Could I Have Tore my Internal Sutures 8 Days After my Tummy Tuck?

Question

I had to go have a scan at the ER to check for a blood clot 8 days after surgery. I told the radiologist I could not lay flat but he insisted I had to. I asked him to slowly lay me back and I would try..He layer my halfway back then dropped me flat on the table. It felt as though all my sutures ripped apart. I screamed!!!! The pain afterwards were herendous and I had to have my stomach drained days later and it was dark red blood. I'm so scared my sutures have ripped a part. I am now 10 wks out.

Christopher V. Pelletiere, MD · Answer

It would be very rare to break the internal sutures that most surgeons use to repair the abdominal wall and use as deeper sutures to bring the incision together. When patients report a tearing sensation, it is often the tissues themselves that have stretched or torn slightly internally. This generally heals fine, but can be painful ( as you found out) and can cause some bleeding. When a suture breaks, it is not a subtle thing. Most patients hear and feel an actual pop when the suture breaks.

Ali Sajjadian, MD, FACS · Answer

Dear Luvinmy3kids,

	 

	I am sorry that you had to go through this awful experience at the ER.

	 

	Deep Tummy tuck sutures are normally strong enough to withstand tension and so their rupture is not common. Could it happen? Yes.

	 

	According to what you have described, it seems that the sutures cut through the tissue causing bleeding, hence the dark blood drained from your abdomen.

	 

	Consequently, pain will result from the tearing that may have taken place as well as the fact that your skin (at 8 days post surgery) did not establish the necessary laxity to withstand the stretch that you may have had when you had to lay flat on your back for the imaging as instructed by the radiologist.

	 

	Therefore, I encourage you to keep your surgeon in the loop of your progressive healing and to keep an eye on any abdominal bulging if it is to occur.

	 

	Best of luck to you and thank you for your inquiry.
	Dr. Sajjadian

Ronald Schuster, MD · Answer

I'm sorry to hear that you have had such a difficult time after your surgery. It is possible to have popped your sutures from your description. Unfortunately even if you did, there is nothing you can really do about it now. Follow your surgeon's instructions and hopefully you will do fine.

Ralph R. Garramone, MD · Answer

There have been a number of questions related to this type of problem and whether some activity could result in tearing or disruption of the muscle tightening portion of the tummy tuck procedure.

	First of all I am sorry you had a bad experience with the radiologist. I am glad though that the test was negative for the blood clot.

	I have performed quite a few tummy tucks over the years and I have never heard of a situation where the muscle fascia plication was disrupted by anything after the procedure.  I have had three patients get pregnant after the procedure as well, one of those patients became pregnant within the first three months after the surgery and in each cases they all looked good after delivering their babies.

	While there may be pain and possibly bleeding after the movement you experienced I would be surprised if any permanent injury was caused.

	Thank you for your question.

Remus Repta, MD · Answer

Hello,

	The sutures placed both for the abdominal wall tightening as well as to close the lower incision are usually much stronger than the tissue they are placed into.  That is, you are more likely to "cheese wire" the suture partially through the tissue that it is in rather than break the suture.  This is also why the pain and sometime additional bleeding is seen when such events as you describe occur since the suture acts almost like a small cutting instrument partially cutting into the tissue that it is located in.  At this point just keep your activity appropriate, keep your abdominal binder very snug, and wait to see how the healing process occurs.  Your plastic surgeon should also check you regularly for seroma formation secondary to this even since a seroma not drained can lead to a pseudobursa.

	All the best,

	Dr Remus Repta

Tom J. Pousti, MD · Answer

I'm sorry to hear about the painful experience you have had after tummy tuck surgery. Generally speaking, your plastic surgeon will be in the best position to evaluate the integrity of the abdominal wall plication sutures.  Also, generally speaking, it would take significant force to disrupt the sutures used to re-approximate the rectus muscles. It is possible that the pain you experience was related to the tummy tuck  incision line that was stressed when you were flat on the radiology table.

	Again, I would suggest follow-up with your plastic surgeon for examination and (hopefully) reassurance.

	Best wishes.

Could I Have Tore my Internal Sutures 8 Days After my Tummy Tuck?

Answers (6)