I had a full tummy tuck in April '15 due to twins. He used permanent sutures to repair my muscles. One year after surgery I developed a hernia an inch above my belly button. I saw my plastic surgeon about it immediately and was told we would just "watch it" despite the fact that I could push it in and out. Upon seeing a surgeon yesterday due to some new pain near my hernia site, I was told I not only have a hernia but i have diastasis again as my lower sutures failed. I am not abnormally active.
Answer: DIASTASIS MUSCLE REPAIR The suture material for the muscle repair usually is non absorbable, so the suture can hold the tissues long enough while the scar tissue gets strong to hold the muscle in place. In some patients that have had a lot of stretching in the abdominal wall such like a twin pregnancy, the muscles on the abdominal wall will not have the best strength and the fascia may be very weak so even a small amount of stress over the muscles, may create a hernia or the diastasis may recur. In those patients the use of a mesh may be needed to hold the repair, but this will be a decision of the surgeon either prior to the surgery or during the surgery.
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Answer: DIASTASIS MUSCLE REPAIR The suture material for the muscle repair usually is non absorbable, so the suture can hold the tissues long enough while the scar tissue gets strong to hold the muscle in place. In some patients that have had a lot of stretching in the abdominal wall such like a twin pregnancy, the muscles on the abdominal wall will not have the best strength and the fascia may be very weak so even a small amount of stress over the muscles, may create a hernia or the diastasis may recur. In those patients the use of a mesh may be needed to hold the repair, but this will be a decision of the surgeon either prior to the surgery or during the surgery.
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Answer: Diastasis Rectus Muscle Repair Thanks so much for your question! Permanent non-absorbable sutures are usually used for plication of the rectus muscle. Sometimes, overexertion or muscle fascia weakness can lead to sutures breaking or popping. However, for this to happen two years after the plication is not as common, though you can certainly develop a recurrence of your diastasis or weakness in your fascia or even a true hernia with an actual defect in your muscle fascia. Hope this helps...best of luck! Sincerely, Joyce C. Chen, MD, MPH, FACS
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Answer: Diastasis Rectus Muscle Repair Thanks so much for your question! Permanent non-absorbable sutures are usually used for plication of the rectus muscle. Sometimes, overexertion or muscle fascia weakness can lead to sutures breaking or popping. However, for this to happen two years after the plication is not as common, though you can certainly develop a recurrence of your diastasis or weakness in your fascia or even a true hernia with an actual defect in your muscle fascia. Hope this helps...best of luck! Sincerely, Joyce C. Chen, MD, MPH, FACS
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June 5, 2017
Answer: Suture Failure after Tummy Tuck It is very unusual to have "failure" of the sutures 2 years out. At this point the body have healed and it really is not relying on the sutures any further. The fact that you have a hernia and diastasis is certainly unusual. I would ask if you have had any weight gain or excessive weight loss during the past 2 years, as that would contribute to the issues at hand.The tissue can certainly stretch over time and lead to a diastasis once again but there usually has to be something that caused it, such as body changes like I mentioned.Hope that helps.
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June 5, 2017
Answer: Suture Failure after Tummy Tuck It is very unusual to have "failure" of the sutures 2 years out. At this point the body have healed and it really is not relying on the sutures any further. The fact that you have a hernia and diastasis is certainly unusual. I would ask if you have had any weight gain or excessive weight loss during the past 2 years, as that would contribute to the issues at hand.The tissue can certainly stretch over time and lead to a diastasis once again but there usually has to be something that caused it, such as body changes like I mentioned.Hope that helps.
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June 5, 2017
Answer: Failure of permanent sutures Dear Scarlett James,permanent sutures don't guarantee that your diastasis will be corrected and that you won't have any complications in the future. In some cases, a hernia or diastasis can occur again. In that case a revision surgery might be needed.Daniel Barrett, MD, MHA, MS Certified, American Board of Plastic Surgery Member, Am. Society of Plastic Surgery
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June 5, 2017
Answer: Failure of permanent sutures Dear Scarlett James,permanent sutures don't guarantee that your diastasis will be corrected and that you won't have any complications in the future. In some cases, a hernia or diastasis can occur again. In that case a revision surgery might be needed.Daniel Barrett, MD, MHA, MS Certified, American Board of Plastic Surgery Member, Am. Society of Plastic Surgery
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June 5, 2017
Answer: Umbilical hernia 2 years after tummy tuck After around 3 months or so, the sutures for the diastasis repair become irrelevant - unneeded. The tissue has enough strength that the repair no longer relies on the sutures. In your situation, there can be at least 3 possibilities for why this developed: 1.) the repair around the belly button didn't extend close enough to it, leaving a weakness still present for the hernia to develop 2.) the was an early disruption of the repair, possibly within the 1st 8 weeks which was not detected but is more evident now for many reasons 3.) your tissues as related to the repair did not heal with enough strength to resist later strong intra-abdominal forces.Regardless, now it sounds like you need to be fully evaluated and have your hernia appropriately repaired.Steven Turkeltaub, MD
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June 5, 2017
Answer: Umbilical hernia 2 years after tummy tuck After around 3 months or so, the sutures for the diastasis repair become irrelevant - unneeded. The tissue has enough strength that the repair no longer relies on the sutures. In your situation, there can be at least 3 possibilities for why this developed: 1.) the repair around the belly button didn't extend close enough to it, leaving a weakness still present for the hernia to develop 2.) the was an early disruption of the repair, possibly within the 1st 8 weeks which was not detected but is more evident now for many reasons 3.) your tissues as related to the repair did not heal with enough strength to resist later strong intra-abdominal forces.Regardless, now it sounds like you need to be fully evaluated and have your hernia appropriately repaired.Steven Turkeltaub, MD
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