Is it possible that my muscle separation became undone?

Hi. Its unlikely for the muscle repair to separate after surgery as permanent sutures are often used. If you are concerned you should see your Plastic Surgeon to arrange for imaging to check on it.

Thank you for your question about the durability of muscle plication after an abdominoplasty, particularly in relation to intense physical actions like nausea-induced vomiting.
Variability in Surgical Techniques: Surgeons employ different methods in muscle plication. Some use absorbable sutures, which can dissolve over time, potentially leading to muscle separation. Others prefer permanent sutures for their lasting effect. Additionally, the number of sutures and layers of closure can vary, impacting the overall strength of the repair.
Risk of Suture Disruption: While robust, the sutures are not immune to extreme forces. Prolonged or intense physical stress, such as severe vomiting, might pose a risk to the integrity of the suturing, though this is relatively uncommon.
Assessing Muscle Integrity Post-Surgery: If you have concerns about the state of your muscle repair post-abdominoplasty, an MRI is the most definitive way to assess whether the muscles remain properly aligned. This imaging can reveal the current condition of the muscle plication.
Weakness in the Abdominal Wall: It's also possible that the muscle repair is intact, but the muscles themselves are weak. In such cases, additional surgical interventions, like mesh insertion, might be necessary to reinforce the abdominal wall.
In conclusion, while it's possible for muscle plication to be compromised by intense physical stress, it's not a common occurrence, especially if permanent sutures and multi-layer closures are used. If you're concerned about your postoperative results, a consultation with your surgeon and an MRI can provide clarity.
I hope this response has been informative and helpful in addressing your concerns about muscle plication post-abdominoplasty.
Good luck on your continued recovery journey.
Sincerely,
Dr. Katzen

Hi,
Unfortunately, the first 6 months after muscle repair is the danger zone to where the sutures can be popped if the intra-abdominal pressure exceeds its threshold. However, the sutures used for this repair are usually VERY strong and are made to withhold force. It is very unlikely, but not completely impossible. I would go get assessed by your surgeon and even inquire if he uses continuous or interrupted sutures in his muscle repairs. In the meantime, I would be wearing very tight compression to support your abd wall.

Hello! Thank you for your question! It would be best to be assessed by your plastic surgeon who completed your surgery to examine you. The rectus abdominis muscles are sutured together during a tummy tuck. Rarely, the sutures can come apart when there is extra stress against the muscles, such as with vomiting. This would most commonly happen shortly after surgery. When this occurs, multiple pops can sometimes be heard and felt by the patient. I would generally expect that after four months that enough scar tissue has formed in the area that it would be less likely for separation to occur at that time.

At four months post op it would be unlikely that muscle repair would fail. If you have concerns that it may have occurred, visit with your surgeon for an evaluation. If you have not noticed changes to the abdominal contour you can assume the repair is intact.

Anything can happen, but at 4 months, the repair is probably intact. If you have concerns, please see your plastic surgeon.

It would be extremely unusual for muscle repair to fail after surgery. That said I’ve seen many different plastic surgeons use many different ways of doing muscle tightening. Personally, I prefer to do it in multiple layers using both interrupted and running suture. Using permanent neutral material. I’ve seen other providers do single layer using absorbable suture.
That said, I’ve never seen a case where mechanical, suture, breaking caused someone to lose muscle tightening after a tummy tuck.
The most common reason people have a bulging of their abdomen after a full tummy tuck is due to excess visceral fat. This is fairly straightforward and easy to diagnose both before and after the procedure.
Individuals who have excess visceral fat, will have a bulging abdomen, despite how the muscle tightening is done.
Best,
Mats Hagstrom, MD