Tummy tuck, diastisis recti repair, umbilical and ventral hernia mesh repair. Can permanent sutures cause pain 8 years later?

Question

I had a tummy tuck, with diastisis recti repair, along with an umbilical and ventral hernia mesh repair 8 years ago. Following the procedure, every time I do anything with my abdominal muscles, I get pain and swelling that will last up to a week or more within the diastisis recti area. I thought that the mesh from the umbilical hernia was the cause of this ongoing pain, but upon a recent exploration of my abdomen, it was found that the mesh does not go up as far as the diastisis recti. This leads me to think that the internal sutures could be causing this issue? Can permanent sutures cause pain 8 years later?

Jerimiah Mason, MD · Answer

It is definitely not a common problem to have this far out after surgery, but it is certainly possible sutures could be causing pain if they are the permanent type.  However, the swelling you mention is also concerning, and the problem may be more complicated than you think.  The most likely explanation based on what you are describing is a recurrent hernia, with either fat or bowel getting stuck in the hernia when you exert yourself.  This is definitely something your surgeon should be made aware of, and would need to be repaired surgically.

Dallas Buchanan, MD · Answer

Thank you for your questions. To be honest, it is hard to know. Generally when doing a tummy tuck, I use long-term absorbable suture rather than permanent suture. If dissolvable suture causes a problem it will resolve with time. But if permanent suture causes a problem, it becomes a permanent problem. So it is possible that if there is still permanent suture in place, it might be causing a problem. That being said, there is no assurance that going back in to remove that suture will correct or reduce the pain. Pain is complicated and can be also from nerve damage or injury that might be unrelated to the suture material. I would say that if the pain is unbearable to live with, then you could consider revision surgery to remove sutures or scar tissue, but be prepared going into that surgery that there is no assurance that it will improve things and its possible it could make things worse, you just never know. 
Best of luck!
Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

Elisa Stein, MD · Answer

Cloverqueen,At the time of your diastases repair a nerve may have been irritated due to its location related to the muscle repair. When you perform certain activities with your rectus muscles, the suture might pull and irritate the area again. Try to notice if certain core muscle activities make the pain return. Other etiologies of the pain should be ruled out like a hernia, muscle strain, mesh (which it sounds like you have done). Sometimes, when nerves are inflamed, they can be injected with a local anesthetic numbing medicine to see if it helps the problem. If nerves are trapped and respond to this, they can potentially be surgically released.
Elisa Stein, MD, MHACertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Tummy tuck, diastisis recti repair, umbilical and ventral hernia mesh repair. Can permanent sutures cause pain 8 years later?

Answers (3)