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How Soon Can I Get my Muscle Divarication Repaired After Childbirth? (photo)

I am 5 2", 138lbs. Hour glass shape body, love working out and eating healthy. These pictures Taken are me 5 days after childbirth of my 4th child. My stomach looked this way after my first child, but stuck out a little bit less, still carrying the little flap hangover and the stomach bulge was still quite noticeable. I've been asked if I'm pregnant several times when I wasn't. I plan on working out when I reach my 6wk postpartum but I know I won't be able to get ride of it entirely

Doctor Answers (11)

How Soon Can I Get my Muscle Divarication Repaired After Childbirth

+2

What you and your surgeon want to have is recovery from the delivery. The amount of extra tissue right after the birth is almost always much greater than the amount 3 or 6 months later, making it not possible to accurately assess the amount of excess needing excision. Too early surgery could result in too much having been removed, or too little. Either outcome would be unsatisfactory.

Four to six months is a reasonable time to have your surgery. However, it is not too early to begin the process of consultation.

When you are 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.


Seattle Plastic Surgeon
4.5 out of 5 stars 30 reviews

When weight and abdominal change is stable

+1

Hello,

Thank you for the question and the photos.  You are a great candidate for a full tummy tuck with abdominal wall repair (muscle repair).  You can undergo a full tummy tuck when you feel like your weight is fairly stable and you do not think your abdominal shape after pregnancy is changing any more.

All the best,

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 82 reviews

How Soon After Delivery Can a Tummy Tuck Be Performed?

+1

I typically recommend waiting approximately 3 months after delivery to have a tummy tuck performed.   This will allow the swelling from the delivery to go away and will give you an accurate assessment of whether or not you need a tummy tuck and your surgeon an accurate assessment of how much tissue needs to be removed.  Congratulations on the new baby!

Sacha Obaid, MD
Dallas Plastic Surgeon
4.5 out of 5 stars 18 reviews

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How Soon Can I Get my Muscle Divarication Repaired After Childbirth?

+1

Try the postpartum plan. If at 3 months still unhappy than consider TT with muscle repair. But too early now to think surgery. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 61 reviews

Diastasis

+1

You will notice that your abdomen will shrink considerably in the next few months. I would wait at least 6 months if not longer

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 9 reviews

How Soon After Delivery Can I Have A FTT With Muscle Repair?

+1

Thank you for this excellent question and your photographs.  Most plastic surgeons would recommend you return to your pre-pregnancy weight.  However, your photographs show that you are not carrying much baby fat, and so this recommendation probably does not apply to you.

You need to allow your skin and muscles to regain their normal tone because a great deal of tension will be placed on them during the tummy tuck, and you do not want your tissue to tear, thereby causing the repair to fail.  

I have done a quick online survey of some of the top plastic surgeons in the country stretching back to 2008, and it appears 3 months to 1 year after a pregnancy is the Real Self plastic surgery community standard for when to do a tummy tuck.  I would say physiologically your skin and muscles should have tone enough to allow a tummy tuck at 6 weeks, however there are other considerations, possibly breast feeding your new baby, allowing you and your family to recover from the pregnancy and delivery before embarking on a surgery that might have a protracted recovery.  Consulting with several Board Certified plastic surgeons and finding just the right one for you all takes time.  

All that being said, I would say 3 months would be the appropriate time to consider a full tummy tuck after delivery. 

 

S. Larry Schlesinger, MD, FACS
Honolulu Plastic Surgeon
5.0 out of 5 stars 185 reviews

How soon for Tummy Tuck after childbirth?

+1

You need to wait until you are fully recovered from childbirth before having  surgery.  This could could take 4 to 6 months.  While you are recovering, you may want to wear an abdominal binder for support.  Take care of yourself, and seek an evaluation from a Board Certified Plastic Surgeon to discuss your concerns and expectations.

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 23 reviews

Tummy tuck timing

+1

Dear Mariah,

   Thanks for submitting your pictures. The are very impressive, but it's only 5 days from surgery. The pictures reveal significant skin laxity , large diasthesis recti (muscles separation ) and possibly umbilical hernia. In my practice I recommend 3 - 6 months interval from your delivery , in order to let the tissues shrink and achieve a stable condition. At that time you will need a full tummy tuck that includes skin and muscle tightening and possibly , umbilical hernia repair. Consult with an experienced board plastic surgeon and check their before and afte pictures to be sure that you like  his or hers results.

                   Best of luck,

                                      Dr Widder 

Shlomo Widder, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 50 reviews

Repair of muscle weakness and tummy tuck

+1

I would recommend waiting for six months, but to wear some tummy support while you are waiting. Then if the problem still persists (and I suspect it might), you will need a repair of not just the divarication of the rectus muscles, but quite likely some tightening of the external oblique muscles (muscles on both sides away from the mid-line  too. At the same time the surgeon will be able to remove any skin excess in the form of a tummy tuck.

Anindya Lahiri, MBBS
Birmingham Plastic Surgeon
5.0 out of 5 stars 5 reviews

Timing to Repair Abdominal Wall Diastasis?

+1

Thank you for the question and pictures. Your pictures do demonstrate impressive abdominal wall muscle diastasis.  You will be an excellent candidate for repair;  you are correct in that no amount of “working out” will be helpful in correcting the muscle separation that has occurred after the pregnancies.

 More specific advice would require in-person consultation but some general thoughts may be helpful to you.  However,  I think that it is safe to say that you will be an excellent candidate for tummy tuck. The “ideal” patient for tummy tuck surgery is one who has completed pregnancies, is psycho socially/emotionally/financially stable,  has an excellent social support system surrounding him/her,  is  Is able to arrange enough recovery time and who has reached a long-term stable weight.

One of the steps of a tummy tuck procedure involves reapproximation (plication)  of the rectus muscles.  These muscles have spread apart during pregnancy and/or weight gain. Bringing them together again in the midline helps to “tighten” the abdominal wall as well as to narrow the waistline.

I use a two layered technique to reapproximate the rectus muscles. The first layer is comprised of interrupted “figure of 8” permanent sutures;  a second layer involves a “running” permanent suture line. Some judgment is required in re-approximating muscle's at the right tension (tight enough but not too tight). The tightening of the muscles extend from the lower border of the sternum (xiphoid  process)  to the pubic bone.

When the time is right, to seek consultation with board certified plastic surgeons. Ask to see lots of examples of their work helping patients in your situation. You may find the attached link helpful to you as you educate yourself about the procedure. I have also attached some advice that I provide to my patients who are about to go tummy tuck surgery:

1. Make sure you are doing the procedure for the right reasons (for yourself)  and that you have realistic expectations.  Be aware that an improvement in the “problem area” may not translate to an overall improvement in your life   situation.  You are bound to be disappointed with results of the procedure if your motivation for doing the surgery is not internally driven.



2. Time your surgery carefully; generally, it is not a good idea to have surgery done during or immediately after a stressful period in life (for example divorce or death of a loved one). The additional stress of surgery will undoubtedly be  more challenging to deal with if a patient's emotional reserves our already exhausted. Remember, that an improvement in your physical appearance will not translate to an improvement in your life situation.



3. If possible speak to patients who have undergone similar procedures and query them about the toughest times of their recovery period. Any practical hints previous patients can provide may be very helpful.



4. Make sure you are aware of potential complications that may arise how to reach your surgeon if necessary.

5. Make sure you have a strong and patient support system (several people if possible) in place who have time/patience to take care of you. Arrange for professional nursing if any doubt exists regarding the availability and/or stamina  of your caretakers.



6. Be patient with the healing process, understanding that it will take several weeks to months to feel “normal” again. It may also take many months/year to see the end results of your surgery.



7. Be prepared to distract your mind with things of interest such as books, magazines, and movies.



8. Expect less of yourself; do not go back to work, school or chores too early and let others take care of you (for a change).



9. Pick your surgeon carefully (a well experienced board-certified plastic surgeon) and trust in his/her advice. Keep in close communication with your surgeon and do not hesitate to communicate questions/concerns and the   emotional swings that you may experience.



10. Resume all medications that you were using preoperatively when cleared by your plastic surgeon and stop the use of narcotics and sedatives as soon as feasible after surgery.



11. Keep in mind the end results as you go through the tougher emotional times after your surgery. 

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 684 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.