During a tummy tuck what type of stitches are appropriate to be used in muscle repair? Dissolvable or permanent?

You should absolutely have permanent sutures placed to repair the muscle separation (rectus diastasis)

Hi Nancie! I usually use permanent suture for the rectus diastasis repair. I have on occasion used the absorbable suture when requested by the patient. It is not supposed to make a difference as the other MDs have said. Hope that helps. Good luck on your journey!
All the best,
Dr. Meegan Gruber

It is appropriate to use either dissolving, permanent, or a combination of the two for the muscle repair during a tummy tuck.  It is really the plastic surgeon's preference.I first place interrupted permanent sutures for the repair (plication) of the muscular fascia during my tummy tucks.Then, over this I place dissolvable sutures. By the time the dissolvable sutures go away, a nice layer of scar tissue will be covering the permanent sutures and this provides further strength to the repair. AND, I think that there is less likelihood that the permanent sutures will be able to be palpated (felt) by the patient under the skin since a layer of dissolvable sutures have also been placed.

Dear Nancie,
I usually use some permanent sutures in the muscle (diastasis) and scarpa's fascia repair.  Although every surgeon approaches things in a different way, it's likely the consensus is to use long lasting sutures due to the tension on the tissues.  Hope this helps!

You'll find fans of both permanent and long-lasting, but dissolving sutures for muscle repair.  They both can work.  Personally, I favor the permanent ones.

The repair of the diastasis requires sutures that last for a prolonged length of time.  For that reason I always use permanent sutures.  The sutures are deep and do not need to be removed.

Most surgeons in the United States use permanent suture repair of the abdominal wall. There are some surgeons who use newer dissolvable sutures as well. Surgeons are using the strongest material to hold the repair together to minimize the risks of the diastasis from coming back in later years. Best wishes, Dr. ALDO 

Great question and you will get plenty of different answers on this, as it really is surgeon dependent. I personally prefer Interrupted absorbable sutures in my patients that don’t require more than 4cm of diastasis repair of the muscle. In general surgery literature there is support for the use of absorbable sutures as their tensile strength is still strong enough leading up to the 6week  mark when the fascia scar tissue should be ample enough to hold itself together. The benefit of absorbable sutures is most significant in patients that develop an infection or wound complications. The presence of nonabsorbable sutures may require the removal of all or most of those sutures to eliminate infection or debride a wound. 
On the other hand, if I have a patient who is overweight, has a very large diastasis , or has intrabdominal fat. They’re going to be pushing against that repair much more than the other type of patient. In these patients I prefer a nonabsorbable suture because of the increased level of tension I’m expecting. I still do interrupted sutures not continuous, just as I would above. The reason is if one suture breaks you still have sutures above and below holding the tension. With a continuous suture if it breaks the whole repair can loosen. The nonabsorbable means that it’s tensile strength is present for a much longer time. 
Some surgeons used barbed sutures , some use a mix of running and interrupted, some use a mix of absorbable and nonabsorbable . Usually these choices have to do with what they’ve had the most success and least amount if problems with. 
Hope that helps.

I appreciate your inquiry. When tightening of the abdominal muscles is performed during a tummy tuck, permanent stitches are commonly used to maintain the tighter, firmer appearance for an extended period. However, the ultimate choice will depend on the surgeon handling the surgery. Choose a surgeon who has the credentials and experience to customise your abdominoplasty to your unique needs and desired outcome to ensure the best possible results. Take your time finding a surgeon you are comfortable working with, since you will have numerous appointments throughout the process. Best wishes for a safe and successful procedure and recovery!
- Morris Ritz, MB, BCh, FRACS

The sutures should be permanent and non-dissolvable for the best results. Otherwise there would be a risk of stretching of the deep tissue once the stitches dissolve.