Tummy Tuck complications
What complications can occur during the tummy tuck surgery?
In the following, the most important complications that can occur with a tummy tuck surgery are briefly described:
- Postoperative swelling
After the tummy tuck, a certain amount of postoperative swelling is normal. It can be in the form of smaller bruises or more pronounced in wound effusions. A certain amount of induration (hardening) is also normal postoperatively. These changes improve appreciatively in the first postoperative weeks. In this phase, compression products are urgently recommended and should be worn for 6 weeks after surgery. Of course, even after that, mild to moderate swelling might be visible. On occasion, one can also see swelling directly over the scar, which is explained by lymph blockage. This lymphatic swelling is also observed after C-section; it reduces in size but often takes months.
In this surgery, large wound surfaces are produced. Therefore it is especially important to carry out meticulous hemostasis. With subsequent compression and insertion of drains, large hematomas in patients without clotting disorders are rather rare. The body can resolve smaller hematomas itself; larger ones require an operative removal on an as-needed basis.
This is avoided as a rule by use of careful hemostasis and compression during surgery. Items described under hematomas apply here as well.
- Disturbance of scar formation after the tummy tuck
So-called hypertrophic scars (or, in the worse cases, keloids) can occur occasionally in people with corresponding disorders.
- Injury to adjacent structures (very rare)
If an abdominal wall hernia or umbilical hernia are present, the bowel can be injured.
The risk of infection should be reduced through highly sterile conditions, and, if necessary, antibiotic prophylaxis.
- Dog ears
Excess skin is present on both ends of the horizontal cut surfaces. The worse the findings, the more extensive the tissue and even more extensive the amount of excess skin that must be removed during the tummy tuck surgery. They are called dog ears because of the resemblance. Removing these surgically is only done with caution in abdominoplasties to prevent excessive widening of the scar. They can be reduced using special suture techniques. It is hoped that they will shrink within 3-6 months and eventually will not be visible. If the desired shrinking effect is not sufficient, then a small revision under local anesthesia can be carried out. With this approach, one can usually keep scar lengths to a minimum.
- Skin sensation in the scar area
Before the tummy tuck, it should be explained that there will be decreased sensation or numbness in the central scar area. Complete loss of feeling is rather rare. However, permanent numbness can remain in the upper half of the median scar segment. This is often already present after a C-section.
- “Grief corner” (problem area)
The problem area ("grief corner") in tummy tuck surgery is localized over the mons pubis. Here the greatest tension exists, and therefore a higher risk for disturbance in wound healing. A minimal disturbance in healing means a mild separation of the edges of the wound in this area. With antiseptic bandages this small problem can be quickly fixed. Larger disturbances of healing are rarer and usually occur in smokers or diabetics.
- Tearing of the wound / sutures
With too much tension and too much movement of the torso, the sutures can become overstrained and tear. Therefore, especially in the first week after the tummy tuck, one should take care of oneself and remain in a slightly flexed position.
- Dying off of tissue
It is possible, especially in heavy smokers, that the perfusion of the skin is no longer viable in the area of the greatest stress, in the middle of the suture line. In this case, portions of the skin can die off. Depending on the size of the defect, this can require the application of antiseptic bandages for a prolonged period of time, or even lead to further surgical revision. Therefore it is important to avoid cigarettes before and after a tummy tuck.
- Wound serous effusion = seroma
In the tummy tuck, relatively large wound surfaces exist, which can produce wound drainage, depending on individual predisposition. Usually this does not develop into changes that are worth mentioning. Sometimes smaller and mid-sized seromas develop, which resolve on their own with time. The larger seromas must sometimes be drained using a cannula.
- Unsatisfactory cosmetic results
In the setting of an effective counseling interview, the expectations of the patient and the possible operative results should be brought into accord to prevent disappointments. For asymmetric, suboptimal scar healing, among other problems, surgical revision can provide a remedy.
- Thrombosis and embolism after a tummy tuck
Thrombosis prophylaxis with Heparin and support hose is advisable during and after surgery.
- The risks of narcotics / anesthesia will not be addressed here.
Updated on 10.08.2014
- Plastic Surgery - Grabb & Smith - Lippinkott Williams & Wilkins - Philadelphia USA 2007
- Ästhetische Chirurgie Lemperle, von Heimburg Ecomed 2008 (Ringbandwerk)
- Plastische Chirurgie Krupp - Ecomed 2008 - (Ringbandwerk)
- Plastische Chirurgie Berger, Hierner - Springer Band 3: Mamma, Stamm - Berlin 2006