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Wound opening after tummy tuck: why it happens, how it is prevented and how it is treated

By Dr Sanjay Parashar, plastic surgeon · Dubai London Hospital, Jumeirah · 21 October 2026

A tummy tuck (abdominoplasty) leaves a long scar under tension, over skin that has been lifted and moved. Most heal well. When part of the wound opens, it is usually for a reason that can be identified and, in many cases, prevented. Here I explain the main causes, what I do in my own surgery to reduce each risk, and how an open tummy tuck wound is treated.

First: is this urgent?

Contact your surgeon the same day, or go to an emergency department, if you have any of these:

• Fever, shivering or feeling generally unwell
• Redness or swelling that is spreading
• Pain that is getting worse rather than better
• Grey, dark or blistering skin around the scar
• Sudden swelling or a tense, bruised area on one side
• Foul-smelling or increasing discharge

What wound opening looks like

Surgeons call this wound dehiscence. It most often starts as a small gap in the centre of the scar, just above the pubic area, or where vertical and horizontal scars meet. This is where skin tension is highest and blood supply is furthest from its source. You may see a scab that lifts, a gap with yellow tissue, or clear or cloudy fluid. Small openings can heal well with the right care. Larger ones need specialist assessment.

Seven causes, and how I reduce each risk

From more than three decades of surgery and from the published research, these are the factors I see most often behind tummy tuck wounds that open, and what I do about each one in my own practice.

1. Bleeding and haematoma

A collection of blood under the skin (haematoma) raises pressure under the flap, stretches the wound and reduces blood flow to the skin edges. It can also become infected.

My approach: I use a stratified infiltration technique. Before dissection, a standardised infiltration solution containing a dilute vasoconstrictor is placed layer by layer through the tissues. This narrows small vessels, gives a cleaner operating field and reduces bleeding. It is combined with careful control of bleeding before closure. Before surgery, patients are told which medicines and supplements to pause, only on medical advice.

2. Long operating time

Research shows that the risk of complications after plastic surgery rises as operating time increases¹, and that combining several procedures with a tummy tuck adds to that risk².

My approach: each operation is planned in detail beforehand, with a set sequence of steps and an experienced team of assistant surgeons and nurses working together. This keeps surgery efficient without rushing. When combining procedures would make an operation too long, I recommend staging them.

3. Removing too much skin

If too much skin is removed, the wound is closed under tension. Tension squeezes the small vessels at the wound edge, and the scar is more likely to open, especially in the centre.

My approach: careful estimation before surgery, with markings made standing and lying and a pinch test of how much skin can safely be removed. During surgery, the planned excision is confirmed with the patient positioned for closure before the final cut, so that the skin closes without tension.

4. Reduced blood supply to the skin

The abdominal skin is fed by small vessels (perforators) coming up from the muscles, especially around the belly button³. Traditional wide undermining divides many of these vessels, leaving the lower skin to survive on less blood flow. Lipoabdominoplasty, in which undermining is limited and perforators are preserved, was developed to protect this circulation⁴. Preserving the deep fat layer above the muscle (Scarpa's fascia) has been shown to reduce fluid collections (seroma)⁵.

My approach: I call it a preservative tummy tuck (preservative abdominoplasty). It is based on a detailed knowledge of abdominal anatomy and aims to preserve as many of the blood vessel perforators, lymphatic channels and skin nerves as possible. Better preserved circulation supports wound healing. Preserved lymphatics help reduce fluid build-up, and preserved nerves help keep skin sensation.

5. Heat injury from energy-based devices

Ultrasound-assisted liposuction (UAL), plasma devices such as Renuvion and electrocautery all generate heat. Used in the wrong place, at the wrong setting or too close to thin skin, they can cause heat damage that only shows days later as skin breakdown. In 2022 the US FDA warned against using the Renuvion/J-Plasma system for aesthetic skin procedures it had not been cleared for; some specific uses were cleared later⁶. A randomised study found more seroma when the abdominoplasty flap was raised with electrocautery than with a scalpel⁷.

My approach: energy devices are used only where they add a clear benefit, at controlled settings, with protection of the skin and the flap, and never as a substitute for precise surgical technique.

6. Suture materials and technique

The skin should not carry the weight of the closure. When deeper layers are not repaired well, the tension falls on the skin edges.

My approach: layered closure, with the deeper connective tissue layer carrying the tension so that the skin edges meet without strain. Quilting or progressive tension sutures fix the flap to the deeper tissues, spread the tension and close the space where fluid collects⁸. Suture materials are chosen for each layer according to the strength and healing time it needs.

7. Dressings and follow-up

A dressing or garment that is too tight can reduce blood flow to the flap. One that is too loose allows fluid to collect. Problems spotted early are much easier to treat.

My approach: carefully applied dressings and a correctly fitted compression garment, and positioning advice for the first days. Every patient follows a fixed follow-up schedule: 24 hours, 3 days, 7 days, 2 weeks, 1 month, 3 months, 6 months and 1 year after surgery. In between these visits, my team is always available for any urgent concern, so that a problem is caught early. If I see signs such as skin scabbing or fat necrosis along the scar, I apply a negative pressure (VAC) dressing over the wound. Studies in abdominal surgery link negative pressure dressings over stitched wounds with fewer wound complications, including wound opening⁹.

Your own risk factors

Some risk comes from the patient rather than the operation, and much of it can be reduced before surgery:

• Smoking and nicotine (including vapes and patches) clearly increase wound healing problems after abdominoplasty¹⁰. Stop well before surgery and do not restart during healing.
• Diabetes should be well controlled before and after surgery.
• Higher body weight and large recent weight loss increase risk².
• Previous abdominal scars can change the blood supply and need careful planning.

If your tummy tuck wound has already opened

Whether your surgery was in Dubai or abroad, our team at Dubai London Hospital can assess it. Treatment depends on the size, depth and cause of the wound, and may include:

• Assessment for infection, fluid collection or haematoma, with wound swabs and tests when needed
• Cleaning and removal of dead tissue (debridement)
• VAC (negative pressure) therapy to clean the wound and encourage healing
• Closure using the surrounding skin, advanced gently with anchoring sutures and VAC, instead of a skin graft, when the wound is suitable
• Scar treatment once the wound has healed

You can see how this approach was used for large wounds after an arm and thigh lift in our case studies.

What you can do now

• Keep the wound covered with a clean dressing and do not apply home remedies or creams
• Take a clear photo every day in the same light
• Gather your operation notes and medication list, especially if your surgery was abroad
• Contact your surgeon, or send us a photo for advice

References

1. Hardy KL, Davis KE, Constantine RS, et al. The impact of operative time on complications after plastic surgery: a multivariate regression analysis of 1753 cases. Aesthet Surg J. 2014;34(4):614-622.
2. Winocour J, Gupta V, Ramirez JR, et al. Abdominoplasty: risk factors, complication rates, and safety of combined procedures. Plast Reconstr Surg. 2015;136(5):597e-606e.
3. Huger WE Jr. The anatomic rationale for abdominal lipectomy. Am Surg. 1979;45(9):612-617.
4. Saldanha OR, Federico R, Daher PF, et al. Lipoabdominoplasty. Plast Reconstr Surg. 2009;124(3):934-942.
5. Costa-Ferreira A, Rebelo M, Vásconez LO, Amarante J. Scarpa fascia preservation during abdominoplasty: randomized clinical study of efficacy and safety. Plast Reconstr Surg. 2013;131(3):644-651.
6. US Food and Drug Administration. Update: use of Renuvion/J-Plasma device for certain aesthetic procedures. FDA Safety Communication, 2022–2023.
7. Marsh DJ, Fox A, Grobbelaar AO, Chana JS. Abdominoplasty and seroma: a prospective randomised study comparing scalpel and handheld electrocautery dissection. J Plast Reconstr Aesthet Surg. 2015;68(2):192-196.
8. Pollock H, Pollock T. Progressive tension sutures: a technique to reduce local complications in abdominoplasty. Plast Reconstr Surg. 2000;105(7):2583-2586.
9. Mantyh C, Silverman R, Collinsworth A, et al. Closed incision negative pressure therapy versus standard of care over closed abdominal incisions: a systematic review and meta-analysis. Eplasty. 2024;24:e33.
10. Manassa EH, Hertl CH, Olbrisch RR. Wound healing problems in smokers and nonsmokers after 132 abdominoplasties. Plast Reconstr Surg. 2003;111(6):2082-2087.

This article gives general information and does not replace medical advice. Treatment decisions are made only after an in-person examination. In an emergency, go to the nearest emergency department.