I had a Tummy Tuck 3 months ago, and the upper abdominal suture tore, leaving a lump on my upper stomach. Although I'm doing everything my doctor told me, should I consider having a second surgery to correct the problem? My doctor suggested Liposuction to reduce the appearance of the bulge, but I don't think that will solve the problem and I'm afraid I will pay the consequences if I don't make the right decision.
Will Liposuction Correct Broken Tummy Tuck Sutures?
Doctor Answers 18
Definitely don't do liposuction
Hi PR. I wanted to say that Dr. Goldstein's answer to your question is important to consider. There are many causes for bulging in the upper abdomen after a tummy-tuck. It might be because the upper abdominal tissue was not cinched together tightly and the lower abdominal tissue was cinched more tightly together. This is well known to cause a bulge in the upper abdomen.
In your case, you mention that a suture broke. This is a very rare occurrence and only you and your plastic surgeon know the circumstances around being able to detect a broken suture. If you truly had a flat upper abdomen one minute, heard a suture break, then had a bulge, then you will likely need to have your tummy-tuck revised and the stitch replaced.
If the suture did break and you go ahead with liposuction, then you are in danger of causing damage to internal organs during liposuction. It is possible to be very cautious and thin the fat just under the skin, but if the suture was truly broken, then it would NOT be recommended. Have some more conversations with your plastic surgeon. Certainly waiting for 6 months before doing a revision is what I would recommend.
Correcting an Upper Tummy Bulge from a Broken Suture
Different scenarios can result in an upper Tummy BULGE AFTER a Tummy Tuck (Abdominoplasty). Such bulges have to be divided into several groups:
- Bulge Present BOTH Before and After Tummy Tuck
- Bulge present IMMEDIATELY After Surgery
- Bulge appears LATER After Surgery
IF your tummy was flat after surgery and after lifting or other event (we had a patient who in a Tae Bo class was kicked in the upper stomach), you felt a snap and began noticing a bulge, then several processes may be involved. A ruptured suture may be associated with a collection of blood and fluid and / or the failure of the muscle tightening suture allows the stomach to bulge out.
I would get an Ultrasound and see if the bulge is mostly made of fluid (old blood etc). If so, it can be sucked out and the area largely flattened. I would NOT liposuction the area without verifying what makes up the bulge. IF the bulge has no fluid and little fat, I would wait at least 6-8 months for the scars to mature. Then, if the bulge persists and you want a flatter tummy, you may need a REVISION ABDOMINOPLASTY (Tummy Tuck) and have the area re-tightened. This time, hopefully, with 2 layers of sutures instead of one.
Dr. P. Aldea
If the bulge is due to excess fat then Liposuction may help.
It is unlikely that you will be improved by liposuction of the upper abdomen following a tear of the plication suture(s). If there is a bulge that is fatty in nature, then it may be somewhat improved, but again this is an unlikely scenario.
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It is relatively early in your recovery from surgery. I would wait at least 6 months and during that time get back to your normal daily routines, work activities and exercise regimens. You can then see how the muscles redistribute their activity. I have seen such bulging from presumed ruptured sutures flatten over time. Although it may not completely resolve, it may improve to the point that a little touch up liposuction may be all that you need, if anything at all. Good luck!
Liposuction won't fix a suture.
While lipo can reduce the appearance of a "lump" if that lump is fatty, it cannot fix a muscular repair breakdown problem. It may make it less appreciable however. Maybe that is what your surgeon aims to do.
Tummy tuck muscular repair breakdown is very rare in my patients. Maybe your repair stretched?
John Di Saia MD
Board-certified Plastic Surgeon
Surgery may be necessary, but liposuction is not the way to go
If the suture in the upper part of your tummy tuck ruptured, liposuction is not the answer. A small fullness above the belly button is not abnormal after an abdominoplasty. You cannot liposuction that area during the original surgery, so the area may be a little thick. When a suture breaks, the fascia or covering over the muscle becomes loose. This bulge will not go away unless you re-explore the area and repair the lax muscle. Liposuction alone may thin the area, but not improve the overall shape.
Yes, you need surgery
It sounds like the buldge above your belly button is from the suture that repaired your muscles tearing. This means that your abdominal muscles are no longer held together tightly in the middle, creating the appearance of a buldge. This can only be corrected with surgery. Liposuction can be an adjunct to this procedure to remove excess fat, but will not fix the cause of the problem.
Kari L. Colen, MD, NYC Plastic Surgeon, colenmd.com
The real cause of the bulge is important to know to determine if additional liposuction would help.
There are several reasons why you may have a bulge in the upper abdominal area following a tummy tuck procedure.
For example, the bulge may be due to excessive upper abdominal skin which was not adequately pulled and transferred inferiorly at the time of your initial surgery. It could possibly be due to excessive fat which sometimes can give the appearance of a bulge in the upper abdomen (this certainly is amenable to additional liposuction).
Ruptured sutures that were used to tighten and bring together the rectus abdominal muscles may be a cause. Also, I have seen bulges in the upper abdomen due to over tightening the muscles below creating the bulge above.
Lastly, a bulge in the upper abdomen may be due to a combination of the causes mentioned above. The actual timing of when you first noticed the bulge and a good physical examination is essential in determing the cause and the best treatment as it relates to you.
I'm sure that your plastic surgeon would be the most suitable one to determing the actual etiology of your bulge and the easiest solution to correct or improve your appearence. He/she knows you the best and understands your pre-operative physical condition. Also, your Plastic Surgeon would know what techniques were employed at the time of your surgery.
I would strongly advise you to continue your dialogue with him. If your confidence is totally lost, then I would seek a second opinion with another plastic surgeon.
Thanks for your question; I hope that this is helpful to you.
Stephen Goldstein, MD
You should probably have surgery again.
This is a good question.
Very rarely after abdominoplasty (tummy tuck) the deep sutures break and need to be replaced. I see this in my practice in patients who went out of the country for surgery and then return back to New York with problems. We are then stuck in a situation where the patient had a surgery somewhere else that now needs to be fixed. From what you describe, I do not think that you need liposuction. If the sutures truly did break or loosen, then you need to have them replaced. You definitely do not need to have the surgery completely redone, but you do need the sutures replaced. This can be done through a much smaller area through an existing incision. Liposuction is sometimes combined with abdominoplasty but not for the problems that you have.
I hope this is helpful.
David Shafer, MD
Shafer Plastic Surgery - New York City
No revision surgery for a minimum of 6 months
I would recommend waiting at least 6 months before considering proceeding with any revisions. This will give adequate time for everything to settle down, and then you can assess exactly what the issue is. Most likely, the bulge is not due to excess fat but rather loosening of the muscles that were tightened during the initial operation. This can usually be seen on an exam, and if that's the case, retightening the muscle would give the best long term result. The downside, however, is that it will be a much bigger procedure than simply trying to perform liposuction on the area, so I would recommend sitting down with your surgeon and discuss the pros and cons of each option.