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

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.

A full tummy tuck requires an incision from one hip to
the other.This incision is carried
through the skin and fat down to the underlying muscle layer.The muscle layer is not entered.The skin and fat layer is lifted off of the
muscle layer up to the belly button.When the belly button is reached, an incision is made around the belly
button, allowing the skin and fat layer to be lifted off of the muscle layer up
to the rib cage.At this point, the
entire muscle layer is well visualized.Normally, stitches are placed in the muscle layer to tighten it up.Some surgeons place individual sutures along
this line from the rib cage down to the pubic bone. Some surgeons utilize one
continuous running stitch along this line.Some surgeons may actually place two rows of running stitches along this
line.After a tummy
tuck, situations that may stress this repair can occur.Nausea and vomiting can create significant
pressure along this suture line.Chronic
coughing after surgery can also stress this area.Other activities that cause tensing of the
abdominal wall could further jeopardize this repair.If individual
sutures were placed and some of them individually break, then a bulge may appear
in that particular area.On occasion,
patients actually report hearing a popping sound when this occurs.If one continuous stitch is placed from the
rib cage down to the pubic bone and it breaks, then the muscle repair is lost
but usually there are no areas of localized bulging.It is very
important after an abdominoplasty to follow the postoperative instructions
given to you by your surgeon to help protect your repair.