Skin Necrosis After Surgery

The hard truth is that no cosmetic procedure—be it minimally invasive injectables or full-on plastic surgery—is without risk. Of all the potential things that could go wrong, skin necrosis is one of the scariest, requiring immediate medical attention.

What is skin necrosis?

Skin necrosis is a wound healing abnormality which results in the death of tissue due to lack of oxygen flowing to that specific region. In fact, disruption in the blood supply to a particular area will result in death, or necrosis, of the cells in that area.

What causes skin necrosis?

In the case of plastic surgery, when the skin is cut and raised, the blood supply has to travel a relatively long distance to get to all the cells, increasing the potential for necrosis. Undue tension on the skin after suturing, such as in the case of a tummy tuck, as well as excess pressure from a post-surgery hematoma or seroma can also cause necrosis. When tissue pressure increases, it exerts a compressive force and clamps down on the small blood vessels and capillaries. There’s then a lack of blood flow and oxygen that can in turn result in necrosis.

What are the signs of skin necrosis?

Pay close attention to how your skin both looks and feels. Common symptoms include redness and tenderness, blisters, swelling, and dark brown or even black discolouration of the skin. Skin necrosis also happens—and progresses—extremely quickly, over a matter of days or even hours. Time is of the essence, so if you notice any of the above symptoms, contact your doctor immediately.

How is skin necrosis treated?

To be most effective, treatment must start quickly and aggressively. What this entails will vary depending on where the necrosis is occurring, what caused it, and how severe it is.

If it’s a result of a mechanical interruption of the blood supply caused during surgery, this can be surgically improved, so long as it is caught early enough.

Similarly, excess pressure from sutures can be released or a hematoma or seroma drained, to alleviate pressure.

Hyperbaric oxygen therapy, during which you sit in a chamber filled with pressurised oxygen, is another potential treatment option; it allows for enhanced absorption of the oxygen to the areas of the body where it’s needed.

In severe cases, leech therapy is sometimes used, because the leeches secrete an anticoagulant that keeps the blood flowing.

And while it’s not always warranted or necessary, sometimes removal of the dead tissue—either surgically or via autolytic wound gels that allow the body to break down the dead cells on its own—is needed. Dead skin can get infected and endanger the surrounding areas. Not to mention that if the original cause of the skin necrosis was, in fact, a bacterial infection, you’ll need to keep the infection from spreading.

How can you prevent skin necrosis?

Stop smoking or using nicotine products 6 weeks before and 6 weeks after any surgery. Your doctor will advise as to exactly how long you need to do so, based on the particular procedure you’re having.

Taking care of your wounds after the fact is also paramount. Make sure to clean them and change any bandages regularly/as directed.

Finally, be mindful of applying any undue pressure on the operated area, particularly with compression garments. Consult with your doctor to make sure they’re fitting properly—and check underneath them regularly, to ensure your skin isn’t showing any of the aforementioned symptoms of necrosis.