Dying skin, or skin necrosis is one of the more serious complications of a tummy tuck. It happens when circulation in the skin of the stomach begins to deteriorate. This deterioration occurs because during the operation, the surgeon must separate the skin/fat layer from the muscles in order to tighten the muscles. The circulation is lost when these layers of tissue are separated.
This is a rare complication since there is usually enough remaining circulation for the body to heal without any skin necrosis. But sometimes the circulation is not good, with this happening to obese patients and smokers in particular, and the skin below the scar line turns black and begins to die. Doctors always recommend that smokes stop smoking for at least four weeks prior to the surgery and for at least three weeks following surgery to keep skin necrosis from happening.
When it does happen, necrosis generally occurs over a very small area and the body will heal itself without further treatment.
Infection occurs in about 1% of all tummy tuck procedures, so the situation is extremely rare. Infections can get serious quickly so it is necessary to take immediate steps to bring it under control. This is done with antibiotics administered intravenously, a return to the hospital and possibly, more surgery to correct the situation.
Blood that collects under the skin after surgery, is called a hematoma. A small hematoma may go away on its own. However the larger ones may require additional treatment and surgery to remove. A hematoma can lead to bouts with skin necrosis.
Seroma, or fluid buildup under the skin happens in the first days after surgery is complete. This a pretty common occurrence. During surgery doctors place drains under the skin in the area of the incisions to allow for run off of the excess fluid. However, sometimes there is an even bigger buildup of fluid than anticipated. This requires the doctor to use a needle and syringe to draw off the body fluids. This is not painful since the body is still numb from the initial surgery.
When the skin puckers at both ends of the scar after surgery, this is referred to as, dog ears. This minor complication is usually suffered by people who have very loose skin in the first place, primarily the morbidly obese who had to have a lot of tissue removed in the first place. Dogs ears are very simple to remove and can be done in the doctor's office under local anesthesia.
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