TUMMY TUCK COMPLICATIONS AND OBESITY
We have previously discussed how the risk of surgical complications increases steadily with a body mass index (BMI) above 35. It is very important to be within a normal weight prior to surgery to help prevent complications like seroma, infection, and slow wound healing, among other things. When a tummy tuck is performed, a lower abdominal incision is done and then dissection is continued toward the midline; the abdominal wall is tightened, the excess skin is removed, and the incision is closed with multiple-layer sutures. What is the importance of losing weight before this surgery? Well, when the lower abdominal incision is performed, the blood supply to the abdomen comes from the top. Before surgery, there is a dual blood supply coming from the bottom and the top, but after the incision is performed, the blood supply that comes from the bottom part is essentially compromised. When patients are overweight, perfusion is diminished. This is why an overweight patient who has a tummy tuck has a higher chance of slow wound healing.
Another consideration is the belly button. When somebody has gained weight, the belly button is elongated; because it is attached to the abdominal wall, it actually gets longer the more fat you have in your abdomen. This can cause problems with wound healing. If you look at this diagram, the cylinder is the belly button, which extends from the level of the skin to the level of the abdominal wall. If you gain weight, the belly button gets much longer. When a tummy tuck is performed and the belly button is detached, the longer the belly button, the less blood will reach the end of the belly button. This is why there is a higher risk of losing the belly button and having wound healing problems around it when you are overweight. The important thing to understand is that because the belly button itself is a scar from birth, wounds around it are not going to heal very well.
The bottom line is that before any cosmetic surgery, you need to understand that having a weight within the normal range is important to avoid wound healing problems around the belly button or in any area where an incision is made.