Very slim & very active - permanent vs dissolvable sutures, mesh/no mesh?

Hi, thanks for your question. It is not the sutures that provide long-lasting strength to the repair, it is the scar tissue that forms as a result of suture placement that will hold things in place for the long-term. The sutures are simply placed to aid this process in the short-medium term. For this reason, for divarication repair, I routinely use sutures that dissolve (but not for several months), and would not typically use a mesh.
Using permanent sutures should not impact the extent of the ‘tightness’ as any suture will stretch and relax to some extent with time, even if permanent.

An exam is needed for the best recommendation, however regardless of the suture type used you should be able to regain full ability to bend and stretch once healed. The key will be closely following your surgeon's post op instructions and advancing slowly once cleared to return to exercise. This will allow you to gradually make progress without causing unwanted outcomes.

Great question. Your muscle separation is likely a big issue for you. Muscle repair is key to a great result. You certainly want PERMANENT sutures as dissolvable sutures will lead to laxity of the repair and compromise your result. Once healed this will not impair your athletic ability.