What if my Fascia is Too Fragile to Pull Together?

The surgeon who did my hernia repair said I have really bad fascia. I understand that the fascia layer is what is pulled together, not the actual muscle. If I have fascia that is too thin to hold the stitching, then how is a the diastasis repaired?

Doctor Answers 7

Tummy Tuck

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That would depend on how your hernia was repaired.  If you had a laparoscopic procedure, they are only grabbing a small bit of fascia.  With a TT, we use a bigger needle and can grab a bit of muscle and thus making a better, stronger repair.

Danville Plastic Surgeon
4.9 out of 5 stars 26 reviews

Weak deep tissue during tummy tuck

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If you are healthy, you should not have weak fascia so I would not worry. But, if you have had multiple surgeries in the past, or have significant medical problems then your surgeon may need to put in something to reinforce the repair. What did your PS tell you?

Suresh Koneru, MD
San Antonio Plastic Surgeon
4.4 out of 5 stars 18 reviews

What if my Fascia is Too Fragile to Pull Together?

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As stated already either use of a "mesh" (biologic or synthetic) vs direct muscle suture. These are my options in your case. 

Fascial strength for hernia repair

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If the surgeon has successfully managed to repair the fascia, and if the tummy stays flat, then you need not worry. In extreme cases in stead of stitching the fascia tightly to repair a hernia, an extra layer (a synthetic mesh) is added to the fascia for extra strength.

Anindya Lahiri, FRCS (Plast)
Birmingham Plastic Surgeon

Weak Fascia

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In the vast majority of cases, the fascia is just fine.  However, if there is any issue then a piece of synthetic mesh material can be used or an acellular dermal product. can be used to help reinforce the repair.  You can discuss these options with your surgeon.

Weak tissues for diastasis repair

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It would be very unusual to find the tissue too weak to support a repair of the diastasis during a tummy tuck. The repair is performed in two layers to bring the sit-up muscles firmly together. There are special circumstances that deserve note. Those who have had a gastric bypass may have weakened fascia and be prone to hernia or recurrent laxity. Also, those who are on steroid medication may have tissues weakened such that the repair may benefit from surgical mesh for better support.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Facia too thin

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There are occasions in which things can not be done. Or in  which the risk is higher that we expect.  It is a wise decision to stop or skip that step in the procedure, that to make a huge catastrophe.  

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.