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 request regarding muscle repair failure and what to do.  Thank you for your history and your pictures.  Muscle repair failure is uncommon after an abdominoplasty or tummy tuck.  During muscle repair, most experienced board-certified plastic surgeons will use multiple sutures in a two-layer closure from the xiphoid to the umbilicus and then from the umbilicus to the pubic or mons region.  Separation of the rectus abdominis is called rectus diastasis.  Repairing the rectus diastasis is achieved by medializing the medial beds of the rectus abdominis muscle.  This is done in the midline to flatten the abdomen.  If you were to have a failure of the repair, the failure would appear in your midline, not as a mass in your left lower abdomen.  The hard spot that you feel to the left of your belly button is probably the permanent suture used to repair the rectus abdominis muscle.  These masses do not mean that the muscle repair is a failure.  If you are concerned, visit your primary care doctor and have an ultrasound or a CT scan of the abdomen to work up the mass in question.  Treatment depends on what the issue is.  If it is a hernia or failure of the rectus diastasis repair, it may need to be surgically treated.  If it concerns you, you have it more thoroughly examined with an ultrasound or CT scan.  Find out what the results show and go from there.  I hope this answers your questions regarding muscle repair six months after a tummy tuck.  Good luck.   If you have any more questions regarding tummy tucks, abdominoplasties, or abdominal liposuction, contact an experienced plastic surgeon.  Since the tummy tuck surgery is a big procedure, please seek an experienced, board-certified plastic surgeon with significant experience in performing tummy tucks.  Do your research.   If you cannot find an experienced tummy tuck plastic surgeon in your neighborhood, consider traveling out of state.  Sincerely, Dr. Katzen, MD, MBA, FACS, FICS. ( Plastic Surgeon, President of the American Society of Bariatric Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

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.

Best Wishes,

Gary Horndeski, M.D.

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.

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.

Muscle repair failure? (Photo)

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