What happens to the tissue between the fascia sewn together during an abdominal repair? (Photo)

The tough connective tissue covering the muscle fascia is stitched together. Over time, the fascia heals together, and the stitches no longer serve the function of holding things together. 

As stated before that tissue folds in on itself and it becomes fused as a scar. And that process usually takes about 6 to 8 weeks. After that the sutures in theory aren’t needed anymore but we still leave them! In answer to your second question I don’t believe that that space in your abdomen becomes tighter.  For this reason, when I do a tummy tuck in patients over 50 years old I always ask them about bloating because I have had a few patients who really hurt in the late afternoon when they are prone to bloating!!!! 

Dear mrs. july,during the muscle repair, distended tissue will be folded inside but it will not affect the position of intestines. During healing process, it will slowly turn into the scar tissue. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

The tissue sewn together occupies little volume. It does not displace internal organs. Over the first 3 weeks or so, the tissue actually softens and weakens then remodels and gets strong again at 6 weeks. This is why most of us restrict lifting for 6 weeks after the fascial repair. On patients with a larger abdomen or problems with gas/bloat, I have the patient do a bowel prep the night before surgery so that I can make them tighter without affecting their respiration. Otherwise, when they are made tight the intraabdominal content pushes up on the diaphragm. Several patients have indicated that the TT has improved their problems with chronic constipation or gas.

the fascia between the recti is a very strong but thin tissue. It folds in on itself and takes up little to no space. The tissue will not be a problem.

That is a great question!  It shows you really understand what is happening when the muscle is put back together.  The answer is that the tissue is infolded but since it is very thin it doesn’t take up much room at all.  It does stay there, first because of the sutures and then with time it heals that way.  The amount of space it takes up is tiny compared to the space available so the tissue itself doesn’t affect the internal organs.  Best wishes!

That is a very good question! So the answer is, that tissue is very thin and bunches back together, where it came from, back to a density that we call the linea Alba. It is essentially a very dense thick scar tissue that holds together and puts the abdomen back into its original shape. As for your second question we are always careful not to over tighten the abdomen. As you suggested creating too much tightness can decrease room for the organs and even blood flow. That can be a very dangerous situation and extremely rare. I would talk to a board-certified plastic surgeon in your area who can help explain this as it relates to you as well. Best of luck! Dr. Boschert

When the muscles are sewn back together in the original anatomic position (pre-pregnancy position) the tissue that was stretched out between the muscle edges is folded inside the abdomen. This tissue is very thin, but yet quite strong, and when the muscle edges are sewn back together this thin tissue ends up under the muscle. However, since this tissue is thin it does not take up any significant space, and actually the tissue ends up becoming a scar, that adds to the thickness of the repair.

Dear Mrs. July,Hello and thank you for your excellent question. When the muscles are sewn together, the tissue insue stays inside. This does make less space inside your abdomen, but your body will adapt quickly.  You may want to look into a body contouring procedure that combines both liposuction with laser, radiofrequency (RF), or acoustic therapy to produce the best balance of fat reduction and skin tightening and smoothing for your body type and anatomy. We use a proprietary technique that we call IDEAL Liposuction. First off, all devices and instruments used are FDA-approved. These procedures are usually performed in the office, with only local anesthesia. We typically use Smart / Laser Liposuction or ultrasound to reduce dense, fibrous fat, and stimulate collagen formation; Radiofrequency-based skin tightening to maximize skin contraction; and Ultrasound, RF, or subcision (Z Wave, Venus, Cellfina) to treat cellulite. Patients go home the same day as surgery, do not need any narcotics postop for pain control, and can return to light exercise and work two days after their procedure. In my practice, we select the appropriate treatment for each patient based on their skin quality, amount of fat and surgical goals. It is best to answer your question during a face-to-face evaluation, when you can discuss your goals and expectations for the procedure, and you can have a physical examination to evaluate for that procedure. I recommend that you find a board-certified, or board-eligible plastic surgeon with whom you are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your surgeon, and review before and after pictures of similar patients whom have had this procedure. If you have any questions, call our office for assistance. Good luck!

Best,

Jon Ver Halen, MD FACS

Harvard educated plastic surgeon

Texas “Top Doc” 2017, 2018

RealSelf100

America’s Top Plastic Surgeons, Consumer’s Research Council, 2010 – 2018

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