Can I fix a muscle repair failure?

Question

13 months ago I had a tummy tuck with muscle repair on turkey. After I come round I was violently sick three times, one of I felt a sharp pop on two of the heaves. I mentioned this to the doctor and he said it was fine. The right side, which is the side that popped, healed months after the left, even coughing felt like a bubble was underneath a section and it was expanding. Today I am healed but the right side muscle is hard and raised from under my rib all the way down.

Emmanuel De La Cruz, MD · Answer

Fixing a muscle repair failure, also known as a rectus diastasis repair failure, is possible, but it typically requires surgical intervention. Rectus diastasis is a condition where the abdominal muscles separate, often due to pregnancy or significant weight fluctuations. Surgery to repair rectus diastasis involves suturing the separated abdominal muscles back together to restore strength and stability to the core muscles.

If a muscle repair procedure fails, resulting in recurrent or persistent diastasis, revision surgery may be necessary to correct the problem. Here are some considerations regarding fixing a muscle repair failure:

Evaluation by a Surgeon: If you suspect that your muscle repair procedure has failed or if you are experiencing recurrent symptoms such as abdominal bulging or weakness, it's essential to consult with a qualified plastic surgeon who specializes in abdominal wall surgery. The surgeon will evaluate your condition, review your medical history, and may perform imaging studies to assess the extent of the diastasis and identify any underlying issues contributing to the failure.

Revision Surgery: Revision surgery may be necessary to correct a muscle repair failure. During revision surgery, the surgeon will carefully assess the abdominal muscles, identify any areas of weakness or separation, and perform additional suturing or reinforcement to achieve a durable repair. The specific surgical approach will depend on the individual patient's anatomy, the extent of the diastasis, and any contributing factors.

Consideration of Contributing Factors: In some cases, factors such as inadequate initial repair technique, excessive tension on the sutures, or compromised tissue quality may contribute to muscle repair failure. During revision surgery, the surgeon will address these factors to optimize the chances of success and minimize the risk of recurrence.

Recovery and Rehabilitation: Following revision surgery, you will need to follow your surgeon's postoperative instructions carefully to ensure proper healing and optimize the results. This may include restrictions on physical activity, wearing compression garments, and participating in a structured rehabilitation program to strengthen the abdominal muscles and support recovery.

It's essential to have realistic expectations about the outcome of revision surgery for muscle repair failure. While revision surgery can often successfully correct the problem, there are risks involved, and outcomes can vary depending on individual factors. It's crucial to discuss your concerns and goals openly with your surgeon and work together to develop a treatment plan that is tailored to your specific needs.

Daniel Barrett, MD · Answer

Dear mitzie87,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Zoran Potparic, MD · Answer

It may happened that you had partial rupture of muscle or repair site which healed with scar and muscle weakness? Only on the basis of detailed in person evaluation, a board certified plastic surgeons could get idea of what is actually going on, whether and how it may be improved. Good luck.

Connie Hiers, MD, FACS · Answer

You did not post photos, so an examination is needed to see what can be done. Once you are healed at least 1 year, EMSculpt might be helpful to tighten your abdominal wall.

Camille Cash, MD · Answer

From your description your muscle repair may have been impacted when you became ill.  An examination is needed to know for sure.  If it has failed, a surgical revision will be needed in order to repair it.

Chris Dunkin MD, FRCS(Plast) · Answer

Hi Mitzie and thank you for your question. I’m sorry to hear you’re still having problems with your tummy tuck this far down the line. There are two ways to answer your question. The first is what you will want to hear, which is specific advice for you. The second is probably not what you want to hear but I hope it will be helpful to a wider audience reading this answer on Realself.Specific advice – from your description, it sounds like you may have developed a rectus sheath haematoma or a seroma after your operation. Rectus sheath haematoma is a small bleed that collects in the sheath that surrounds your tummy muscle. A seroma is a fluid collection (rather than blood) under the skin and fat causing a lump. You would expect both of these to have settled by now but they can grumble on. It is possible your rectus plication stitches have given way but this is pretty uncommon. The best advice I can give you is to go and see an experienced UK plastic surgeon who can examine you and help work out the problem and see what they can do to help.On a more general note - plastic surgery operations in general and tummy tuck in particular need good aftercare with experienced staff who know what they are doing. For this reason we only work at hospitals that offer good customer care and medical aftercare. With the best will in the world, this is very difficult to provide 1500 miles from home. We see people with problems after surgery abroad quite regularly and there is usually something we can do to help. Good luck.

Mats Hagstrom, MD (license on probation) · Answer

To make an accurate assessment of the outcome of a plastic surgery procedure we always need to see proper before and after pictures. If you don’t have before, and after pictures of the pictures that you took. I do not recommend people travel long distances to have elective surgical to procedures especially not major operations like a tummy tuck. The results of cosmetic surgical outcomes are generally based on two variables. The first is the patient’s candidacy for the procedure, and the second is the skill and experience of the provider.
In that sense, your surgeon is responsible for the outcome of your procedure, and you were responsible for choosing that surgeon. The correct surgeon to make an assessment is your provider. When people choose to travel for surgical procedures, they should be ready to travel for aftercare as well.
Unfortunately, a significant number of people who choose to travel for elective surgical procedures do not recognize the importance of having multiple in person consultations before choosing a provider, the number of people left major issues after surgical procedures, the importance of in person follow up care, the number of people needing revisions, and that complications actually do happen.
Without seeing before and after pictures, we don’t know if you were a good candidate for the procedure in the first place, and cannot make any type of quality assessment regarding the outcome.
Consider re-posting it with proper before and after pictures, follow up with your provider or schedule in person second opinion, consultations with local plastic surgeons in your community.
I don’t think anyone is going to be able to give you any type of quality response based on a limited post.
Mats Hagstrom, MD

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