Thank you for your question regarding whether tummy tuck stitches can open up years after the procedure. It’s not common, but in rare cases, internal stitches—especially those used for muscle repair (rectus diastasis repair)—can loosen or fail over time, particularly if there's added strain on the abdominal muscles. This could lead to bulging or distention in the abdomen, which might appear as a protrusion in the upper or lower abdomen, depending on where the muscle repair was performed. The fact that your stitches still show up in X-rays suggests that permanent sutures were likely used. While these sutures are designed to hold the muscles together indefinitely, they can sometimes stretch or loosen due to factors like: Weight gain or fluctuations Physical strain or heavy lifting Aging and muscle weakening over time If you're noticing abdominal distention or a bulge years after your tummy tuck, it's a good idea to consult with your plastic surgeon or a specialist to determine if this is due to muscle separation or a potential hernia. An evaluation, potentially with imaging like an ultrasound or MRI, can help identify if the muscle repair has loosened or if another issue, such as visceral fat accumulation or scar tissue, is causing the distention. In summary, while it's not common, internal stitches from a tummy tuck can loosen or stretch over time. I recommend seeking a professional evaluation to get a clear diagnosis. Even better, discuss your concerns with your plastic surgeon. Sincerely, Dr. Katzen