What Are My Options? I'm A Fit, Thin Woman With Rectus Diastisis And Umbilical Hernia (photo)

Thank you for your question and pictures.

You are one of a small number of individuals who appears to be an excellent candidate for an endoscopic tummy tuck. The endoscope allows the diastasis recti to be fixed through a belly button incision and a small cresent of skin can be removed from the lower tummy similar to a mini-tummy tuck. The umbilical hernia can also be fixed at the same time through the belly button incision.

You would likely get an excellent result with a minimally invasive approach and limited incisions.

I hope this helps.

Hi there-

I would agree with Dr. Johnson, and have had great success with this technique- Low transverse scar (very inconspicuous), complete exposure and muscle repair from ribs to pubis, with umbilical float.

Good luck!

While you are not the typical abdominoplasty candidate you are by no means rare. Here in Vancouver we see many fit, trim women who present with unavoidable changes after childbearing.

You would require repair of the hernias, rectus diastasis repair as well as removal of the excess skin. It is difficult to tell from your photos alone whether you would be a candidate for a modified procedure or whether a full abdominoplasty would be appropriate. This decision would be based on the laxity of your skin as assessed at the time of consultation.

If it appears that a general surgeon is needed to deal with a hernia we strive to organize a combined procedure so everything is dealt with in one sitting.

All the best!

 

 

 

Thank you for the photos. You are not the typical abdominoplasty patient seen by most plastic surgeons. Your problem is straightforward: need an abdominiplasty with muscle plication and repair of hernias. You do not need liposuction or other procedures which might increase the potential complication rate. As most plastic surgeons have a general surgery background (including myself), repair of the hernias can be done at the time of the abdominoplasty. You do not need a general surgeon involved unless you pick a surgeon who feels uncomfortable with your presentation. This year alone I've done about 8 very similar cases to yours (these women are athletes, yoga teachers and runners). Good luck.

You have figured out that exercise doesn't correct the diastasis, and it won't tighten loose skin. A tummy tuck is usually the best option in those cases, and any board-certified plastic surgeon should be able to give you a nice result. Usually best to see more than one before deciding.

I'm not sure you do need a tummy tuck. You can have the diastasis repaired without skin excision and from your photos, I'm not sure you have much skin to excise. The type of repair of your rectus would really depend on the degree of laxity. If it were severe we might need to interpose a piece of allograft or xenograft and consider a component separation to mobilize healthy strong tissue to the midline.

It's always hard to know exactly what your options would be without an examination, but based on what you're saying I think a tummy tuck would be an excellent option, the goals of which would be to repair the rectus diastasis, repair the hernias and remove excess skin.  In terms of picking a surgeon, most of us operate on a wide variety of patient body types, so I would recommend checking out the photo galleries of a few surgeons in your area to get a sense of the results they can achieve and then maybe set up a couple of consults to find the surgeon that you feel the most comfortable with.

Good luck!  Dr. S

It is always a challenge to give advice without an exam.  From the photos, it does look like you would be a good candidate for eithe a modified or a full adominoplasty depending on your skin laxity.  Patients with a severe rectus diastasis frequently also have umbilical (belly button) hernias.  One of the more important aspects of a tummy tuck is the plication or tightening of the rectus fascia (connective tissue covering the abdominal muscles) with permanent sutures.  This repairs the rectus diastasis.  Most plastic surgeons will repair the umbilical hernia at the same time, or have a general surgeon do while it is exposed.  Apart from realself.com, another good way for patients to find a board certified plastic surgeon in their area is at the ASPS website (plasticsurgery.org).  It is never a bad idea to speak to a couple plastic surgeons before making up one's mind.  Patients should ask their plastic surgeon about their experience, and get an opportunity to review photos of patients similar to them. 

In general , a thin fit patient with excessive lower abdominal skin and rectus diastasis would benefit from a mini tummy tuck through which the rectus diastasis and umbilical hernia are treated simultaneously.

Quite a few patients have similar concerns.

 

Thanks for your question in the attached photos.

I am not sure that I am seeing much in the way of skin excess in these photos. If I am mistaken, a small incision much like for a C-section could be used to tighten the entire abdominal wall and repair of the hernias. To do this the navel might be detached from the abdominal wall then reattached at the conclusion. Whatever small amount of skin excess would be excised. RRR

I am correct, you might want to consider just having the abdominal wall corrected and this can be done endoscopically, with minimal incisions. The appropriate surgeon to your community maybe a plastic surgeon. In many communities, the surgeon with the most experience, judgement, and skill at this type of surgery may well be a general surgeon.

Reluctant best wishes