Skin death sounds nasty, and it is. This is a serious
healing problem which is due to poor circulation to the abdominal
skin. It occurs because in order to perform the abdominoplasty
operation, your surgeon needs to separate your skin/fat layer from
your inner girdle (so that your skin and inner girdle may be
tightened). When these layers are separated, some of the circulation
is lost. Usually enough circulation remains to allow healing without
skin death (doctors use the term "necrosis"). However, in some cases
(especially smokers and obese patients, but possibly in anyone), the
remaining circulation is inadequate. The skin above the scar line
may then turn black and die. Fortunately, this is uncommon, and if
it does occur, it is usually limited to a small area and heals on
its own within a few weeks.
may occur following any operation and may require additional
surgery, intravenous antibiotics, and hospitalization. The risk is
Hematoma is a collection of blood under the skin, which is due to
bleeding that occurs after surgery is over. If the hematoma is
large, you may require surgery to remove it, and it may predispose
to skin death.
Seroma is a fluid collection under the skin and is due to your own
body fluids which collect under the skin after surgery. To prevent
seromas, many surgeons place drains under the skin at the time of
surgery. A seroma may occur, anyway and can be removed using a
needle and syringe. Because your abdomen will be numb after this
operation, seroma removal is not painful.
Dog ears are puckers of skin on either end of your scar. If you have
very very loose skin, you will be more likely to have dog ears.
Fortunately, your plastic surgeon can remove your dog ears in the
office under local anesthesia as a simple procedure.
Jean M. Loftus, MD, FACS, Jean M.
Loftus, MD, FACS, Cincinnati, OH
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