Have I Compromised my Muscle Repair?
- Asked by PollyPocket in Australia
- 4 years ago
I am 5 weeks post-Tummy Tuck with muscle repair. I have been doing very well but when having a normal bowel movement the other day I heard what sounded like a stitch pop in the area above my belly button, I also heard this again when I sneezed the next day. Have I compromised my muscle or could this be other dissolvable stitches? I have done nothing to strenuous to jeopardise my Tummy Tuck results, yet it still feels tight inder the skin at this point.
"Popping" Sounds Alone are Usually OK
If you disrupt the plication or repair, you will know it! "Popping" sensations do opccur after exertion, sneezing, laughing, etc. The muscles continue to contract around the plication (repair) sutures and cancreate that sensation.
If you truly disrupt the repair, you will feel a significant tearing and often see a bulge in the area....you will know it! If there is ever concern about it, contact you surgeon immediately.
A stitch goes pop: Muscle repair with tummy tuck
Generally scar tissue is well formed by 5 weeks after surgery and it is not likely that you compromised your muscle repair.
It is important to maintain the results of your repair by performing core strenghtening exercises which will enhance the results of your repair. Pilates or Yoga is excellent in this regard.
Performing aggressive traditional stomach exercises like crunches and affect your result producing a bulging stomach muscle.
Notify your surgeon and keep an eye on your belly but don't be overly concerned.
A few popping stitches are OK after tummy tuck
As for the popping sound - it can be stitches. However, most plastic surgeons use many sutures to reshape the muscle layer and typically place two layers. So, feel comfortable that as long as your abdominal shape has not changed, one or two "popping" sounds will not change your results.
It is always a good idea to discuss this with your surgeon as well during your next visit.
Abdominoplasty involves "plicating" the rectus muscles with suture and is a regular part of the procedure as performed in my San Francisco area practice.
This repair is typically most vulnerable at week 2 after your surgery. This is because the normal healing process can actually make the tissues the suture passes through more weak for a period as scar tissue deposits. People are also generally feeling better and becoming more active at this point.
Most surgeons would not choose a suture that would dissolve as quickly as 5 weeks so the sensations you felt were probably not that.
If you haven't noticed a difference in profile you probably have not compromised the repair. (Though it is possible a suture has ruptured).
As always - because the surgeon that performed your surgery understands better than any of us what was done - it is important to follow-up with your doctor if you have post-op questions.
I hope this helps!
You've not likely hurt anything
Most surgeons perform "muscle tightening" during tummy tuck procedures - some use absorbable sutures whereas others use permanent sutures. In most cases, the repair is almost "bomb-proof" - enough to withstand sneezing, coughing, movement, etc. You may have broken an absorbable suture, pulled a little fascia (which is your abdominal wall covering)... or something completely unrelated.
It is very unlikely the you have created a problem. Rest easy and recover according to your instructions to date.
Hope this puts you at ease.
I think it's doubtful you disrupted your repair, as most often this would have been accompanied by significant pain. I would, however see your surgeon for an evaluation.
Let your surgeon know that you have experienced a problem or have a concern
- There different ways to repair the muscle layer. Most plastic surgeons will close the fascia (the dense white fibrous tissue that surrounds the muscle) in layers. I typically use a running over and over type suture similar to a baseball stitch. When this is done the tension in one area will be splayed out over a wider area and is much less likely to tear through or break.
- It takes time for the muscle / fascia to heal, but at five weeks you are getting fairly solid.
- Most likely there is some stiffness to all of the tissue, skin and fat of your abdomen. This is called an induration and is a normal process. Think of this layer like concrete. It is stiff and hard. When you turn suddenly, there can easily be a disruption or tearing of this stiff tissue giving you the sensation of something breaking or popping.
- A change in your shape would result if a suture actually ruptured or broke. As long as you have not noticed any change in your shape you are most likely fine.
- It is important, during the early healing period to avoid activities that place unnecessary tension or force on the muscle repair, this would include crunches, sit ups, lifting weights or strenuous activities. Give the area a chance to heal.
- The repair of this layer, and any sutured area, is at its weakest point at two weeks. After two weeks it begins to get stronger, it may take a few months to be at its maximum as far as tensile strength.
- Follow up with your surgeon and get his or her advice. He knows what your original tissue was like and will have a specific insight into the likelihood of a rupture of your repair.
Tummy tuck and stitch popping
The sound you heard was probably a stitch popping. At 5 weeks you probably are OK, but it would be a good idea to see your doctor so that he/she can check you out.
It is very unlikely that the muscle repair 5 weeks after an abdominoplasty could be compromised.
It is possible for a stich to break 5 weeks after a tummy tuck especially if it is not permanent. However, at 5 weeks, the body has pretty securely fixed the repair with collagen. It is not our of the question that a repair could be disrupted but it would be most uncommon. I can't imagine that sneezing or straining in the bathroom could do this.
After Tummy Tuck Surgery
After tummy tuck surgery it is very important to refrain from strenuous activity and intense stretching as to not disrupt the healing process. It is normal to feel tightness on the abdomen for quite some time after your tummy tuck surgery, until your muscles heal and relax. Several layers of sutures are used to tighten the abdominal wall, so if indeed it was a stitch that caused the popping sound, your results likely have not been disrupted, but it wouldn't hurt to check in with you plastic surgeon for a quick post operative exam. A note with the abdominal muscles after surgery. Once you are healed it is important to continue abdominal exercises to maintain a toned and fit appearance.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.