Hot Springs Doctors

Can a Diastasis Recti Repair Go Back To Pre-Op Status Because of "Inherent Weakness" of My Fascia?

I am a male with a 36" waist. I had my large diastasis recti repaired (surgery) in December 2010. The result was stunning. But the situation gradually reoccurred and the appearance now is the same as before. The surgeon blames it on "the inherent weakness of your fascia". He says such a condition is rare and that it could not be anticipated before surgery.

Hello,

This is possible, but it is always hard to know what the event really was.  It could be your tissues, or the suture type, or the amount of straining that you had after surgery, or any combination of these.  At this stage, the options for abdominal wall tightening would be to redo the tummy tuck to allow access to the abdominal wall or to utilize an endoscopic technique.  I would recommend strong suture bites using a non-dissolvable suture.  If significant tissue weakness is suspected a dermal matrix product can be used to reinforce the abdominal wall but this rarely necessary.  Wearing your abdominal binder for 4-6 weeks and refraining from rigorous activity for about 6 weeks would also be prudent.

All the best,

Dr Remus Repta

Remus Repta, MD

Phoenix Plastic Surgeon

Will I Be Able to Do Ab Exercises, Etc. After Tummy Tuck Heals?

I have diastasis recti and lots of wrinkly loose skin from having 3 large babies. Before the kids I did extremely taxing ab routines of 40-60 minutes of various exercises working all the ab muscles. I also do six or more hours of cardio per week and weight train. If I get a full tummy tuck and repair the diastasis will I eventually be able to resume all of these exercises? I've heard some women are instructed never to do things like pushups etc. Will the stitching be like cheesewire on my abs?

Hello,

The short answer is yes.  You will have to wait about 6 weeks or so for full healing.  I would also encourage you to start out slow and ramp up the intensity of your workouts.  You should also know that it will take a while for you to feel like you're 100% back to normal during your workouts.  How long this feeling will take varies, but it is not uncommon to feel some soreness and discomfort after your workouts many months and maybe up to a year after your tummy tuck.

All the best,

Dr Remus Repta

Remus Repta, MD

Phoenix Plastic Surgeon

Do You Reccomend Lovenox Injections for DVT/PE Prevention After TT and if So, for How Long?

Also wondering if you reccomend an overnight hospital stay.

Hello,

This a very important question as the risk of DVT/PE is perhaps the most worrisome complication of an abdominoplasty procedure.  The risks of DVT/PE are increased by a handful of factors including:

1) Dehydration: thats why you should received plenty of IV fluids during surgery and make sure you drink lots of water when you go home.

2) Lack of movement: Sequential compression devices during surgery and a pillow under the knees during surgery will help.  Movement at home including walking around the night of surgery will also help.

3) Medications:  Certain medications such as birth control pills can increase the chance of DVT/PE.  Medications such as Lovenox can help reduce the risk but increase the risk of bleeding.  Surgeons differ on how these medications are used.  Some utilize them only after surgery, others before.

4) Genetics:  Our bodys's clotting ability ranges from too little to too much and everything in between.  Certain blood abnormalities increase the chance of blood clotting and DVT/PE.  Your history or family history may hint at this which should be followed up by a workup if suspected.

I hope this helps.

All the best,

Dr Remus Repta

Remus Repta, MD

Phoenix Plastic Surgeon