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Surgery for Diastasis Recti and Umbical Hernia

Q:

I delivered my second baby 2 months back. I realized that I had diastasis recti during my second pregnancy. For the first 2 trimesters I had umbilical pain but then it stopped. My diastasis is about 3 finger width. I do try to fit in some of the exercises meant for diastasis but I am not so diligent about it, if at all. I opt for surgery: how early can I have it? Can both diastasis and hernia be fixed via laproscope? Is it possible to avoid using mesh to fix Diastasis? Thank you in advance...

A:

The diastasis is a gap down the middle of your abdominal wall that occurs commonly after pregnancy.  Since the rectus muscles have spread to the side because of the diastasis, doing abdominal exercises usually does nothing to narrow the diastasis.  An umbilical hernia, also very common, is often associated with the diastasis.  As plastic surgeons, we frequently fix these problems as part of an abdominoplasty.  One primary manuever during an abdominoplasty (tummy tuck) is correcting the diastasis (and hernia, if present) by bringing the rectus muscles back together again.  This has the effect of firming and flattening the abdominal wall.  Mesh is not necessary in the vast majority of cases and usually only necessary in complex or recurrent hernias.  If you don't need a tummy tuck you could consider a laparoscopic hernia repair (done by a general surgeon) and this would likely involve mesh, but would probably not serve to tighten your diastasis.

Douglas J. Mackenzie, M.D., FACS
Santa Barbara, CA

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