During a tummy tuck procedure, the skin and any fat on the abdomen are elevated off of the underlying muscle fascia so that the muscle can be tightened with sutures and the skin can be repositioned, pulled tight and the excess removed. In this process, about 80% of the blood supply to the skin is removed so that the lower abdominal skin has only around 20% left. This can cause delay in the healing of any wound that develops in that area.
It is critical that the remaining blood vessels remain intact to prevent any further reduction in blood supply so that a critical level is not reached, which can result in skin loss. Inhaling cigarette smoke or secondary smoke within a month before of after surgery can have devastating effects and is absolutely prohibited as it results in constriction of those remaining blood vessels. This also includes nicotine patches, gum and e-cigarettes for the same period of time.
Old Surgical Scars
Scars from previous abdominal surgeries can sometimes limit the result of a tummy tuck and may preclude some types of abdominoplasty. Lower vertical abdominal scars and scars from cesarean sections or hysterectomies generally do not cause a problem and are usually removed with a tummy tuck. Upper abdominal scars can be an issue. Long vertical midline abdominal scars can’t be removed and may limit the amount of skin that can be removed. Long oblique scars along the lower edge of the rib cage, such as from an open gall bladder removal cuts across those critical blood vessels and may preclude a full tummy tuck or require a modification that will limit the amount of skin that can be removed.
No Excessive Pressure
After most tummy tucks, as abdominal binder is worn to hold the bandage in place, for something to attach the drain(s) to and to place some mild pressure in an effort to prevent fluid building up between the skin and the muscle. It is important that the pressure is only mild so that those residual blood vessels are not compromised. If your binder feels tight, it is OK to loosen it as a little too loose is better that too tight.
If you have any open areas on your incision line, such as from where a drain was removed or a stitch come out, do not cover it with a band-aide or nonabsorbent telfa dressing. It is best to clean the area with soap and water in the shower and twice per day with hydrogen peroxide and cover it with an open gauze dressing that is changed twice per day until it heals.
We advise taping over the closed incisions and leaving the tape on for several days before removing it. It is best to do this for three to four months. If you get irritated from the adhesive, try silicone sheeting which sticks without adhesive. Forget expensive scar gels or vitamin E.