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

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.

You may have harmed your muscle sutures, but it will take months to determine if that happened.  If there is persistent bulging after 6 months, you probably tore something.  

Thank you for your question regarding the potential damage to your tummy tuck internal sutures following a fall.

Experiencing a fall just a few weeks after a tummy tuck with muscle repair can certainly be concerning. It's understandable to worry about whether you've harmed your muscle repair or torn any internal sutures. If you notice a significant increase in abdominal pain, especially if it feels sharp or is localized to the area where you felt the pull, this could be a sign that something has shifted or been damaged. Another indicator might be noticeable swelling, bulging, or a change in the contour of your abdomen. A bulge could suggest a hernia, which can occur if the sutures have torn.

In addition to these signs, new or worsening bruising at this stage might be concerning, as it could indicate internal bleeding or damage to the sutures. Changes in wound healing, such as your incision starting to open or the presence of discharge, redness, or unusual warmth around the incision site, should also be closely monitored, as these could be signs of a problem. Furthermore, if you develop a fever or start feeling generally unwell, it could point to an infection or another complication that needs to be addressed.

Given the potential for complications, it's crucial to reach out to your plastic surgeon as soon as possible. They may recommend an in-office evaluation or imaging studies like an ultrasound or CT scan to determine if there has been any damage to the muscle repair or internal sutures. It’s always better to err on the side of caution and have your surgeon assess the situation to ensure that everything is healing properly and to address any issues promptly if they arise.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS

Abdominoplasty not only removes excess skin, but also
tightens the underlying abdominal wall muscles.  These muscles can be weakened, stretched, and torn during
pregnancy.  This can result in the
characteristic protuberant abdomen that is commonly seen following pregnancy.

Abdominoplasty tightens these muscles in a side to side
manner which results in a flatter abdomen.  Most surgeons use a continuous suture for this closure, but
in some cases individual sutures may be used instead.  These sutures maintain the structural integrity of the
abdominal wall until the wound has regained adequate strength.  This usually occurs in about 6 to 8
weeks.  At this point, these structural
sutures have served their purpose.

When trauma of any type occurs during the initial phases of
wound healing, disruption of these sutures can result in a recurrence of the
original problem.  Under these
circumstances a flat abdominal wall may suddenly bulge in an outward direction.

If you’re concerned about disruption of your internal sutures,
consultation with your plastic surgeon is appropriate.  Your surgeon should be able to evaluate
your abdominal wall and determine whether or not a disruption of your closure
has occurred.

Even though the muscle layer is repaired with two sets of sutures internally, a sudden strain or abrupt movement might tear the sutures in the first few weeks after surgery.  This problem would be diagnosed with a sharp pain in the torn area possibly accompanied by a  bulge in that area.  It is very important to protect the muscle repair for several weeks following surgery.

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.

Yes, it is possible for you to have torn the sutures. It is not necessarily an easy diagnosis to determine on physical examination and you may need a CT scan to help you make a definitive diagnosis. Discuss this with your surgeon who will perform an examination as the first step.

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.

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. 

If you would like more information about abdominoplasty (tummy tucks) I recommend that you visit the attached link.

I hope this info helps...