How Can I Tell if I Tore my Tummy Tuck Internal Sutures or Worse?

Tummy tucks are a two layer repair. The top layer is skin- that is the scar you see. The internal layer is corseting your muscles back together.  All women after childbirth have some separation of their rectus muscles (the six pack).  This separation is the "diastasis."

When we repair the separation, we normally use very strong suture in two layers.  I do one layer of interrupted sutures reinforced by a layer of running suture. 

You CAN pull out the internal sutures.  When we stitch you closed, your body needs to scar it into place to reinforce it.  For this reason after a tummy tuck we don't let you do any exercise, heavy lifting, or straining for weeks. 

If you had an abrupt move and you tore a stitch, it would not be subtle - you would most likely have had a sharp pain, bruising, and a bulge in the area. 

There is an 8 week time period after surgery that it takes for your muscle repair to gain its fullest strength. During that time you should treat it as though you had a hernia repair and not strain the abdomen with exercises or certain activities that stress the repair. These activities include gardening on your hands and knees and pulling weeds, playing sports that involve sudden lunging movements like tennis, and pushing and pulling a heavy vacuum.

As long as your abdomen didn't suddenly look dramatically fuller after your fall, you probably are okay. You wouldn't want to re-operate on anyone at this point anyway because the tissues would be inflamed and wouldn't hold new sutures as well as they would after 3-4 months.

You might want to wear a binder such as a Flexi which can be purchased at most major department stores. This will give you a feeling of security and can serve as a reminder to let your abdomen heal for 2 months before straining it. Of course you can't prevent accidents but usually the stitches are very strong that are used in the muscle repairs.

The muscle repair should not be strained for 6 weeks.  In Jacksonville, we recommend our tummy tucks patients to wear a abdominal binder for 4 weeks during the healing process to allow for the muscle repair to heal and protect against accidental strains. There is generally a two layer tightening performed, so even if you did pull one stitch it will likely not effect your overall result. Unless you notice some bulging that you didnt see immediately before, you should continue to be on the road to a wonderful result.

Unfortunately, it is possible to disrupt the muscle wall repair.  The unfortunate accident you sustained could have torn some of the key sutures.

You can tell if you noticed new bulges or a change in your abdominal contour after the injury.

Of course, you should consult with your surgeon as soon as possible.  Upon examining you, your surgeon may be able to tell if there's been any damage to the repair.

although it is possible that you might have torn one or two of them it is unlikely. Some surgeons, including me, use multiple independent sutures so that if one tears the other ones are still good. The best way of knowing if you need to have anything done is to wait for several weeks until the initial inflammation subsides. If you develope local bulging in the midline which gets worse with straining then you should have it evaluated by your plastic surgeon.

The farther you are from your surgery date, the harder it is to bust a muscle (plication) repair suture. Since the sutures used are not small, it takes a large blow or trauma to break them (or get them to cheese wire through the muscle lining). The last patient we had to do this was doing Tae Bo training and was accidentally kicked in the upper abdomen.

There will often be a popping sound or feeling followed by a fullness (which could either be blood or the failed repair coming to the surface). You may need a CT, MRI or ultrasound to investigate further.

Dr. P. Aldea

The stitches used to tighten the muscles of the abdomen are really strong. It is very unlikely that you tore them. It is, however, possible. Falling after a tummy tuck will hurt, particularly in the middle of the tummy where the tension is highest. I would recommend you visit with your surgeon and get evaluated. You will probably find that everything is OK. 

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I hope this info helps...

It is not uncommon to feel a pull or sharp twinge in the recovery. it is unlikely any sutures pulled through. May surgeons will place two separate sets of sutures such that if one breaks or pulls Thur there is redundancy to prevent a problem.

if you had pulled through or disrupted a number of the internal plication sutures, depending on the degree of your healing,nothing may happen. or it could occur that you get a slight bulge or change in contour of that area.

Your operating surgeon should be able to give you an opinion after an exam.

The muscle wall repair portion of the tummy tuck helps give excellent contour to the abdomen.  Generally, this repair is accomplished with very strong sutures that are placed in two layers.  While it is possible to "pop" these sutures, it would take a very significant force.  At 2 1/2 weeks after surgery, the chance of ruining the repair are higher since the muscle wall repair has not reached full strength.  If you notice a new bulges or changes in your contour, the repair may have be disrupted.  The best thing to do is discuss the issue with your plastic surgeon. 

To learn more about abdominoplasty (tummy tuck), visit our website:

I doubt you have much to worry about.  It is possible to disrupt abdominal repair sutures but it would be most unlikely.  In any event, it is not an emergency and you should wait to see how things look over the next few weeks.  My guess is that you will be just fine.  By the way, you need to be more careful.