Possible to Undo Muscle Plication After Tummy Tuck?

Question

My wife had a Tummy Tuck 6 months ago. Unknown to her she had muscle repair. She had a permanent stitch removed at week 5 due to pain above her belly button.She is still in crippling pain just above her belly button. She stopped work and family life has been severely impacted. She's even afraid that she won't be able to have one child as a result of the pain. Can muscles be unplicated? I love her so much. Please Help!

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding whether muscle plication can be undone after a tummy tuck. Yes, it is absolutely possible to undo muscle plication, and this can be done through the previous tummy tuck incision. Muscle plication involves stitching the rectus abdominis muscles back together to correct muscle separation (diastasis recti), and in rare cases, patients may experience ongoing pain from the muscle repair.

In your wife’s case, if the permanent sutures used during the muscle plication are causing her discomfort, they can be removed, and the muscles can be unplicated or revised. This would typically be done by reopening the same tummy tuck incision to avoid additional scarring. I have undone muscle plication before and the patient felt extremely relieved, even right after surgery.

I highly recommend that you and your wife consult with a board-certified plastic surgeon who has experience in revision surgeries. They can assess the situation and determine whether the muscle repair is the source of her pain and what the best course of action would be. Many patients go on to have healthy pregnancies after a tummy tuck, so this issue can hopefully be resolved to improve her quality of life and future family plans.

Sincerely,
Dr. Katzen

Otto Joseph Placik, MD · Answer

Of course, it can be released but then you must accept the consequences of a "pot belly" like appearance.
Removing the stitch may not necessarily relieve the pain.
Even if you were to leave the stitch in place, your wife could proceed to have a child. I have had several patients become pregnant after undergoing a tummy tuck with muscle repair.
In many instances, I have seen patients complain of pain following a tummy tuck when they gain weight and stretch the muscle repair. Weight loss and time appear to resolve this pain.

Peter A. Aldea, MD · Answer

I agree with both Drs. Placik and Pollack.  I have performed this operation several hundreds of times and I have never come across such symptoms.
It DOES sound like your wife may have EITHER an entrapment syndrome,  a neuroma or an atypical pain syndrome.
In the process of tightening the rectus muscles and bringing them back to the midline, the fascia lining of the muscle is stitched together. The nerves supplying the rectus muscles are SEGMENTAL (they penetrate the side of the muscles every few inches) and are MOTOR (muscle moving) nerves NOT sensory nerves. The problem your wife complains about, on the other hand, is seen with sensory nerves which run in the fat ABOVE the muscle and are NOT normally caught in the plication suture.
Before undoing the repair needlessly only to find out that the pain persists, I would suggest that you may want her to see a Pain specialist. IF he/she can locate a single location where the pain starts and that pain can be numbed up - this is must likely a neuroma which is totally treatable. If on the other hand the pain cannot be reduced with a local block, it is more suggestive of an atypical pain which could be managed with certain medications.
Having a tummy tuck does NOT preclude your wife from having a baby. But - a pregnancy is likely to take away the flat tummy created by the operation. As such, plans for more children should have been discussed before the surgery.
Dr. P. Aldea

Robert B. Pollack, MD · Answer

Martin,
Your wife may have a nerve trapped in the stitch above the belly button resulting in a tangled nerve called a neuroma. If the location of the pain can be pinpointed at a single spot sometimes the neuroma can be injected with good success. Otherwise it is a little harder to acomplish but, yes, the permanent stitches can be removed as well. It can be a difficult problem to correct but since she has been suffereing with this for 6 months it sounds reasonable to try to be as aggressive as possible.

Richard P. Rand, MD, FACS (retired) · Answer

What you are describing is extraordinarily rare. As the other doctors have said it could be from many things including an entrapped nerve. I would suggest a CT scan or MRI of the abdominal wall and then a re-expoation of the area looking for an abnormality.

Possible to Undo Muscle Plication After Tummy Tuck?

Answers (5)

More Tummy Tuck Questions

WE SEND PRETTY
EMAILS

Answers (5)

More Tummy Tuck Questions

Risks of Combining Breast Augmentation with Liposuction and Tummy Tuck?

Tummy Tuck for Patient with VP Shunt?

Why Are Tummy Tuck Incisions So High?

Tummy Tuck for Overhang After an Operation?

Obgyn to Perform Partial Tummy Tuck During C-section?

Tummy Tuck Worth It on Loose Skin for a 17-year-old?

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS