Any recommendation for permanent vs absorbable sutures for rectus plication (I am an athlete)?

The sutures in muscle repair are permanent sutures. You will not see or feel them. The deep fascia of the skin, the lower layer of the skin (DERMIS) and the skin are all closed with absorbable sutures.

The technique I use for rectus plication is permanent sutures made from Prolene. Also, if you are not planning future pregnancies, I use mesh to reinforce the repair. The mesh creates a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight. Mesh is incorporated into the body and quite strong.

Best Wishes,

Gary Horndeski, M.D.

Thank you for your excellent question. The idea behind sewing the rectus muscle bellies together during abdominoplasty is to allow them to heal to each other, thereby correcting the diastasis. This is a process that takes several weeks. Once they are adhered to each other, the sutures are no longer necessary. I have used both during my career. Early on, I used permanent polyester sutures and had no problem with them. Occasionally, in a rare, very thin individual, you could feel them under the skin. I switched to absorbable sutures when barbed, PDS sutures become available. These sutures last a very long time, on the order of months. They provide a very secure muscle repair, and because of their barbed nature, a surgeon can save a bit of time in the OR. Through hydrolysis of the suture material, they completely dissolve. I wouldn't say one is better than the other, but it's nice to know that no foreign body remains once the absorbable sutures are gone.