Can the permanent sutures break 10 years after the abdominalplasty?

Question

I had an abdominalplasty, radical hysterectomy and they built up my pelvic floor all at the same time. I was 112 lbs, 5'3". Originally it was pulled too tightly and the pelvic floor build was bulky and hung over mambilicus. I left me physically limited. I have had chronic abdominal spasms and trouble walking. Recently, my massage therapist was massaging my abs. She pressed palms downward on my sternum/ ab area and a deep release. The upper abs feel opened to me now.

Stefan Mark Szczerba, MD · Answer

I personally don't use permanent sutures because of long term risk of feeling the suture or infections.  I would check if your surgeon used them before considering any surgical repair.  You may just felt scar tissue because this was 10 years ago.  Definitely touch base with your original plastic surgeon or try to obtain the operative report.  Best Wishes!!

J. Timothy Katzen, MD, FACS · Answer

Thank you, rowlandjl69, for your question regarding the possibility of sutures breaking 10 years after your abdominoplasty. It is highly unlikely that the permanent sutures from your muscle plication have broken. Over time, scar tissue forms around the sutures, reinforcing the repair. Additionally, most surgeons use a two-layer technique for plication, meaning even if the outer layer of sutures were compromised, the inner layer would still hold the muscles in place. This double-layer approach is designed to provide long-term support and minimize the risk of sutures failing years later.

The "release" you felt during your massage was likely due to a relaxation or stretching of tight muscles or fascia in the abdominal area, rather than the sutures breaking. Abdominal tightness, spasms, or chronic discomfort could be related to scar tissue, nerve entrapment, or muscle strain rather than an issue with the sutures themselves.

Possible Solutions:
If you are experiencing ongoing discomfort or feel that your abdominal area has "opened up," there are several approaches that might help:

Physical Therapy: Working with a physical therapist who specializes in post-surgical recovery could help improve muscle function, reduce tightness, and address any discomfort from scar tissue or muscle imbalances.
Scar Tissue Management: Techniques such as deep tissue massage, myofascial release, or ultrasound therapy could help break up tight scar tissue and improve flexibility.
Consult Your Surgeon: It’s always a good idea to consult with your original surgeon or a board-certified plastic surgeon to rule out any complications. They may recommend imaging, such as an ultrasound, to ensure that the muscle repair is still intact and address any underlying issues.
While it’s unlikely that your sutures have broken, these steps can help alleviate your symptoms and ensure that everything is functioning properly.

Sincerely,
Dr. Katzen

Daniel Barrett, MD · Answer

Dear rowlandjl69,
generally speaking, permanent sutures can break at any time. 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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Jose Leon, MD · Answer

Hello, thank you for your question. Actually, after a few months, the suture's job is replaced by scar tissue, so even if it breaks, scar tissue should be able to hold everything in place

Camille Cash, MD · Answer

Over time your own tissue forms over the internal sutures and strengthens the area.  It's not likely that your massage therapist pressing along the area made any significant change to your surgery, especially ten years later.  It is great that you are feeling better though!

Mats Hagstrom, MD (license on probation) · Answer

Permanent sutures loose their strength over time and will eventually not maintain their strength. Typically the body is not dependent on the suture material but rather scar tissue to hold together after surgery. This is why some surgeons use long lasting dissolving sutures with similar outcomes. It’s unlikely your massage changed your surgical outcome. 
Best,
Mats Hagström MD

Can the permanent sutures break 10 years after the abdominalplasty?

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