During a Tummy tuck, do you use permanent sutures to close the diastasis or dissolving sutures, and why?

Question

One doctor told me that he uses stitches that dissolve in about 8 months because the permanent sutures can have a "grating" affect on the muscles. He says that the diastasis will permanently heal and will not reopen after they have been held in place for 6-8 months. It seems that most surgeons are using permanent stitches to tighten the abdominal muscles. I would like a consensus. Thanks for your reply!

Ankur Mehta, MD · Answer

As plastic surgeons, we all have different experiences and based on those have different preferences. There are plastic surgeons that will swear permanent sutures must be used and those that swear that there is no difference between dissolving and permanent suture in rectus plication. You know what this means? Well, it means that either way is probably just as good as the other and it doesn't really matter as long as the muscles are brought together in the right manner. I prefer to use permanent suture. I have had no problems using this suture to date. I do not think you should base your decision on who you go to based on the suture used. The most important things are how you feel about the surgeon when you met him, what do his results look like and does he have mostly good reviews/good word of mouth. There are many other factors that should be used when picking a board certified plastic surgeon to perform your tummy tuck but those were just a few I think are important. Ankur Mehta MD

Jeff Angobaldo, MD · Answer

Thank you for your question.  I would say it would be surgeon preference. I use permanent sutures for the diastasis repair.  Best wishes.

Vishnu Rumalla, MD · Answer

Thanks for your inquiry, I use two layers of suture, first permanent interrupted suture, followed by a long lasting continous absorbable suture.  As you have experienced there will be no consensus, as you have heard both approaches already.  Hope more of colleagues give you their input and best of luck.

Yily De Los Santos, MD · Answer

I personally use permanent sutures, but dissolving sutures will not separate after they heal either, so both of them are good. Best luck!

Jeffrey G. Lind II, MD · Answer

Thanks for your excellent question.  As others have mentioned, some plastic surgeons will use permanent sutures b/c it makes us feel better.  I use permanent sutures.  However, absorbable sutures can be used.  As long as the sutures are tied appropriately, over time, the muscle repair will scar down and will hold no matter what suture is used.  Best of luck to you in your decision choosing your surgeon!

John Mesa, MD · Answer

Traditionally, permanent sutures are used to repair the diastasis of the recti during a tummy tuck. Resorbable sutures that last long time (eg. 6-8 months) could be used, but are less common among plastic surgeons. These reservable sutures 'reserve' by the time the body heals and forms scar tissue at the site of the diastasis of the recti repair. In my practice, I routinely use permanent sutures since they are stronger than resorbable sutures, thus decreasing the risk of suture rupture and hernia like formation in case the suture breaks while the tissues at the level of the diastasis of the recti are healling ( forming scar)

Nelson Castillo, MD · Answer

Thank you for your question and I do agree with your plastic surgeon that either type of suture will effectively perform your muscle repair.  Once healed it will not separate.  Hope this helps.

Jeffrey A. Sweat, MD · Answer

You will find that if you ask several surgeons, you will get many different answers as there is no one standard "right" answer or technique.  I trained in a program where we used permanent sutures and thus I have always done the same, but there is no reason not to use a long-acting dissolvable suture as I agree with your surgeon--eventually you should heal without the need for permanent sutures.  In my mind, I like to have the permanent suture on the off-chance that something doesn't heal together properly.  Regarding the "grating" effect, I'm not sure what he is talking about as I have never had that issue.  But again, there is no one "right answer".  Go with the surgeon who makes you feel the most comfortable.  Best of luck!

Michael M. Omidi, MD, FACS · Answer

Thank you for the question below.  As my colleagues have mentioned below, it depends on the surgeon's preference or experience.  Both type sutures are effective anyway.  Best of luck, Dr. Michael Omidi.

Nicholas Tarola, MD · Answer

Thank you for your question.  As you can see here, there will be no consensus on this issue because both types of sutures are equally effective.  It simply comes down to surgeon preference.  Personally, I use permanent sutures for the rectus plication.  I do not believe you should choose your surgeon based on the type of suture used to perform the muscle repair.  Best wishes!

During a Tummy tuck, do you use permanent sutures to close the diastasis or dissolving sutures, and why?

Answers (18)

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