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Is There a Medical Reason to Have my Ab Muscles Repaired?

I have had two children, youngest 8, prolapsed vaginal wall and bladder resulting in partial hyst.w/bladder sling, 2 years later second surgery to have bladder attatched to pelvis. Now lower abdom. muscles are bulging along the sides of ab. (occured after second bladder surgery) One side is more prominate then other and both sides have sections in muscle that feels squishy when muscles are flexed and tight around them. I teach and ins. cov. is a big deal right now.

Doctor Answers (5)

If you're not having any symptoms, you don't have to have your "ABs repaired".

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What you are describing is separation(diastasis) of the two vertical muscles in the central portion of your abdomen (rectus muscles). This is what accounts for the laxity of the lower abdomen. If you are suffering from a hernia, either around the belly button, in the groin, or in a surgical incision, then your insurance carrier may approve correction. Speak with your board-certified plastic surgeon about your condition and see if you are a candidate for repair


Houston Plastic Surgeon
4.0 out of 5 stars 10 reviews

Medical reason to have my ab muscles repaired

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Yes there can be insurance covered repair of abdominal muscle laxity. But over the internet there is NO WAY to guide you. I recommend 3 consultations with boarded plastic surgeons in your area. There they can determine the type of insurance you have and if there will be any coverage. Best of Luck

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 62 reviews

Medical Insurance Payment of Tummy Tuck Muscle Tightening

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Regarding : "I have ... prolapsed vaginal wall and bladder resulting in partial hyst.w/bladder sling, 2 years later second surgery ...Now lower abdom. muscles are bulging along the sides of ab....One side is more prominate then other and both sides have sections in muscle that feels squishy when muscles are flexed and tight around"

I regret your condition but the truth is that, to muscle separation being so extremely common,  insurance companies do not regard it as a disorder that MUST be corrected. A uterus is the size of a small lime. As the pregnancy proceeds, it grows gradually into the size of a watermelon which stretches out the entire abdominal wall: muscles and skin. To allow women to survive pregnancy, the six pack muscles split apart allowing the growth to continue. After delivery, the uterus gradually shrinks but the skin and muscles are stretched permanently and will NOT return to their "before Baby" stage without an active surgical repair.

In a FULL Tummy Tuck, we put the muscles together again, flattening the tummy and repairing any midline hernias, we thereby narrow the waist, we also remove all loose tummy skin, lift a sagging Mons pubis and even lift and smooth dimply, cellulitic anterior thighs.

Insurance companies largely will pay for repair of a Ventral Hernia. Your condition MAY be a Ventral hernia caused by your two operations. If this is the case the hernia is likely to be paid for by the insurer.

However, I have never seen an insurer willingly pay for a Tummy Tuck which is a MUCH more extensive operation intended to make you look better than simply correcting a midline bulge.

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 60 reviews

Medical coverage of muscle repair with tummy tuck

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Hi,

Although some patients complain of subjective pain or soreness with separated abdominal wall muscles (rectus abdominus muscles), insurance companies almost never cover the cost associated with repairing the gap. Unlike true hernias, in which segments of bowel can get strangulated, separated abdominal wall muscles are not life threatening.

If you have soreness, or do not like the appearance, your best bet is consultation with a board certified plastic surgeon. Even though you will not get insurance coverage for the procedure, most plastic surgeons participate with third party financing companies with can make the procedure quite affordable.

Best of luck. All the best - Sam Jejurikar

Sam Jejurikar, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 30 reviews

Abdominal muscle repair with tummy tuck

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Despite some studies showing improvement with back pain following muscle repair (WARP: Wide Abdominal Rectua Plication), third party payors are reluctant to reimburse for these procedures.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 44 reviews

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.