How to Fix Protrusion Left After Umbilical Hernia Repair?
- Asked by mum in maryland
- 4 years ago
I am 9 mos postpartum (twins). This was my second pregnancy. They were big (7 lbs) and carried to term. Amazingly, I have not a single stretch mark and only a very, very small (maybe 1/4 inch) of extra skin only visible if I bend over and near the c section scar.
I had an umbilical hernia repaired, and my OB says she put a small diastasis recti back together during the c section. But I still have this protrusion that makes me look about 5 mos pregnant. What the heck is going on and how can I fix it?
I don't want a tummy tuck. Can the diastasis recti be repaired without one, i.e. no scary hip to hip scar?
Post Partum Belly
Repeated stretching of the abdominal wall especially with a large twin pregnancy can cause the rectus muscles to become very thin. Thin to the point that they become over stretched and don't return to their prepregnancy resting state. Instead they have found a new resting state. I have seen this and although surgery can fix it you may not need it.
Strengthening the rectus muscles and getting them to shorten and return to their prepregnancy state is the key. So start with crunches, leg lifts etc and work those abs hard for 6 months. I doubt you'll need surgery then.
You may be a candidate for a mini-tummy tuck
During the C-section the only area of the rectus muscle that the OB could have seen was around the C-section incision. He/she might have thightened that area a little bit but it sound like the rest of the rectus muscle still has a diastasis. If the problem is only minited to the muscle you could undergo a much more limited incision mini-tummy tuck to only expose the cetral area of the rectus muscle. Without needing much skin tightening the length of the incision can be much shorter than a standard tummy tuck and similar location to your existing C-section scar.
By the way, congratulations on your twins. Mine are boy-girl twins and are almost 5 years old!
Check yourself for a diastasis (muscle separation) after pregancy especially multiples.
SEE VIDEO FOR SAMPLE OF Diastasis repair.
My guess is that you have a persistent uncorrected diastasis. This is quite easy to diagnose. Have a doctor perform this. You can find your own diastasis by laying down flat. Without using your hands try to lift your head and back upwards (like a partial situp). Feel just above your belly button vertically up to your "solar plexus" or breast bone. There should be a little valley that is not wider than a finger. IF the area bulges outwards or has a vertical valley that measures more than two fingers wide, then you have a distasis. This can be repaired with or without a tummy tuck.
Umbillical hernia repair at time of C section delivery
At the time of C section delivery of TWINS, your tissues are in no shape to undergo a meaningful and long lasting repair. If you are not nursing consult a board certified plastic or general surgeon to do the repair, depending on your desire to have more children.
Hernia repair and tummy tucks.
from what you are describing, it is more of a ventral hernia and not an umbilical hernia. It appears that the attempt at repairing that during the c-section failed and needs to be repeated. If that is the only concern, then it likely will be able to be repaired through the prior c-section scars as long as no skin is removed.
Scary hip to hip scar.
based on your description a long scar is not necessary if diastasis is your only (mostly) problem. also as a side note if you did not consent to the procedures done in a non-emergent surgery done by an OB working on the very fringe (if not outside) her specialty, you may have been assaulted. in legal terms of course. see a plastic surgeon comfortable or dual boarded in general surgery. there are still some of us dinosaurs roaming the earth. good luck.
How to get the benefits of a tummy tuck without the long incision
Hi Mum - It sounds as though you're a good candidate for a mini-tummy tuck. This allows your abdominal muscles to be tightened with only a small incision in your bikini line. Your c-section scar may also be revised with this if you'd like. Since I'm right by you in Baltimore, I can give you a better idea of what your options are if I can see you in person. A mini-tummy tuck is very well tolerated with minimal downtime and little discomfort. Either way, make sure you are finished having children because if you get pregnant again it will stretch out any tightening of the muscles done with a mini-tummy tuck.
Web reference: http://www.DrSchreiberPlasticSurgery.com
Tummy Tuck for Umbilical Hernia or Rectus Muscle separation
You do not state WHO repaired your umbilical hernia but do specify that the OB who performed your C-section repaired your diastasis recti separation during the C-section.
The reason for the 5 month of pregnancy protrusion in ALL likelihood is either a poor muscle repair or a repair that fell apart. Either way, to give you a flat tummy you would probably benefit from having a Tummy Tuck (Abdominoplasty).
The vast majority of Plastic surgeons have ALSO completed training in General Surgery and are comfortable correcting abdominal and ventral hernias. I suggest you see a Plastic surgeon (www.PlasticSurgery.org) and see what he/she has to say.
A properly done Tummy Tuck will bring the displaced muscles together, flatten the tummy, narrow the waist, lift a sagging Mons pubis and if a Lockwood (High Lateral Tension) Abdominoplasty is done, lift the anterior lateral thigh and smooth cellulite dimples.
Abdominoplasty after C-section
If you are still having protrusion, it is possible that the diastasis was not completely repaired. You may consider seeing a plastic surgeon for an evaluation. Also, if they only partially repaired the diastasis then the part that was not repaired will protrude as you describe. I hope this is helpful. Good luck.
Web reference: http://www.ShaferPlasticSurgery.com
I agree with Dr. Rand.
Additionally, it sounds like your OB tried his hand at a tummy tuck, and it didn't quite work out that great.
I don't agree that you need a double boarded surgeon however. If you have a plastic surgeon who has general surgery experience and feels comfortable with the hernia repair, or works with a general surgeon, that should be fine.
It sounds like you need to have a tummy tuck to repair the diastasis repair that the ob did. An evaluation would be the first step.
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.