Sutures folding over themselves. Is this normal?

Question

I’m 18 months post-op: hernia repair, tummy tuck and full muscle repair. I have healed wonderfully and am back to my weight-lifting routine. Sometimes when hunched and bearing weight (such as holding an abdominal crunch), the upper portion of my muscle repair above my belly button WEIRDLY seizes: placing a hand on the spot I feel what I’d describe as my sutures folded over themselves. Upon relaxing and straightening, I feel the sutures flip open/unfold. Normal? I’m otherwise healthy and strong.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question about sutures after a tummy tuck and muscle repair. What you're describing – a sensation of your sutures feeling like they are “folding” over themselves during certain movements – can happen after an extensive muscle repair, especially during activities that strain the repaired area, such as crunches or lifting.

Typically, this feeling is due to scar tissue or internal sutures interacting with your abdominal muscles and fascia. It’s not unusual for patients to experience sensations like tightness, “catching,” or even slight popping as the repaired tissue adjusts to certain movements. If the sensation is mild, temporary, and not associated with pain or bulging, it may simply be a normal response as your body adjusts to high-impact activities like weightlifting.

However, if the sensation becomes painful, leads to visible bulging, or if you feel a “give” in the repair, you should discuss this with your plastic surgeon. In some cases, an ultrasound or MRI can help assess the integrity of the repair. Overall, it sounds like you’re doing great, but a quick check with your surgeon may give you peace of mind as you continue your fitness journey.

Sincerely,
Dr. Katzen

Julio Molina, MD · Answer

No, it is not normal since they should have guided you about that and when you could start doing strong exercises

Elie Levine, MD · Answer

The best person to answer this question is likely the surgeon who performed the operation. The method of hernia repair and the method of muscle tightening can vary and that can contribute to what you are seeing. In addition, some patients may experience muscle spasms post procedure that may be causing this. If it is a muscle spasm, often these become less pronounced and less severe with time - but the best person to really answer this is the surgeon (or surgeons) who performed this procedure.

Connie Hiers, MD, FACS · Answer

Your sutures are not flipping, but your muscle may be folded some on itself and will contract and relax making that area feel like it is flipping. The muscle does not flip either.

Pawel Szychta, MD, PhD, DSc · Answer

What you're describing&mdash;a seizing sensation in the upper portion of your muscle repair, with a feeling that the sutures are "folding over themselves" and then flipping open&mdash;is likely related to the healing process of the internal sutures and scar tissue.
After a tummy tuck (abdominoplasty) and full muscle repair (often done for diastasis recti), sutures are placed in the abdominal muscles to bring them back together. These sutures can take a long time to fully integrate and become less noticeable. Here's what might be happening:
However, it’s always a good idea to check in with your surgeon to confirm that what you're feeling is a normal part of the healing process. They may want to assess the area to rule out any potential complications like suture issues or small hernia recurrences. Since you’ve returned to weight-lifting, ensuring your core is properly supported and gradually increasing your intensity are also key to avoiding unnecessary strain on your repaired muscles.
Overall, this doesn’t sound immediately concerning, but getting professional advice is wise for peace of mind. Keep listening to your body and adjust your workouts if needed to avoid aggravating the area.

Camille Cash, MD · Answer

It's difficult to say exactly what you are experiencing when working out.  It could be the muscle contracting when holding a given position.  If it isn't painful and reverts to normal after completing the exercise I wouldn't worry about it.  You could visit with your surgeon and try to recreate the scenario if it is bothersome.

Mats Hagstrom, MD (license on probation) · Answer

Your description makes it difficult to assess the problem.
I suggest reposting and including some pictures.
Best,
Mats Hagstrom MD

Sutures folding over themselves. Is this normal?

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