Belly Button Necrosis After a Tummy Tuck: What to Expect

Belly button necrosis — when the skin of the belly button loses its blood supply and dies — is actually a relatively common complication in both tummy tuck patients and DIEP flap breast reconstruction patients. It looks alarming, but the outcome is usually better than you'd expect.

During a tummy tuck or DIEP flap procedure, the surgeon makes a small incision around the belly button and dissects down to the abdominal wall. There are tiny blood vessels around the belly button that provide its blood supply, and during this dissection, some of those vessels can be disrupted.

With a DIEP flap, the surgeon works very close to the belly button because those same small blood vessels also help keep the flap alive. This proximity increases the chance of compromising the belly button's blood supply.

If you're having a hernia repair at the same time as a tummy tuck — especially a larger hernia — the risk of belly button skin necrosis goes up as well.

Belly button necrosis is very different from fat necrosis. Fat necrosis happens under the skin where you can't see it. Skin necrosis is visible:

1. Right after surgery: the tissue appears slightly purple or darker than the surrounding skin
2. Over the next couple of weeks: the tissue becomes progressively darker
3. Eventually: it turns into what's called an eschar — a black, dry scab

Usually, these small eschars are simply left alone. They eventually fall off on their own, revealing healed tissue underneath. Your surgeon will likely have you do some type of dressing changes — Dr. Killeen typically has patients paint the area with Betadine to keep it dry and provide antimicrobial protection, though every surgeon has their own preferences.

Here's the surprising part: once that eschar falls off, the belly button usually looks really good. In fact, surgeons often joke that it sometimes looks better than a typical post-tummy tuck belly button. The tissue scars down into a very natural belly button shape, and you also avoid having the typical circular incision scar.

So while no one wants to see black tissue on their body after surgery, this is a complication that typically ends with an aesthetic result that's not too different — and sometimes even better — than what it would have been otherwise.

Belly button necrosis is alarming to experience, but it's a manageable complication with a usually favorable outcome. If you're dealing with this after a tummy tuck or DIEP flap, make sure your surgeon is attentive and guiding you through the healing process. A year from now, it will likely be just a distant memory.