally firm and painful to the touch.

  According to plastic surgeon, Dr. Peter Aldea, necrosis appears as a "...bluish discoloration that begins to look mottled and eventually becomes extremely bruised and dark." If necrosis is not treated, gangrene can set in, and if that happens, you may get very ill, or possibly even die.

Smoking

• You need to stop smoking completely if you want a tummy tuck. Nicotine constricts the blood vessels, which can then cause the incisions to break down in a process that results in necrosis.

  Doctors are absolutely adamant that patients avoid all forms of nicotine before and after a tummy tuck. As Dr. Aldea says, "The reason why most plastic surgeons feel so passionately about this is that while some complications cannot be prevented, this one is totally preventable."

Warning

• Men have a greater risk of skin necrosis after a tummy tuck procedure than do women. In a study conducted by doctors at the University Medical Center Utrecht, necrosis occurred in 64.3 percent of male patients, compared to 15.3 percent of female patients.

  It is important to sit down with your plastic surgeon and discuss the possible complications of a tummy tuck before undergoing the surgery. This article is intended as a general overview only, and should not replace the advice of a qualified medical professional.