Pros and Cons of Permanent Vs. Dissolvable Sutures for Diastasis?

Correction of separated abdominal muscles (rectus diastasis) either makes or breaks a good tummy tuck.  Not only what thread the surgeon uses but what type of suturing he or she does should be very important to the informed consumer of an abdominoplasty.  Abdominal musculature, not only the rectus muscles but the obliques as well, allow us to bend and twist in all sorts of directions, therefore, the suture repair with permanent suture needs to be a figure of 8 technique interrupted, both above and below the umbilicus followed by a running locking suture to bury the figure of 8 sutures and reinforce the repair. 

 

I use permanent sutures because you never know how long it is going to take until scar tissue takes over the job of keeping the muscles together and correcting the diastasis recti.  Everyone's body chemistry is different and one person may dissolve the dissolvable stitches at a faster rate than another person, and since you want a permanent repair, use permanent sutures. 

 

Plastic surgeons are used to putting permanent things in people's bodies such as breast implants, chin implants, etc.  I can certainly understand why this might freak you out, but please understand that the body will wall these sutures off with scar tissue protecting you from these permanent sutures and increasing the necessary repair for the correction of the separated muscles. 

With regards to permanent vs. absorbable sutures for diastasis repair, the problem with dissolvable sutures is that their degradation is ahrd to control from patient to patient, as well as their loss of strength.  You generally need a good six months of soild healing for everything to sacr down and solidify internally, and even the best/strongest dissolving sutures are usually pretty weak at that point.  They will still be there, but will not have nearly the tensile strength as the permanent sutures.  I hope this helps

I do a two layer muscle repair.  The deep layer is with permanent suture and the more superficial layer is with a long lasting absorbable suture.  You should not be able to see or feel the sutures.  Permanent sutures are used on most intestinal surgery, joint and tendon surgery, and in most vascular surgery without any consequence.  You want a long-lasting repair, and for many plastic surgeons-that means using some permanent suture.  Good luck with surgery.