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About Alan M. Engler, MD, FACS
Expertise
Dr. Engler has answered over 2700 plastic surgery questions for Allexperts. His expertise is in cosmetic plastic surgery including breast surgery (breast enlargement with implants, breast reduction, breast lifts), liposuction, eyelid surgery, tummy tucks, facelifts etc. Dr. Engler has been listed as one New York`s Top Doctors, and as "One of the World's Most Famous Aesthetic Surgeons" (Aesthetic Surgery, TASCHEN Books, Angelika Taschen, Editor). He is the author of 4 books, including "BodySculpture" (a best-selling plastic surgery book on breast surgery, liposuction and tummy tucks), "EyeScapes" (Plastic Surgery of the Eyelids), "Restylane," and "The Slim Book of Liposuction." Dr. Engler has two US Patents for surgical instruments that he's designed, and has appeared on numerous television shows, including The Tyra Banks Show, The Ricki Lake Show (four times), and the Dr. Keith Ablow Show. Videos of his appearances are available on YouTube (SEARCH FOR "DR. ENGLER"). His website is www.bodysculpture.com.

Experience
Dr. Alan Engler is a board-certified plastic surgeon in New York and the author of BodySculpture - Plastic Surgery of the Body for Men and Women (ISBN 0966382749) one of the top-selling plastic surgery books on amazon.com, barnesandnoble.com, etc.

Education/Credentials
Dr. Engler graduated from Yale University (undergraduate) and the College of Physicians and Surgeons of Columbia University (medical school). He did his residency training in General Surgery and, after that, Plastic Surgery, at the Montefiore Medical Center in New York. He is on the faculty of the Albert Einstein College of Medicine in New York.

You are here: Experts > Health/Fitness > Surgery > Plastic Surgery > tummy tuck skin problems

Plastic Surgery - tummy tuck skin problems

Expert: Alan M. Engler, MD, FACS - 10/27/2009

Question
QUESTION: I recentely had a tummy tuck 5 weeks ago, I am wondering why after 3 days it looked like My stomach, around my belly button and on above and below the incision it looks like I was burnt badly?? It turned a very dark brown and thick scabs developed which peeled and left scars. Also my incision didnt close properly on the left side leaving me with a opening that is about and inch wide and very deep?? My doctor doesnt want to re stitch it because of infection?? I am really worried it wont heal properly and I will have to endure this painful surgery again. Can you explain why this happened? Thank you.

ANSWER: from Dr. Alan Engler
www.bodysculpture.com

Hi Vivian,

I'm sorry for the problems you're having.

It sounds like you've had some wound healing problems, and those can occur with any procedure, but particularly with certain types of procedures (such as tummy tucks, facelifts, some breast reductions) and also particularly if there are any associated issues, such as diabetes, smoking, other medical problems, etc. They can occur in the absence of any of those conditions, too, but are even more likely if one or more of them is present.

Any areas that turned to scabs and opened up (such as around your belly button) or that just opened up on their own (such as the left side of the incision) presumably had suboptimal blood supply. Other possibilities include excess tension, infection and other things, but it basically comes down to not enough blood supply to allow for the anticipated healing.

Once the wound has come open, it's actually not a good idea just to try to stitch it back together because it becomes contaminated with bacteria, and the tissue is swollen and - because of both of these factors - the tissues do not typically hold sutures (stitches) well and will just tear open again.

The best way to treat these areas is by cleaning them up (basic wound care, including showers, dressing changes, etc) and then letting them close up on their own. If they are very large, you c can ask about a VAC treatment. This basically a strong suction device that's applied to the open wounds for 23 hours a day and that helps pull them together. Smaller areas will just heal on their own.

Depending on what it looks like you may, in fact, need to have something done to improve the quality of the scars. But it's too early to be concerned about that. Work with your PS to get the wounds closed, and then you can address the final result later.

I hope that this helps, and good luck,

Dr. Alan Engler
www.bodysculpture.com

---------- FOLLOW-UP ----------

QUESTION: I also had liposuction on the sides is this why it looked like I was burnt? I just don't understand why this happened? I have viewed other peoples pictures online and I don't see anyone who experienced what I did. My doctor just told me that this happens?? I understand why my incision is still opened thanks to your explaination. Have you seen this happen to anyone else?

Answer
Hi Vivian,

Some people feel that extensive liposuction can increase the risk of this occurring but there is plenty of evidence that lipo is safe to do at the same time, so that's not that clear.

I have seen things like this; usually, though, in association with some of the other things we talked about including medical problems, smoking, obesity, etc.

sorry about that...but you should wind up with a nice result once this is healed and, to that end, work with your plastic surgeon on wound care,

Dr. E

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