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

I'm concerned and "creeped out" by the idea of permanent sutures for diastasis and would like to be more informed about dissolvable sutures. Is there a real, increased risk of muscles coming apart at some point? What is the impact of ab work/exercise in mitigating that risk or making it worse? Are the muscles pretty much fused/scarred together by the point that they dissolve? Any data on the prevalence of permanent vs. dissolvable? I'm 5'8" and 138 lbs, and fairly active.

Doctor Answers (11)

If You Want A Permanent Repair, Use Permanent Sutures

+3

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. 


Honolulu Plastic Surgeon
5.0 out of 5 stars 215 reviews

Absorbable Sutures in Abdominoplasty

+2

Since the desired end result of most plastic surgery is a permanent improvement in appearance, the diastasis is repaired with permanent sutures.  In my practice, while I do use permanent sutures, I place them in a way so the knots are buried and therefore you should not be able to feel them.  I share the opinions of most of the physicians answering your question here in that this is something you should not spend your time worrying about and rather focus on the myriad of other factors to consider when having surgery.  Good luck with your endeavors.

Theodore Diktaban, MD, FACS
Manhattan Plastic Surgeon
4.5 out of 5 stars 11 reviews

Either choice is fine

+2

Dear Louise 10,

Using either type of suture will be acceptable. After a certain period of time has elapsed, the diastasis repair is healed, and does not depend on the sutures to hold thing together. This occurs well before a dissolvable suture has dissolved, so a non-permanent suture is acceptable. I have used both types of sutures in tummy tucks with no differences noted in any of my patients. Good luck.

Best regards,

Lawrence Tong MD FACS FRCSC

Lawrence Tong, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 18 reviews

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Permanent vs. dissolvable

+1
Its definitely an odd thing to think about, but dont let it keep you up. The sutures are really there just to hold things together while the body heals everything in place. However, many surgeons feel that in such a dynamic and often used portion of the body, if a permanent result is desired permanent sutures are better suited to that effect.

To be on the safe side, I prefer permanent sutures as do most plastic surgeons. Some use dissolvable and seem to do just fine, so you could go either way.


Zach Barnes, MD
Bakersfield Plastic Surgeon
5.0 out of 5 stars 5 reviews

Permanent sutures in tummy tuck

+1

There are no studies that I know of which compare dissolving and permanent sutures in tummy tuck. Some do use dissolving sutures for diastasis repair, most do not. Similar to a repair of a hernia, permanent support has been important to reduce recurrence. There is no downside or disadvantage to a permanent suture, so you shouldn't put much worry into it.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 30 reviews

Permanent Sutures Better For Diastasis Repair

+1

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

Christopher V. Pelletiere, MD
Barrington Plastic Surgeon
4.5 out of 5 stars 25 reviews

The choice depends on the plastic surgeons experience

+1
There is not wrong or right way. The longer lasting restorable sutures perform as well as permanent sutures without the risk of spitting out.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
5.0 out of 5 stars 58 reviews

Permanent sutures are not creepy

+1

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.

Vishnu Rumalla, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 79 reviews

Diastasis repair: permanent or dissolvable sutures

+1

In my diastasis repairs, I always use permanent sutures because I want the security of the strength and pesistance of it as compared to dissolvable sutures. There is some variability of duration of dissolvable sutures as well as or their residual strength and if the suture strength decreases faster than the clinical need for a particular level of force, then breakage of the repair can occur. PDS suture, a dissolvable one, may last long enough in most people to not be associated with this problem but I would rather not risk it even in a few patients.

Permanent, persistent deep sutures virtually never present a problem.

 

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 20 reviews

Permanent or dissolvable sutures for diastasis?

+1

I would not be too concerned about this.  There is a lot of things to consider when having surgery, but this issue is something for the surgeon to decide on.  I use dissolvable (PDS) or permanent sutures for diastasis repair and I think that they both do a perfectly good job.

The sutures will be very deep in your abdomen and you should not be able to feel them. 

Jonathan J. Staiano, FRCS (Plast)
Birmingham Plastic Surgeon
5.0 out of 5 stars 9 reviews

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.