Very Sore Spot After Tummy Tuck

Question

I had abdominoplasty (extensive muscle repair without any liposuction) 5 months ago to correct a severe diastasis recti that was causing back pain and extreme abdominal weakness. Five months post-surgery, my abdomen finally is just beginning to feel more "normal" again, as persistent swelling is decreasing and some abdominal strength and sensation are returning. However, I am concerned about one localized, very sore spot just above and to the left of my navel, along the vertical line of permanent stitches that I can feel under my skin.I first became aware of this spot approximately 1 month ago, a day after having slightly strained my abdominal muscles while pulling on the Spanx undergarment that I'm still wearing to support my muscles post-surgery. This sore spot feels like a small piece of suture material (perhaps a broken suture or the knot of a suture?) that moves slightly under my fingers when I touch the area. It is constantly sore and uncomfortable, and the pain increases if I touch the spot with my finger.I am concerned about whether this sore spot means that my muscle repair is compromised and also whether the pain/uncomfortable sensation at this spot eventually will go away. When I asked my surgeon about this, she only said that what I am feeling is "a stitch" and that the pain may be due to a pulled muscle or muscle spasm and likely will resolve; she said the muscle repair is "probably OK" since my abdomen still appears flat and unchanged since the localized soreness began.

David Rankin, MD · Answer

This is most likely the knot of one of the permanent sutures that your surgeon used to plicate (tighten) your muscles. it is most likely a permanent suture and you may feel this area forever or it may encapsulate and you won't feel it as much. If it is really sore, then you may be reacting to it a bit and hopefully the soreness will go away over time. If your belly is still flat, then you most likely did not disrupt the tightening that you achieved from your previous surgery. It is hard to really give you a great answer without seeing you. Good luck and I hope your soreness goes away.

J. Timothy Katzen, MD, FACS · Answer

Hello, SoreTummy. Thank you for your question regarding persistent soreness after your tummy tuck.

It’s not uncommon to experience localized soreness and discomfort several months after abdominoplasty, especially in areas where permanent sutures were used for muscle repair. Your concern about the sore spot above and to the left of your navel, particularly after a slight strain, is understandable.

Based on your description, it seems likely that the soreness you are feeling could indeed be due to a suture or the knot of a suture. This is a common experience for many patients, as sutures can sometimes cause localized irritation or discomfort as they heal and integrate with the surrounding tissue. Sutures, especially permanent ones used in muscle repair, can sometimes cause localized irritation or discomfort. This can be exacerbated by any strain or pressure applied to the area, such as pulling on a compression garment.

The healing process after extensive muscle repair can take several months. As the tissues heal and the swelling decreases, it’s normal to start feeling sensations and discomfort in previously numb or swollen areas. As your surgeon mentioned, the soreness could also be due to a mild muscle strain or spasm. This is not unusual, especially if you exerted your abdominal muscles more than usual.

It’s reassuring that your surgeon has assessed the situation and believes that the muscle repair is intact. However, it’s important to monitor the area. If the soreness persists, worsens, or if you notice any new symptoms (such as swelling, redness, or changes in your abdomen’s appearance), you should contact your surgeon for a follow-up evaluation. Over-the-counter pain relievers and anti-inflammatory medications can help manage the discomfort. Gentle massage and warm compresses may also alleviate some of the soreness.

Remember, recovery from abdominoplasty can be a lengthy process, and individual healing times can vary. Continue to follow your surgeon’s advice, wear your compression garment as recommended, and avoid activities that may strain your abdominal muscles. I hope this provides some reassurance and guidance on managing your post-operative soreness. If the discomfort persists or if you have further concerns, don’t hesitate to seek additional advice from your surgeon.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS

Steven Schuster, MD, FACS · Answer

Dear Sore
Sounds like you had a great deal of work on the abdomen. If you are happy with the overall result and this is your only concern -- DON'T WORRY ABOUT THE MUSCLE FALIING APART! After 6-8 weeks the repair is strong enough without any sutures to hold up to routine activity including crunches in most cases. If this area bothers you why not go back and speak to your surgeon. If it is a knot then usually it is near the umbilicus and near the midline. It should be relatively easy to remove this under local anesthesia in the office if this is the case. Go back and speak to your surgeon again about possibly correcting this problem.

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