Hi there. I am new to all of this and trying to understand all of the different aspects of tummy tuck. Besides the appearance, is there a medical necessity to repair the diastasis recti during a full tummy tuck if one has no hernia or muscle weakness? Can having the classic split between the muscles from childbirth cause problems later in life? I am wondering whether I should just get my excess skin removed and leave my muscles alone if there is no problem. Thanks for your help!
Diastasis Recti Repair Necessary?
Doctor Answers (8)
this is a standard part of the tummy tuck and will flatten your upper abdomen. not all patients need it. your surgeon is the best person to decide
No Medical Necessity to a Diastasis Repair but it Will Give You a Flatter Stomach
There is no medical necessity to a diastasis repair, and the widening of the muscles after pregnancy will likely not cause problems later in life. That being said to get the best result from a tummy tuck the abdominal wall should be addressed. Tightening the abdominal wall will give you a flatter stomach and help define your waistline.
Tummy tuck muscle repair usually gives better results
The rectus muscles that go from the rib cage to the pubic bone often become pushed apart (diastasis) during pregnacy. There is no exercise regimen that can bring them back to their normal position, but also no medical problems as can happen with a hernia. If there is a diastasis, the abdomen will not be as flat and you will have missed an opportunity to get the best result if it isn't repaired. This is the situation with about 90% of abdominoplasty patients.
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Diastasis Repair with a Tummy Tuck
A repair of the diastasis of the rectus muscle is performed during a tummy tuck to make the abdomen flatter. The diastasis is stretching of the tissue between the muscles. This most often occurs with pregnancy but can also occur with significant weight gain. A diastasis of the rectus muscle is not a hernia and will not cause medical problems. The abdomen will often protrude because the tissue is stretched. In a tummy tuck, the diastasis is repaired and the excess abdominal wall tissue is removed.
Diastasis Repair Is Not Medically Necessary
There is no medical reason for having a diastasis recti repaired. However, if you have any significant separation of your muscles, you are likely to be happier with your tummy tuck if you include the muscle repair. The only downside is a bit more discomfort for the first few days.
Diastasis Recti Repair Necessary
In the overwhelming majority of patients, a diastasis that is present will cause no symptoms, and failure to treat it will have no consequences.
Plicating the rectus muscles is a "standard" part of a TT. Its purpose is to restore the position of those paired muscles back toward the vertical midline, from which they may have migrated during pregnancy or weight change.
There are a subset of patients seeking TT whose rectus muscles are solid and positioned properly. Those patients may not have any benefit from plication. Often this can be determined at consultation, but the decision to plicate or not is best left to the surgeon's judgement at the time of surgery.
When you ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified, but also is a member in good standing of the major plastic surgery organization in the U. S.
Thank you for your question, best wishes.
Plication with TT
The answer to your questions really depends on your expectations. Most of the we see for LipoAbdominoplasty or a Tummy Tuck have an expectation/ request of taking their abdomens back to near their pre-childbearing appearance. This often does require plication of the abdominal wall due to spreading or separation that occurs during pregnancy(s). An examination often helps to delineate if, why and where the plication is required. May I suggest you express your expectations & concerns over plication to your plastic surgeons at the time of your consultation. Best,
Gary R Culbertson, MD, FACS
Why you need diastasis repair during tummy tuck
The tummy tuck procedure is far more than just removing skin from the lower belly. The flattened appearance and tight waistline are all due to the plication of the fascia that overlies the muscle. That is, the connective tissue that encloses the muscles is sutured to plicate any that is redundant. Even if you have no hernia, the side to side narrowing and diastasis plication will flatten the belly so the overlying skin will be hugging a smaller underlying abdomen. I would not advocate just removing the skin. The result will not be all that it can or should. Good Luck
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.