I had my surgery two months ago. Now I'm discovering that my muscles were stitched together only partially - repair ends slightly above the navel. And I still have diastasis recti - about 3/4 of an inch under my ribs, so after a meal I have a bulge in the stomach area. Diastasis recti was one of my primary concern. I wonder if there are any norms/guidelines for plastic surgeons? Or plastic surgeons can do what they feel like? I don't trust my surgeon to answer that.
Full Tummy Tuck - Still Have Diastasis Recti. Are There Any Norms in the PS?
Doctor Answers (5)
If you are having trust issues, get a second opinion from a Board Certified Plastic Surgeon. Thank you for your question and good luck with everything.
Correction of Diastasis Recti During Abdominoplasty (Tummy Tuck)
I agree with the other surgeons. If a full tummy tuck is performed, I repair the diastasis from the xyphoid prominence all the way down to the pubic bone, in order to avoid any bulging.
I agree with the other surgeons and generally repair the entire length of rectus muscles. There are expections where I have not done any tightening or in cases of a mni-tummy tuck, only below the navel. This is discussed with the patient beforhand. Sometimes things are found at the time of surgery that require the surgeon to make a decision that differs from the pre-op plan. I would talk to your surgeon about your concerns.
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Muscle Plication during TT
Like Dr. Rand I always tighten the abdominal muscles from the breast bone to the pubic bone to avoid the problem you are faced with now. In dong a mini-abdominopalsty no incision is made around the umbilicus and tightening the upper half of the muscles becomes more challenging. There must be a reason your surgeon choseto do what he/she did. Plastic surgeons are not taught to do "what they feel like" but what they consider needs to be done for each patient and set of circumsances. Clinical judgement must be used in every case and experience hones our judgment. Have an open discussion with your surgeon. Perhaps he/she is not happy with the results either and would be willing to make it right for you.
Plastic surgeons make decisions in the OR
All plastic surgeons take their training and experience and make intraoperative judgements every day. There are no "norms" that are required to be followed other than to perform the best, safest surgery you can based on the surgeon's experience and training and the patient's anatomy and desires.
That being said, I always plicate the muscle all the way from the umbilicus up to the xyphoid and from the umbilicus down to the pubis because when you tighten only part way or just below the umbilicus the loose areas can be made to buldge out from the tightening elsewhere.