Can my permanent stitches be removed without being replaced 1 year after tummy tuck?

Dear Swflmom81,

I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

There are different options when choosing sutures for the repair of the abdominal muscles in a tummy tuck. Peremanent vs. absorbable, braided vs. monofilament among others. At the end of the day it really comes down to surgeon preference and what that surgeon has found works the best in his or her hands. Most of the healing of the surgery takes place in the first 2 months. Once the internal repair has healed well the sutures are no longer necessary and therefore could be removed without needing to be replaced without any effect on your result.

Thank you for your question regarding the possibility of removing permanent stitches after a tummy tuck. Based on your description, you have granulomas caused by the permanent sutures used for muscle repair, and these are causing discomfort during exercise.

Removing permanent sutures without replacing them is a delicate matter. The permanent stitches were likely used to close your diastasis recti (separation of the abdominal muscles), which is a crucial structural repair. Removing these sutures could potentially compromise the muscle repair, leading to the re-opening of the diastasis or a weakening of your abdominal wall. This could result in a bulging abdomen or other functional concerns over time.

However, if the granulomas and discomfort are significant, removal of the problematic sutures may be necessary. In such cases, the muscle could potentially be re-repaired with absorbable sutures or other materials, depending on the surgeon’s evaluation of the integrity of your muscle wall.

I recommend consulting a board-certified plastic surgeon experienced in revisional tummy tuck surgery to evaluate the extent of the granulomas, assess your muscle strength, and determine the best course of action. In some cases, a simple excision of the granulomas without removing all sutures may alleviate your discomfort.

Sincerely,
Dr. Katzen

Yes, these sutures can be removed without losing any correction. It is been shown that there is no difference between permanent and absorbable sutures for repair of muscle looseness in abdominoplasty. The permanent sutures usually last about 6 months which gives plenty of time for the muscle repair to have fully healed. If tyour granulomas are removed, the sutures would certainly be found loose and is not serving any particular purpose.

After a tummy tuck, most permanent stitches used in deeper layers are meant to hold tissues together long-term and are typically not removed unless complications arise. If you're considering stitch removal a year after your procedure, it’s crucial to consult with your surgeon. Here’s why:
1. Purpose of Permanent Stitches: They are often intended to provide lasting support, especially in areas with muscle tightening, to help prevent future separation.
2. Risks of Removal: Taking them out could reduce the stability of the repair, leading to a higher risk of complications, like tissue separation or weakening, depending on where they are.
3. Reasons for Removal: Sometimes, stitches may be removed if they’re causing irritation, are visible under the skin, or are causing complications like infection.
A consultation with your surgeon can help assess the state of your healing and discuss whether removal is safe or if alternatives (like absorbable sutures) could be considered to maintain stability.

Theoretically yes you can remove the permanent sutures and not replace them, but it's important to understand what that would mean. The incision would need to be opened in order to access the sutures. Your abdominal repair/results could be impacted by the removal of the sutures. I encourage you to discuss your concerns with your surgeon as you may be able to address the granulomas in a less invasive way.

Removing the sutures would entail reopening your previous incision so it’s no minor endeavor. Unless the pain is focal and exactly the location of the sutures there’s also no guarantee that the pain is related to the sutures. The sutures could be removed and as long as your muscles are scarred they don’t need to be replaced however with the sutures removed you’re a higher risk of Muscle weakness down the line. I suggest you consider massaging the area (consistently focally and deep) to help with both breaking up the scar tissue and desensitizing the area. If that fails then you have to weigh the risks of surgery again against the severity of your symptoms.