53, 127lbs, c-sections, hard knots inside tummy tuck incision, what can be done about it? (Photos)

Dear Joyjoy15,
I understand your concern. Based on your description, there is a chance that you feel sutures. 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

Hi. The hard knots under the scar may be due to the fact that you had "dead skin" that needed to heal slowly, or it can be due to retained sutures from the surgery. Steroid injection isn't likely to fully correct either problem. Usually, the most successful treatment is to remove the area but cutting out the hard part and then reclosing it with stitches. This can be done with just local anesthesia in the office, so it's not a big deal. Talk to your surgeon about this option to see if he/she feels you are healed enough to try it. Best of luck!

It looks that due to secondary healing as a result of skin necrosis as well as scars around deep sutures, you developed scars that are more irregular than scars in other areas. Injection of corticosteroids may help to soften and decrease volume of these; it is best to consult your plastic surgeon about this issue and follow recommendations. Good luck.

An examination is needed to be certain. Keloids do not develop internally, but are from the skin. However, you may have a suture granuloma with excess scar tissue is forming around a stitch (not a keloid) or could be an area of fat necrosis which will feel hard or could be a permanent stitch's knot. The treatment is the same for all three--cut out the hard knot. Steroid injections probably will not be helpful and could thin fat in the area and leave a depression.

I encourage you to return to your surgeon for an evaluation. The knots could be various things including sutures that haven't dissolved. The treatment will depend on the underlying cause. Your surgeon should be able to guide you after an exam.

Dear Joyjoy15,
You really need to follow up with your surgeon for answers and options for managing your current concerns. Only he/she knows exactly what was done and your course of recovery. The photo with dressings still on your belly button begs some questions that might help to better explain the source of your complaints. Anything that we suggest might fly in the face of what your surgeon knows and his, or her methods of treatment.

It is not uncommon to have firm nodules under the incision of an abdominoplasty. Sometimes, it is necrotic (dead) tissue where the suture knots tie the two flaps together to align the edges and reduce skin tension. These areas take 6-12 months to resolve. They may be permanent and require steroid injections to soften them or if painful, surgical excision (usually local anesthesia).
Try massaging them now and ask your surgeon to evaluate them.
Best wishes,
Dr. Taranow

The 2 posted photos show a well dive full TT with muscle plication. As for the “knots” under scar the most likely issues is use of incorrect suture material and/or your potential reaction to them. Might be worth the try to inject a steroid but there are risks to doing those injections. Or have sub cutaneous ultrasound in offyce yo detect if the knots are indeed suture material reaction(fee$500). Best to seek in person or virtual consult with boarded lactic surgeon in private practice. Good luck

It sounds like you may have some excessive scar tissue from healing complications. I suggest you follow up with your plastic surgeon and have him or her assess your outcome.
You may be a candidate for a scar revision. Steroid injections may or may not be appropriate depending on what the underlying ideology is. Steroid injections can have potentially undesirable side effects such as thinning out and stretching of the scar.
Follow up with your provider.
Best,
Mats Hagstrom, MD