TT incision opened up 3 weeks post op, about an inch and a half. After a few days I started seeing cloth type stitches? (Photo)

It sometimes happens after tummy tuck that the stitches which are dissolvable spit out.  These spitting stitches need to be removed or the irritation they cause will not allow the wound to heal.  You need to be seen sooner than 4 weeks.  The suture spitting in and of itself is not a problem, but it requires some care from the surgeon.  

What you are describing is known as a stitch abscess or spitting stitches. Both of the stitches (sutures) you describe are absorbable sutures that dissolve. Occasionally these sutures become exposed and the wound opens up.The cloth sutures you describe are most likely Vicryl sutures and have a higher propensity to spit then the fishing line suture which is likely Monocryl. The good news is, that this is usually self limited, and closes up with local wound care with little effect on the ultimate quality of the scar.However, these stich abscesses can become bigger and may even have what is know as fat necrosis below them. In some cases there may be even fluid below them known as a seroma contributing to the opening.I  would follow up with my plastic surgeon sooner then later, to remove the exposed sutures to ensure there are no other under lying processes contributing to this open wound.Yours,Jon M. Grazer, MD, MPH, FACS

I would call your surgeon back and request to be seen within the next several days. The exposed suture material should be removed and local wound care started to allow the wound to close and heal as quickly as possible.

Although rare and unfortunate-- wound issues do occur.  I would recommend being seen by your surgeon, cultures obtained, possibly some probing to determine if there is any deep problem. Any visible suture- I would remove and then initiate twice daily wound care regimen. When the culture results with sensitivity returned - I would consider adjusting the antibiotic if needed.

Sorry to hear about the complication you have experienced. These types of superficial separations or wounds can occur, and sometimes may “look worse, before it looks better”. In my opinion, the most important “factor” involved with successful treatment of the complication will be close follow-up with your plastic surgeon. He/she will be in the best position to monitor situation carefully. Infections should be ruled out and “foreign bodies” such as sutures that may prevent quick healing may be removed. The open wound should go on to heal over the course of the next several weeks, hopefully without long-term sequelae. Concentrate on a well-balanced ( good protein source) diet. Best wishes.