Diastasis Recti refers to a separation of the paired Rectus Abdominus muscles, which run vertically down the center of the abdomen from the lower ribs to the pelvis. Diastasis Recti typically develops as a result of relaxation of the abdominal wall fascia (the fibrous tissue between the muscles), most commonly as a result of pregnancy. Diastasis Recti is not a true hernia, since the abdominal wall muscle and fascia remain intact but functionally weak, and there is no protrusion of abdominal contents through the diastasis, even though a paradoxical "bulge" (which looks like a hernia) may be present when patients with diastasis perform a sit-up or straight-leg raise, tensing the abdominal wall.
By itself, Diastasis Recti should not prevent a surgeon from performing liposuction, either laser or traditional liposuction. However, before performing liposuction, your surgeon should carefully evaluate your abdominal wall musculature. Many patients have an umbilical hernia, which usually involves protrusion of a small wad of fat (pro-peritoneal or omental) from inside the abdomen. Umbilical hernias and other abdominal wall hernias may also include loops of intestine in addition to the intra-abdominal fat. These hernias CAN present problems if liposuction is done without making note of, or correcting the hernia first, since bowel injury may result. Patients with Diastasis Recti also typically have relaxation of the (hypogastric) lower abdomen below the belly button, which will not be corrected by liposuction in any case
If Diastasis Recti is severe enough, and there is diffuse laxity of the abdominal wall, liposuction may in fact be the wrong choice of operation. If there is excess skin and fat in addition to laxity of the abdominal wall, an Abdominoplasty or Tummy Tuck is most likely the better option. During this procedure, the wide separation between the rectus muscles is sutured together, strengthening the abdominal wall and narrowing the waistline in the process.
If you have Diastasis Recti, do the right thing. Consider Abdominoplasty rather than liposuction alone, if weakness of the abdominal wall is the problem. Correct the Rectus.
