TT 12 years ago and green sutures have been coming to abdomen surface forcing hole in skin trying to come out (Photo)

Dear Joanna2962,

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

Hi Joanna2962, thank you for your question and for sharing your history and pictures.

What you are experiencing is unfortunately not uncommon in cases where permanent sutures, like green Ethibond sutures, were used during your tummy tuck. These sutures are braided and typically used to repair the rectus abdominis diastasis or to reapproximate deeper layers of tissue, such as Scarpa’s fascia. While these sutures are designed to remain in place permanently, in some cases, the body identifies them as foreign and begins to reject them, causing them to migrate toward the surface of the skin. This process often leads to discomfort, irritation, and, as you’ve described, holes forming in the skin as the sutures attempt to push through.

Once the sutures begin to break the surface, most plastic surgeons recommend a conservative approach: removing the sutures as they emerge. This can often be done in the office under local anesthesia. Although this method is less invasive and avoids additional surgical risks, it may still leave small dimples or scars where the sutures exited.

For a more comprehensive solution, you could consider undergoing a revision procedure to remove all the visible Ethibond sutures at once. This approach involves reopening the abdomen under general anesthesia to locate and remove the sutures entirely. However, this method requires a longer recovery period—typically one to two weeks—and comes with the usual surgical risks. While it is more aggressive, it can help prevent further complications, including infection or recurring suture eruptions.

It’s critical to contact your surgeon or a board-certified plastic surgeon as soon as possible, especially since you mentioned that the most recent suture has become infected. Infection can complicate the situation and requires prompt treatment, which may include antibiotics and removal of the infected suture.

To minimize future scarring and manage this situation effectively, stay in close communication with your surgeon. Be sure to explore both conservative and surgical options based on your comfort level and the extent of the issue.

Good luck, and I hope this helps answer your question regarding your recurring suture issues.

Sincerely,
Dr. Katzen

Thanks so much for your question,

Sutures emerging from the skin many years after a tummy tuck, known as "spitting sutures" or "suture extrusion," can occur, especially with non-absorbable sutures like green-colored Prolene. These sutures are used in deeper layers during the procedure and, in rare cases, may not be fully absorbed or integrated, leading them to work their way to the surface over time.

See Your Surgeon or a plastic surgeon to evaluate the area, clean it properly, and remove any visible suture material. This procedure is usually straightforward and may provide immediate relief.

Suture extrusion after so many years isn’t common, but it can happen. With proper care and possibly a quick procedure to remove the suture, the skin should heal well.

Sincerely,
Dr. Emmanuel Mallol