Muscle repair failure? (Photo)

Question

I had a tummy tuck 6 months ago and I have a hard spot to the left of my belly button. You can't see it when standing, only feel it. But it is visible when lying down. I tried the test of lying down and raising my leg straight and it does become more visible so I'm guessing it is a muscle repair failure? Can I leave it like this or will it get worse? Does it need to be treated? My surgery was abroad so not as simple as seeing my Dr for his opinion.

J. Timothy Katzen, MD, FACS · Answer

Hello, and thank you for your question regarding whether you may have a muscle repair failure after your tummy tuck. I appreciate you sharing your history and pictures. From what I can see, the hard spot to the left of your belly button is likely due to the sutures used during your rectus abdominis muscle repair rather than a full muscle repair failure. Typically, during a tummy tuck, permanent sutures are placed from the xiphoid (the bottom of your sternum) to the pubic bone to tighten and flatten the abdominal muscles. These sutures are usually placed in a buried figure-of-eight fashion with additional reinforcement from a running suture along the midline. Around the belly button, the rectus muscle isn’t fully plicated because a small opening is needed to allow the belly button to remain in place. This can sometimes create a small lump or a palpable area due to the running suture placed on one side of the belly button.

If the area is not painful and does not appear to be worsening, you may not need any treatment. At six months post-op, you are still healing, and over time, this area may soften on its own. If it remains bothersome, there are some non-surgical options to consider, such as lymphatic massage, ultrasound, or radiofrequency treatments like Morpheus8 to help soften the scar tissue. Steroid injections may also help if the lump is due to thickened scar tissue.

If the lump persists and continues to bother you, a minor surgical procedure could be performed where an incision is made around the belly button to release or remove the suture. However, removing the suture could compromise the muscle repair, so this option should only be considered if the lump is significantly bothersome. A revision tummy tuck would be the most invasive solution if there is a true muscle separation, but that would require another surgery and recovery period.

It’s important to monitor the area for any changes. If you notice increased bulging, worsening discomfort, or signs of a possible hernia, I recommend seeking an in-person consultation with a board-certified plastic surgeon who specializes in tummy tuck revisions. However, if the area is stable and not causing you significant issues, it’s best to give it more time to heal before considering any revision. I hope this helps answer your question, and best of luck with your recovery!

Sincerely,
Dr. Katzen

Camille Cash, MD · Answer

At six months post op it would be unusual to have muscle repair failure.  It could be a small seroma or even a hernia.  I encourage you to visit with your surgeon for an evaluation.  The correction would depend on the cause.  If it is muscle repair failure it is up to you if you wish to have it corrected.

Gary M. Horndeski, MD · Answer

At the time of tummy tuck, the muscle is not repaired but what is repaired is the fascia, which is support layer that surrounds the muscle.  A hernia is a complete tear in the fascia, which allows intra-abdominal contents to project all the way under the skin level.  A weak fascia will allow bulging.  You will need to be examined to determine exactly what is going on.

Best Wishes,

Gary Horndeski, M.D.

Jose Leon, MD · Answer

Hello, thank you for the pics and your question. Although your muscle repair seems fine, the pictures need to be standing up, not lying down. It appears to be scar tissue, or maybe a small chronic serum pocket, but your best assessment is from a board certified surgeon that can see you in person and touch the defect.

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