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What would be the best corrective surgery for Diastasis recti?

Q:

I have a pretty bad Diastasis recti that makes me look 5 months pregnant.  It also gave me a distended navel, that hurts sometimes when I urinate, and when I wear shape wear that sucks everything in.  I've read about the tummy tuck procedure (including having to get a new navel opening), and it seems horrific.  My question is, is there another alternative to a tummy tuck, that would still give the same cosmetic improvement results?

A:

A full tummy tuck involves removal of most or all of the skin and fat between the pubic area and the existing belly button, tightening of the rectus abdominis muscles from the bottom of the sternum to the pubic bone, and creation of a new belly button. Some abdominal and hip liposuction is usually performed as well.

Although in my practice, we do offer non-surgical body contouring procedures, like CoolSculpting, there is no replacement for a tummy tuck. Non-surgical treatments can be wonderful for the right person, but they have limitations.

M.M. Law, MD

A:

This situation can develop unfortunately after even one pregnancy. I have seen it more commonly after the 2nd pregnancy orc the delivery of twins. When the recti muscles cannot return to the midline you have a diastasis. There can be a number of factors at play in the process. Tightening the area as well as fixing the umbilical hernia can be adequate in most instances. I have seen in other cases after surgery especially of the lower abdomen where patients develop a weak EZs of bulge that has to be re-enforced. I suggest having a couple of opinions of board certified Plastic Sugeons with experience in cosmetic and reconstructive surgery of the abdominal wall.

R.W. Whitfield, MD

A:

Without a picture or an exam, it is impossible to really give you advice about your diastasis. However, it sounds that you have significant intraabdominal fat. That pushes outward on the muscles and spreads them apart. It also pushes on the navel and causes it to distend. By pushing the muscles out from within, you do look pregnant. The treatment of this is gradually modifying your diet to one with less total calories and, of those remaining, less than 40% are carbohydrates. Once you are on the proper diet, you can add exercise to speed the fat loss. If you have excess skin after the weight loss, then you may be a candidate for a tummy tuck.

R.T. Buchanan, MD

A:

What your describing sounds very much like an umbilical hernia in addition to a rectus diastasis. The correction of the rectus diastasis and umbilical hernia can only be done surgically. Skin and superficial fat can be addressed by a variety of devices from Coolsculpting to Exilis but this will not address the hernia or the diastasis.

It is the diastasis which leads to the rounded protuberant abdomen not the skin and fat. The tummy tuck can be done under anesthesia with long acting blocks to minimize the discomfort after surgery.

Seek out a board certified plastic surgeon to help review this information and provide the insights you need to make a good decision.

R.W. Kessler, MD

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