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Why would a Tummy Tuck be performed without Diastasis repair?

Q:

I recently had ventral hernia repair with an abdominoplasty. I have a very large diastasis, that was NOT fixed. I still have a huge protruding area in my abdomen. I'm unhappy with my results, now my Plastic Surgeon says he can correct the diastasis. The reason he gave for not fixing it initially was "we don't fix it at the same time as a hernia repair because the muscle could stick to the sutures and cause a problem". Should I let him redo the surgery, another Plastic Surgeon...or just leave it alone?

 

A:

I would recommend you get a second consultation to discuss your concerns with a different surgeon. That may help you feel comfortable with the solution to your concerns.

A:

Indeed when repairing a large ventral hernia, the repair of the diasthesis would reinforce the ventral hernia repair. In fact in very large ventral hernias, a component separation would help reconstruct the abdominal wall. There are very rare instances where the diasthesis repair is not indicated. Consult a member of this society for your options.

A:

There is really no way to know exactly what was done and why other than to ask your surgeon. Most often a ventral hernia and diastasis are repaired together, but there may have been some specific issue in your case. Talk to your surgeon about this.

Richard A. Baxter, M.D. - View Other Answers by this Doctor
Mountlake Terrace, WA

A:

A tummy tuck or abdominoplasty is performed to treat skin only in some cases and skin and muscle in others.  For example, a person who have had massive weight lose may only have skin to remove because there is no muscle issue.  On the other hand, a women who have had children may have a stretched abdominal and may require a diastasis repair for the best result.   The discussion with your plastic surgeon is critical and it is always good to to return to your doctor.  He has your best interest and knows what procedure he performed.

A:

Typically the diastasis should be repaired at the same time as the hernia repair.  

There are certainly exceptions to this rule, and your surgeon may have had very good reasons.

It never hurts to have a second opinion.  Often that reinforces the choice the original surgeon made.

A:

If the abdominal muscles are not split and there is no diastases recti then during a tummy tuck a muscle repair is not needed.

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