Will oblique repair be beneficial for someone who has had rectus muscle diastasis repaired, but still has a protruberant abdomen? I would really appreciate some expert knowledge as I seem to be hitting a brick wall. A second surgeon has confirmed that the repair of my rectus muscle is intact and very tight, but says that it is likely that my obliques have also been a large part of my problem. Does anyone know of a surgeon that could help me?
Oblique Repair for Abdominal Bulge After Diastasis Repair?
Doctor Answers (4)
The real issue is whether tightening will work
The real question is not the direction of tightening but if tightening will work.
If you take a tube of toothpaste (with the cap on) and squeeze the tube, the paste moves to another part of the tube not under pressure. This is similar to what you may have. If your doctor tightened you as he or she should have- regardless of the technique, the intraabdomenal contents has to go somewhere. Without an exam or photos it is hard to make an accurate diagnosis, but I do not want you to be disappointed with another sub par procedure.
The fascia over the oblique muscles is weak. It is not, in my opinion, totally reliable when tightened as one does in the center of the abdomen. We have abandoned oblique repairs for that reason during tummy tucks.
Better in my opinion to tighten the center (diastasis and central tightening) more aggressively where the fascia is strong.
Remember, when fascial tightening is performed, there are limitations to its success. If the fascia has lost its elasticity, either congenitally or through various diseases, tightening of the fascia does not necessarily make a flat abdomen... just a flattER abdomen. You still have the original fascia with all its elastic properties, just a tightened version of it.
It may help
Oblique repair may certainly help, but there are other conditions that may account for a protuberant abdomen after a tummy tuck. It may be due to medical conditions like Celiac Sprue, IBS or simply a large, intra-abdominal content. If you have no other medical conditions and are thin, then oblique repair may be worth a try! Good luck!
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Yes, this might help
If you still have laxity of your muscles after tightening of the rectus muscles, oblique tightening may help. I often do this during the tummy tuck which adds additional support but also increases pain post operatively. If your rectus muscle is truly intact and tight, then this may be the way to go.