Tummy Tuck: Are Stitches on Ab Muscles Permanent or Do They Dissolve?
- Asked by MyTime in Southern California
- 2 years ago
I was just curious about the stitches on the abdominal muscles that are performed on a Tummy Tuck. Do the stitches stay in forever or do they dissolve with time?
Suture choices for abdominal muscle (sheath) plication.
All of the answers will tell you that each surgeon chooses suture material on the basis of habit, experience, training, or perhaps on the basis of the tissue characteristics and desired outcome. As plastic surgeons, we all are taught the differences in suture construction (braided or monofilament), type (permanent or absorbable), material (natural or synthetic), size, and if absorbable, rate of absorption. These characteristics must be matched to the surgical "job" at hand.
None of us wants our abdominal muscle plication sutures to "tear through" when our patient coughs, sneezes, or strains in the restroom (sorry, but true!). That is why we also have restrictions on activity--too much lifting can cause sutures to break, tear through tissue, or lose strength prematurely. Realize that the tissues you sew together also have a role in the overall wound tensile strength--steel cables sewing two pieces of wet toilet tissue together will still tear through very easily with very little tension on the "repair." So surgeons should choose suture materials based on all these factors. You would be surprised how many surgeons simply do what they were taught in residency and don't even give these other factors much consideration--it's one of the first things I teach a medical student or resident when they spend time with me (and it's usually the first time they had even considered these facts)!
Your surgeon, of course, is a fully-trained, experienced, ABPS-certified plastic surgeon who understands all of these factors, makes educated and informed choices in your best interests, and lets you participate in these decisions where appropriate. For instance, I utilize a long-acting absorbable suture (running, so the forces are distributed along the length of the suture with stress such a cough, etc.) interspersed with a triple loop, buried-knot, permanent monofilament suture (triple looped to minimize "cheese-wire" cutting through the tissues, and monofilament to minimize the potential for harboring bacteria in the interstices with suture"spitting" over time) every few centimeters (inch or so). This has provided my patients with long-term, lasting muscle repairs that can still withstand weight gain or the occasional unanticipated pregnancy after tummy tuck. Still, this technique is no better than any of my esteemed colleagues' techniques--it is what works for me, and it is based on science and individual patient needs rather than habit, or "what my professor taught me." Experts may choose slightly different means to a similar end, but the end result is still our prime focus, and how to best achieve it may be slightly different with each of us!
Web reference: http://www.mpsmn.com/html/tummy-tuck.html
Tummy Tuck muscle tightening sutures
Dear MyTime in Southern California:
The type of suture used for a tummy tuck varies by plastic surgeon. Click on "more" below to view part 1 of a 4 part tummy tuck video. Realistically, if the sutures hold for 6 weeks, you body will heal and maintain the resultant tightening.
Personally, I use permanent sutures, and I prefer a woven polyester suture, as this seems to incorporate in the scar and may provide additional structure and support. The body remodels with time, and the sutures need to provide sufficient support to hold the tightened tissues together and provide time for your body to heal.
Eventually the sutures are not providing the majority of support and the repair is glued together with scar. As long as dissolvable sutures last long enough for this to happen, theoretically, the results should be the same.
Web reference: http://www.drmele.com/abdominoplasty.html
Stitches used for abdominal wall repair during tummy tuck
Most plastic surgeons will use permanent (non-absorbable) sutures for the abdominal wall tightening (plication) during a tummy tuck. You can ask your plastic surgeon which type specifically he used.
Web reference: http://www.williambrunomd.com
It totally depends on the surgeon's preference. I use permanent stitches but a slowly-absorbing absorbable suture is used by some surgeons. In my hands, a permanent suture tends to yield better results.
Sutures for tummy tuck
Most surgeons use permanent sutures to bring the abdominal muscles together. Dissolvable sutures would only produce an adhesion between the muscles once they dissolve. This adhesion is much weaker and more susceptible to dehiscence (separation).
Permanent or dissolvable sutures for the muscle repair?
Most plastic surgeons, including myself, use permanent sutures for the muscle repair as its durability and retaining of strength is predictable. There are some who will use dissolvable sutures which may be longer lasting but there still is a risk that they will lose the desirable strength too early - before the tissues have fully "healed" where there would no longer be a risk of disruption.
You should inquire of your plastic surgeon what his/her preference is.
Web reference: http://www.turkeltaub.com
Tummy tuck stitches
Most plastic surgeons use permanent stitches in the muscle fascia plication. The suture material is made of polypropylene (like fish line) and does not dissolve. However, that does not mean that they hold forever, because the sutures can cut through the tissues resulting in a recurrence of the bulge. In addition the entire abdominal wall can stretch back out over time after tightening, resulting in the recurrence of the bulge.
Dissolving versus permanent sutures
This is personal decision by the surgeon based on training, beliefs, and experience. Both absorbable and permanent sutures can work just fine. There is no one right suture to use. Every surgeon makes his choice and has his or her reasons. I personally use permanent suture but have used absorbable suture at times and would have absolutely no criticism of anyone who uses absorbable suture.
Suture material to plicate the tummy muscle
It is really up to your plastic surgeon what suture material she/he uses for tightening the abdominal muscle. I use the permanent suture; some may use long-lasting dissolvable sutures. It is preference of the surgeon.
Web reference: http://www.drkimplasticsurgery.com/tummytuck
I use permanent suture for muscle plication for tummy tuck. These suture stay forever, unless removed by another surgery for the abdomen. They are harmless and cannot be felt through the skin. There are however different types of permanent sutures and each surgeon has his/her own preference.
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.