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.