What Is The Cause Of This Extruding Suture After My Tummy Tuck?

Q: Dr. Eppley, I had a  circumferential body lift performed in late 2008 during which my navel was also removed. Approximately a year later I noticed a sharp protrusion from my navel. I at first thought it was a bit of suture too close to the surface of the skin to snip off. About the middle of 2011 I noticed that there were small blood clots around the area. It progressed until I needed to clean the area daily, during which smears of blood were found. Approximately 3 days ago what appeared to be a knotted loop of green dental floss protruded from my navel. I made an appointment with the plastic surgeon, and the nurse told me that this was an extrusion. She said this was highly unusual this far after the original surgery date, but the doctor would look at it. I notice no pain, but the site is still numb. Is this unusual or dangerous? Each day more of the suture comes out, and now there is about 3-4″ clearly visible. I am concerned about what can be done and how much of this material is yet to protrude. Please advise as I am concerned about the consequences.

A: What you undoubtably have is extrusion of some of the abdominal fascial plication suture used for rectus muscle tightening in your tummy tuck. The knots often are around the navel area. Because the suture is permanent (non-resorbable) there is always the risk of lifelong issues with the embedded suture. (although they are uncommon) The fact that it appeared years later after surgery is not unusual and it just as easily could have occurred ten years later as opposed to three. It is a foreign body reaction that has appeared due to its close proximity to the skin and scar around the navel area. The suture merely needs to be cut back to where it lies deep under the tissues again. This may require opening up a small area of the incision to permit it to be ‘chased’ and removed until it is far from the incision line.  

Dr. Barry Eppley

Indianapolis, Indiana