I got a question from a woman worried she ripped out her internal sutures two weeks after a tummy tuck when she fell. How would she know?
Tummy tucks are a two layer repair.
- The top layer is skin- that is the scar you see.
- The internal layer is a corset of your muscles. All women after childbirth have some separation of their rectus muscles (the six pack). This separation is the “diastasis.” It is why you have the bulge in your belly when you are not constantly sucking it in. We plastic surgeons sew the muscles back together as part of the abdominoplasty repair. Why can’t you just do more sit ups? Can’t I fix it with pilates? No. (sorry!) There is no muscle which crosses the midline, so when the muscles separate, you can’t “bring them back together.” Stitching them together is the only answer.
When we repair the separation, we normally use very strong suture, and we do two layers. I know you Bay Area women will be tough on my repair. I do one layer of interrupted sutures (so if one loosens the whole thing won’t unzip) reinforced by a layer of running suture.
You CAN pull out the internal sutures. When we stitch you closed, your body needs to scar it into place. After a tummy tuck we don’t let you do any exercise, heavy lifting, or straining for weeks. I don’t let my patients work out their core (sit ups, pilates) for three months after surgery. Wound tensile strength is weakest at 3 weeks out. (!!)
Give your belly time to really cement in.
So even though it is hard for my Bay Area uber athletic types, no exercise at all for 4-6 weeks minimum and no core for 3 months. Even if you follow these instructions to a tee, scarred sutured tissue is never as strong as your original tissue. But alas we don’t have the option of having the body and tissue of a 20 year old with no kids.
Back to the original question. At two weeks out, if you had an abrupt move and you tore a stitch, it would not be subtle- you would most likely have had a sharp pain, bruising, and a bulge in the area. You have to see your doctor.