Failed Muscle Repair After Tummy Tuck, What Would Be The Most Likely Reason For This? (photo)

Question

I had a floating tummy tuck with MR 6 months ago. While I was never truly flat, I developed a considerable bulge about a month ago that is getting worse. It is around and below my BB. In obtaining my op report I read that my surgeon used dissolving sutures on all layers, including the MR. I also had vomited around 5 times on the first post op evening from anesthesia. I have a confirmed separation from another PS, and I feel it too. What would be the most likely reason for this scenario?

Vincent N. Zubowicz, MD · Answer

Failure of fascia repair after abdominoplasty is almost unheard of. You should check with your surgeon as a revision might be indicated.

James N. Romanelli, MD, FACS · Answer

A variety of factors may be involved.  Personally, I use permanent sutures, although others use long lasting dissolving sutures.  The vomiting is another risk factor.  Abdominal exercises, especially when resumed too quickly, or weight gain are two more factors.  And, finally, patients have different quality fascia ( the abdominal wall canvas-like layer that envelops the muscles).  Poor quality fascia, which is essentially genetic, will not hold a repair well.  It is worth considering a repair with permanent sutures.  Good luck.

Jourdan Gottlieb, MD · Answer

Based on what I read here, the likeliest cause is the vomiting. We all try to minimize nausea and vomiting, but not with 100% success. This can happen with permanent or dissolving sutures. 

	There are still discussions about the relative benefits of permanent vs. non-permanent sutures. Non-permanent sutures have been demonstrated to be equally effective in abdominal wall closures since the 1970'ies. By the time the dissolving sutures are gone, the healing strength of the wound is stronger than the sutures were. 

	All the best.

Remus Repta, MD · Answer

Hello,

	Thank you for the question and the photo.  There are a few things that can be occuring with regards to your abdominal wall.  The sutures could have broken, the sutures could have pulled through the tissue, the amount of tightening could have been insufficient, and if the suture used was a Vicryl or a Monocryl it could have weakened too soon.  Its difficult to know which of these is the cause.  The solution will be to go back in and re-tighten (re-suture) the abdominal wall.  This involve re-elevating all of the abdominal soft tissue similar to how it was done during the initial full tummy tuck.

	All the best,

	Dr. Remus Repta

Jeffrey Zwiren, MD · Answer

It does seem that you have a recurrent abdominal bulge due to laxity of the anterior abdominal wall fascia.  An examination would be needed to determine the extent of the problem and whether or not a re-plication of this layers is indicated.

Failed Muscle Repair After Tummy Tuck, What Would Be The Most Likely Reason For This? (photo)

Answers (9)

Answer: Torn muscle repair after tummy tuck

Answer: Torn muscle repair after tummy tuck

Answer: Recurrent abdominal bulge

Answer: Recurrent abdominal bulge

Recommended reading

Everything you need to know about Tummy Tuck

Our mission is to create a world where every investment in modern beauty is Worth It.

Failed Muscle Repair After Tummy Tuck, What Would Be The Most Likely Reason For This? (photo)

Answers (9)

Answer: Torn muscle repair after tummy tuck

Answer: Torn muscle repair after tummy tuck

Answer: Recurrent abdominal bulge

Answer: Recurrent abdominal bulge

Browse related questions

Recommended reading

Everything you need to know about Tummy Tuck

Our mission is to create a world where every investment in modern beauty is Worth It.