Removing prolene permanent stitch 6 years post tummy tuck? (photos)

Question

8 weeks ago I woke up with a mass that was bigger and bruised at first but has shrunk to the size of a small pea. It is no longer shrinking, bruise has resolved but i still have a small mass. Underneath the mass is a permanent prolene stitch from tt 6 years ago. General surgeon says its just a callus and stitch needs to come out. I dont understand how a callus would be big, bruised and then shrink but not disappear. Local ps office says to deal with my original doc who is out of state. Help!

Larry C. Leverett, MD, FACS · Answer

Hi Arizona Neighbor:Most Plastic Surgeons (including myself) use permanent sutures to hold your corset muscle repair in place because not only does it work, but it also lasts. Unfortunately, a suture may irritate its way through the skin. What happens next depends on what was done at the original surgery. If this prolene suture was all that you have holding your distastes (muscle separation) together, another suture will be required to maintain your corrected abdominal narrowness.If you simply have this irritation removed in the office, it is possible that your abdominal width would expand. If, however, you had another row of reinforcing sutures at the original surgery (or have another reinforcement placed, this time) , you will likely maintain your narrow contour. In order to find out what the original surgeon did, you would best ask the surgeon to send to you (or your new surgeon) your operative record. This would not only be extremenely helpful to the surgeon, it would also allow you to be more completely prepared for the likely scenarios.

Peter Fisher, MD (retired) · Answer

Hello and thank you for your question. Unfortunately  I saw this too often in my practice and therefore stopped using permanent suture years ago. The sequence that you have described is typical for a delayed reaction to a permanent stitch. The fact that it nearly cleared up is great, but if left will most likely eventually break through the skin as a suture abscess. I do believe your general surgeon can remove it through a small opening under local. If he doesn't want to,  consult with more plastic surgeons and hopefully you will find one that will. Good luck. Peter Fisher M.D.

Richard P. Rand, MD, FACS (retired) · Answer

Exactly because of your kind of experience I stopped using permanent sutures over 20 years ago. They are easily removed under local anesthesia though and the general surgeon should be able to handle it nicely under local anesthesia.

Vincent D. Lepore, MD (retired) · Answer

I'm sorry to hear about your problem, but on occasion, a suture can become irritated or infected long after a previous surgery.  It sounds as if this may be the case in your situation.  If so, I would agree with your surgeon to have the suture removed.  If you leave it in it is likely to become irritated again.   It should be a relatively minor procedure to remove it.  Best wishes, Dr. Lepore.

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