Tummy Tuck: Are Stitches on Ab Muscles Permanent or Do They Dissolve?

All of the answers will tell you that each surgeon chooses suture material on the basis of habit, experience, training, or perhaps on the basis of the tissue characteristics and desired outcome. As plastic surgeons, we all are taught the differences in suture construction (braided or monofilament), type (permanent or absorbable), material (natural or synthetic), size, and if absorbable, rate of absorption. These characteristics must be matched to the surgical "job" at hand.

None of us wants our abdominal muscle plication sutures to "tear through" when our patient coughs, sneezes, or strains in the restroom (sorry, but true!). That is why we also have restrictions on activity--too much lifting can cause sutures to break, tear through tissue, or lose strength prematurely. Realize that the tissues you sew together also have a role in the overall wound tensile strength--steel cables sewing two pieces of wet toilet tissue together will still tear through very easily with very little tension on the "repair." So surgeons should choose suture materials based on all these factors. You would be surprised how many surgeons simply do what they were taught in residency and don't even give these other factors much consideration--it's one of the first things I teach a medical student or resident when they spend time with me (and it's usually the first time they had even considered these facts)!

Your surgeon, of course, is a fully-trained, experienced, ABPS-certified plastic surgeon who understands all of these factors, makes educated and informed choices in your best interests, and lets you participate in these decisions where appropriate. For instance, I utilize a long-acting absorbable suture (running, so the forces are distributed along the length of the suture with stress such a cough, etc.) interspersed with a triple loop, buried-knot, permanent monofilament suture (triple looped to minimize "cheese-wire" cutting through the tissues, and monofilament to minimize the potential for harboring bacteria in the interstices with suture"spitting" over time) every few centimeters (inch or so). This has provided my patients with long-term, lasting muscle repairs that can still withstand weight gain or the occasional unanticipated pregnancy after tummy tuck. Still, this technique is no better than any of my esteemed colleagues' techniques--it is what works for me, and it is based on science and individual patient needs rather than habit, or "what my professor taught me." Experts may choose slightly different means to a similar end, but the end result is still our prime focus, and how to best achieve it may be slightly different with each of us! Best wishes! Dr. Tholen

Most plastic surgeons will use permanent (non-absorbable) sutures for the abdominal wall tightening (plication) during a tummy tuck. You can ask your plastic surgeon which type specifically he used.

Best wishes,

Dr.Bruno

Dear MyTime in Southern California:

The type of suture used for a tummy tuck varies by plastic surgeon. Click on "more" below to view part 1 of a 4 part  tummy tuck video. Realistically, if the sutures hold for 6 weeks, you body will heal and maintain the resultant tightening.

Personally, I use permanent sutures, and I prefer a woven polyester suture, as this seems to incorporate in the scar and may provide additional structure and support. The body remodels with time, and the sutures need to provide sufficient support to hold the tightened tissues together and provide time for your body to heal.

Eventually the sutures are not providing the majority of support and the repair is glued together with scar. As long as dissolvable sutures last long enough for this to happen, theoretically, the results should be the same.