Necrosis After a Tummy Tuck: What Is It & How to Prevent It

During a tummy tuck, your surgeon will remove excess subcutaneous fat. He doesn’t, however, remove all of it. The fat left behind after the surgery is vulnerable to fat necrosis, so it’s important to understand this potential post-surgical complication. Fortunately, it’s not as dire as its name suggests.

What is Necrosis After a Tummy Tuck? Why Does It Occur?

Necrosis is the word doctors use to describe tissue death. After a tummy tuck, some patients experience something called fat necrosis, which is specifically the death of some of their fat cells. This occurs when and if the blood supply to these fat cells is damaged during surgery for some reason. Remember that although it’s controlled, surgery is a traumatic experience for your body no matter how skilled your surgeon. Rearranging the skin and fat of your abdominal area can easily change blood flow patterns a bit.

How Common is Necrosis After a Tummy Tuck Surgery?

Fat necrosis is a rare enough tummy tuck complication that it shouldn’t keep you up at night worrying prior to your surgery. It’s common enough, however, that you should be aware of it. Hard and fast statistics about the exact number of patients who experience fat necrosis after the procedure are difficult to come by. The risk of fat necrosis is higher in plastic surgeries that take place in areas of the body with larger amounts of fat, however, including the breasts and belly.

What Does Fat Necrosis After a Tummy Tuck Look and Feel Like?

Although some patients do report mild discomfort from time to time, fat necrosis is generally not at all painful. Areas of fat necrosis typically start out as nodules full of an oily substance that may leak a yellowish fluid. As they progress, these nodules become firmer to the touch. If they are very close to the skin, areas of fat necrosis can be visible as well as palpable.

Fat necrosis can appear as red nodules but may also appear dark and black in color. Patients often confuse areas of fat necrosis with areas of infection as the two can appear similar. While fat necrosis is generally a mild complication, infection can become more serious. It’s important to talk to your doctor if you see or feel anything that seems a little out of place or questionable. He would much rather see something that turns out to be a false alarm than have you wait until an issue turns into a serious problem.

How to Avoid and Prevent Fat Necrosis After a Tummy Tuck

There isn’t a lot you can do to prevent fat necrosis, but the one thing you can do is a big one. If you smoke, quite a few weeks before your surgery and continue avoiding the habit as you recover. Cigarette smoke is known to constrict and narrow our blood vessels, which is a big no-no when you’re trying to preserve blood supply. Avoiding cigarettes is so important that your surgeon may literally refuse to perform your tummy tuck (or other procedures) if he thinks you’re still smoking. Some may even test your blood for the presence of nicotine to make sure you aren’t fibbing about having quit.

Other than avoiding tobacco, your options for preventing fat necrosis are essentially limited to working with an experienced surgeon. Even she can’t guarantee you won’t have any issues with fat necrosis, however.

How to Treat It

There are several ways to treat fat necrosis, but doing nothing is sometimes the best course of action. In time, your body should absorb the dead fat cells and the necrotic tissue will go away on its own. If you find the fat necrosis bothersome, however, or if it seems to be lingering longer than you would like, treatment is available.

If the necrosis is still young and filled with oils, fine needle aspiration can sometimes remove the fluid and shrink the necrotic area. The body can then absorb the few remaining dead cells more quickly. If the nodule has already hardened, your doctor may be able to numb the area and extract the dead tissue with a hollow tube. He may attach the tube to a vacuum for a little extra suction power.

When these methods fail, surgical excision of the necrotic tissue under general anesthesia is possible. Your surgeon may hesitate to jump to this alternative too quickly, however, since surgical trauma is what caused the fat necrosis in the first place.

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