Muscle repair release from tummy tuck - can it be done without complications?

Question

I could not function daily with dry heavy nasal breathing, I can’t take a deep breath. I went to see both pulmonary specialist and ENT. They ruled out heart, lungs and nasal disruption but I only have deviated septum without any cause like turbinate swollen. I also have mulptiple suture granulomas on muscle repair. I have both permanent and absorbable sutures for it. I only had 2cm diastasis recti on upper midline as stated on my op report. I wonder if my surgeon over tightened my abs. I was seeing her to solve this problem, but through her I’ve been lots of a with mri, ct scan and pain management. Have you had any patient to do muscle repair release with removal of suture granulomas and permanent suture? How were the patients? Any complication? I understand second Abdominalplasty Carry high risks than primary surgery.

Mert Demirel, MD · Answer

Muscle repair release can be done in selected cases, but it is not a simple or risk-free revision. Before considering release, it is very important to confirm that the plication is actually causing the breathing or tightness symptoms, because dry/heavy nasal breathing is not usually explained by abdominal muscle repair alone.
If the pulmonary and ENT evaluations are reassuring, the next step is to separate the issues: nasal airflow/deviated septum, anxiety or breathing pattern dysfunction, abdominal wall tightness, pain, and suture granulomas. These can overlap, but they may not all have the same cause.
Suture granulomas and permanent sutures can sometimes be removed if they are painful, inflamed, infected, or creating palpable nodules. This may be more targeted than fully releasing the muscle repair. However, if the repair is truly over-tightened and causing functional restriction, partial or full release may be discussed with an experienced revision tummy tuck surgeon.
The risks include bleeding, infection, seroma, wound healing problems, recurrent bulging or diastasis, contour irregularity, more scar tissue, persistent pain, and no improvement in breathing symptoms. A second abdominal operation is generally more complex because of scar tissue and altered blood supply.
My advice would be to get an independent second opinion from a plastic surgeon experienced in complex tummy tuck revisions, and bring your operative report, MRI/CT results, and photos. Ask whether the symptoms are likely from over-plication, suture granulomas, nerve/myofascial pain, or another cause. If the main confirmed problem is granulomas, targeted suture removal may be safer than releasing the entire muscle repair.

John LoMonaco, MD, FACS · Answer

Yes, I have released the muscle repair in 2 patients. One was done in Mexico and they clearly tightened her too much, such that she developed reflux and other problems. Another was in my own patient who was very thin at the time of surgery. She gained 20lbs and this caused the repair to be too tight, so i released it. She is happy at a slightly higher weight and feels much better.

The surgery involves another incision, downtime, and anesthesia so you'll need to discuss this with your doc to eb sure it's worth the trade.

The surgery involves another incision, downtime, and anesthesia so you'll need to discuss this with your doc to eb sure it's worth the trade.

Luis A. Mejia, MD · Answer

Thank for your question, It is completely understandable to feel frustrated when you have waited two full years for your final results and still aren’t happy with how your chin and neck look—especially after expressing your concerns to your surgeon early in the process.
At two years post-op, what you are seeing is your final result. It is no longer a matter of waiting for things to "heal" or for swelling to go down.
Dr. Luis Mejia.
Let's make it better.

Muscle repair release from tummy tuck - can it be done without complications?

Answers (3)

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