Is it ok to pop stitches after muscle repair and tummy tuck?

The answer to your question depends on how your plastic surgeon corrected your rectus diastasis (muscle separation).  Obviously, the muscle repair is one of the most important pieces of a tummy tuck.  If the muscle repair comes apart, you will have a bulge, either above or below the belly button or both.I believe it is most unlikely that your muscle repair would fall apart if your tummy tuck was done by a well trained and experienced Board Certified plastic surgeon.  Every plastic surgeon has his or her own technique for muscle repair, so only your plastic surgeon would know the likelihood of their own technique to have their muscle repair unravel secondary to a coughing fit.The process by which all plastic surgeons repair abdominal muscles is more art than science.  By that I mean, we all grab a certain amount of fascia covering the rectus muscles and bring one side together with the other.  The tensions on these two pieces of fascia on either side is never equal, therefore coughing could lead to a tear in some of the fascia and still keep the muscles together.  My personal, hopefully tear proof technique, is first sewing the two sides of the fascia together with a thread as thick as kite string in a figure of 8 fashion to decrease the chance of this layer coming apart no matter what kind of lateral or diagonal movement your abdomen makes.  Then I cover this layer with a layer of suture that is strong and, by its nature, unable to pull apart.  This is done from the bottom of the sternum to the belly button, and then from the belly button to the pubic area.  All the doctor mumbo jumbo above means it is unlikely to pop a single stitch and have your entire muscle repair separate, and very often a popping sound plus pain is unrelated to muscle separation.At this point, take a deep breath, trust your surgeon, and stop worrying. 

Dear sandra76The first few days after abdominoplasty are difficult and coughing only adds to the pain and discomfort. At this point, you should listen to your doctors advice and be patient. Once you have healed more and swelling has settled you can assess the outcome. If  at 3-4 months you and your surgeon see a problem, you can address at that point.

The popping sensation and sound are concerning.  However, the only way to tell is by the appearance of the abdomen, and that at 6 months.  It is overly aggressive to open everything up and look to see if the muscle repair is intact.

During tummy tuck surgery, mulitple sutures are used to repair the abdominal wall so its unlikely that you have "popped" any let alone all the sutures.  The loss of one suture is not likely to cause significant concern but if you did indeed "pop" multiple sutures then it may cause an abdominal bulge.  Discuss your concerns with your plastic surgeon and continue to follow your post operative guidelines.  

It is my pleasure to answer your question. If your plastic surgeon evaluated you and told you everything is ok then there is no problem. you must follow all orientations from him.

It's unlikely that you "popped" the repair but it's very important that you find out the type of procedure you've had follow up with your PS regarding these concerns.

At 3 days post-operatively, it is too early to determine the significance - if any - of a failed plication suture.  Your surgeon likely placed multiple interrupted sutures in your rectus fascia to reapproximate the rectus muscles.  This is performed to correct the rectus diastasis (muscle separation in the midline that commonly occurs following pregnancy or significant weight gain) and to improve core strength.  At this stage, I recommend following your surgeon's post-operative instructions (regarding abdominal binder and avoidance of strenuous activities or heavy lifting) as healing occurs.  Hopefully the loss of one plication suture will not be significant, however your surgeon will be able to examine you at a later stage once healed to determine if any abdominal bulge is present.Best, Stephanie Power MD, MSc, FRCSC

Just because you heard a pop does not necessarily mean that your whole muscle repair has come undone.  At just 3 days post op there is not much to be done right now.   Try to protect your abdomen when you cough or sneeze by holding a pillow over your tummy and wear your compression garment if you have one.  But, follow you doctor's advice for now and try not to worry.  best wishes.