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

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.