What holds it all together? Yes, I know stitches, but do the muscles actually heal together? Is there scar tissue that helps strengthen the rectus abdominis? I just want to know how it all stays together and strong.
When an Abdominoplasty is Performed. How Does the Rectus Abdominis Muscle Heal?
Doctor Answers (4)
During an abdominoplasty, the diastasis recti is repaired usually with permanent sutures and then scar tissue develops which reinforces the repair.
The muscle fascia heals together with time
When abdominal wall plication is done during abdominoplasty, it is actually the tough connective tissue covering (the muscle fascia) that is stitched together. The muscles themselves are not technically stitched together, but the maneuver has the effect of putting the muscles back, side to side again. When the muscles are brought back together like this, there are two main benefits:
- The rectus diastasis and laxity of the abdominal wall is eliminated. The abdominal wall becomes taught, looking flatter and slimmer.
- The rectus muscles have their normal anatomical configuration (i.e. anchored side by side to each other) restored; this has the effect of restoring their normal muscle mechanics. With normal muscle mechanics restored, the rectus muscles work much more efficiently, and 'become stronger'.
Over time, the fascia heals together and the stitches no longer serve the function of keeping things together. The scar tissue between the fascia does not have a direct effect on 'strengthening' the rectus muscles, it is the improved mechanics.
Lawrence Tong MD FACS FRCSC
Tummy tuck muscle repair explained and compared to tree grafting.
We often use permanent sutures to hold muscles together until they heal, A simple analogy is grafting two tree brancehes with duct tape. initially the tape is all that holds the branches together. With time the branches grow into each other and the tape plays a secondary role and is eventually unnecessary. In a similar fashion stiches hold muscles together unitl they heal. With the proper exercise and core strengthening the muscles remian in alignment and rely less on the sutures. I hope that helps!
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There is some scar formation between the approximated rectus muscles- but what is really holding the connective tissue together is permanent, non-absorbing suture. Placing absorbable suture in a rectus muscle plication can lead to recurrent abdominal wall laxity.
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