Have I Compromised my Muscle Repair?

I am 5 weeks post-Tummy Tuck with muscle repair. I have been doing very well but when having a normal bowel movement the other day I heard what sounded like a stitch pop in the area above my belly button, I also heard this again when I sneezed the next day. Have I compromised my muscle or could this be other dissolvable stitches? I have done nothing to strenuous to jeopardise my Tummy Tuck results, yet it still feels tight inder the skin at this point.

Doctor Answers 16

A stitch goes pop: Muscle repair with tummy tuck

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Generally scar tissue is well formed by 5 weeks after surgery and it is not likely that you compromised your muscle repair.

It is important to maintain the results of your repair by performing core strenghtening exercises which will enhance the results of your repair. Pilates or Yoga is excellent in this regard.

Performing aggressive traditional stomach exercises like crunches and affect your result producing a bulging stomach muscle.

Notify your surgeon and keep an eye on your belly but don't be overly concerned.

Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

"Popping" Sounds Alone are Usually OK

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If you disrupt the plication or repair, you will know it! "Popping" sensations do opccur after exertion, sneezing, laughing, etc. The muscles continue to contract around the plication (repair) sutures and cancreate that sensation.

If you truly disrupt the repair, you will feel a significant tearing and often see a bulge in the area....you will know it! If there is ever concern about it, contact you surgeon immediately.

Michael S. Beckenstein, MD
Birmingham Plastic Surgeon
4.9 out of 5 stars 21 reviews

You've not likely hurt anything

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Most surgeons perform "muscle tightening" during tummy tuck procedures - some use absorbable sutures whereas others use permanent sutures. In most cases, the repair is almost "bomb-proof" - enough to withstand sneezing, coughing, movement, etc. You may have broken an absorbable suture, pulled a little fascia (which is your abdominal wall covering)... or something completely unrelated.

It is very unlikely the you have created a problem. Rest easy and recover according to your instructions to date.

Hope this puts you at ease.

Dr. Kaufman

Popping post-op

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Abdominoplasty involves "plicating" the rectus muscles with suture and is a regular part of the procedure as performed in my San Francisco area practice.

This repair is typically most vulnerable at week 2 after your surgery. This is because the normal healing process can actually make the tissues the suture passes through more weak for a period as scar tissue deposits. People are also generally feeling better and becoming more active at this point.

Most surgeons would not choose a suture that would dissolve as quickly as 5 weeks so the sensations you felt were probably not that.

If you haven't noticed a difference in profile you probably have not compromised the repair. (Though it is possible a suture has ruptured).

As always - because the surgeon that performed your surgery understands better than any of us what was done - it is important to follow-up with your doctor if you have post-op questions.

I hope this helps!

Let your surgeon know that you have experienced a problem or have a concern

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You are still in the early healing process following your abdominoplasty. It is very normal to feel varying degrees of tightness, as well as tugging. There are several points however that need to be considered:
  1. There different ways to repair the muscle layer. Most plastic surgeons will close the fascia (the dense white fibrous tissue that surrounds the muscle) in layers. I typically use a running over and over type suture similar to a baseball stitch. When this is done the tension in one area will be splayed out over a wider area and is much less likely to tear through or break.
  2. It takes time for the muscle / fascia to heal, but at five weeks you are getting fairly solid.
  3. Most likely there is some stiffness to all of the tissue, skin and fat of your abdomen. This is called an induration and is a normal process. Think of this layer like concrete. It is stiff and hard. When you turn suddenly, there can easily be a disruption or tearing of this stiff tissue giving you the sensation of something breaking or popping.
  4. A change in your shape would result if a suture actually ruptured or broke. As long as you have not noticed any change in your shape you are most likely fine.
  5. It is important, during the early healing period to avoid activities that place unnecessary tension or force on the muscle repair, this would include crunches, sit ups, lifting weights or strenuous activities. Give the area a chance to heal.
  6. The repair of this layer, and any sutured area, is at its weakest point at two weeks. After two weeks it begins to get stronger, it may take a few months to be at its maximum as far as tensile strength.
  7. Follow up with your surgeon and get his or her advice. He knows what your original tissue was like and will have a specific insight into the likelihood of a rupture of your repair.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

A few popping stitches are OK after tummy tuck

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At 5 weeks after a tummy tuck, it is common to still feel some tightness. Scars - even inside ones - take many months to soften.

As for the popping sound - it can be stitches. However, most plastic surgeons use many sutures to reshape the muscle layer and typically place two layers. So, feel comfortable that as long as your abdominal shape has not changed, one or two "popping" sounds will not change your results.

It is always a good idea to discuss this with your surgeon as well during your next visit.

Bahram Ghaderi, MD
Chicago Plastic Surgeon

Probably Okay

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Hi there-

I think it's doubtful you disrupted your repair, as most often this would have been accompanied by significant pain. I would, however see your surgeon for an evaluation.

Tummy tuck and stitch popping

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The sound you heard was probably a stitch popping.  At 5 weeks you probably are OK, but it would be a good idea to see your doctor so that he/she can check you out.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Consult With Your PS To Relieve Anxiety-- Results Likely Not Compromised

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It’s unlikely that you’ve compromised your muscle repair after straining and sneezing five weeks following surgery. At this point the wound should have regained most of its tensile strength. For this reason, disruption of the muscle repair sutures might not lead to a recurrent diastasis.
This assessment requires a physical examination. In most cases disruption of the abdominal plication would be accompanied by a bulge. In addition, most patients would also have swelling and localized pain in the area.
The type of closure is also important. In some cases surgeons utilize interrupted suture, while in other cases they use continuous sutures. Disruption of a continuous suture has much more significance than disruption of a few interrupted sutures.
If you’re worried about dehiscence of your abdominal muscle plication, consultation with your plastic surgeon is appropriate. Your surgeon should be able to answer your questions and alleviate your anxiety.

Have I compromised my muscle repair?

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It is unlikely that those two events would lead to breaking a stitch. If the muscle repair did break you would likely notice a bulge in the area. It would be helpful to know whether or not your muscle repair was performed with interrupted sutures or if one continuous suture was used to close the repair. If one continuous suture was used abdominal stress normally stretched but not breaks the suture. Individual sutures however have a slightly greater chance of breaking. It would be best to discuss this with your surgeon that he or she could give you an accurate assessment.

For a simple and illustrated explanation of tummy tuck and body contouring procedures, watch my video.

John J. Edney, MD
Omaha Plastic Surgeon
4.8 out of 5 stars 133 reviews

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.