Is Repair of Diastasis Recti Possible During Scar Revision? (photo)

Hi I am 6 weeks post-op from a full tummy tuck & want my PS to do a scar revision on me at the 6-12 month mark as my scar is very high ( he doesn't seem very willing to do it). He also did not do repair on my diastasis recti and I have a 3 finger separation. ( I have very good skin skin with no stretch marks from pregnancy) if I can convince him to do the scar revision would I be able to have my muscles tightened/ sewn together at same time? Would my skin need to be peeled back to ribcage again?

Doctor Answers (13)

Tummy tuck revision

+1

Repair of rectus diastasis will require dissection and readvancement of the abdominal flap.  It is also possible to lower the incision to a less noticeable location.


Los Angeles Plastic Surgeon
5.0 out of 5 stars 47 reviews

Muscle tightening is usually a part of a tummy tuck

+1

Thank you for your question and the photos. Yes, diastasis recti repair can be done at the time of scar revision. Also, muscle tightening is typically part of a full tummy tuck. Did you and your surgeon discuss whether he was going to do this before the surgery?  Did he discount your tummy tuck because he was not planning on doing this? What was the reasonable expectation? Your tummy in the pictures looks okay but can your feel the three-finger separation? You don't want it to protude with time.  See your surgeon again and provide clear communication about what you expect and get some clear answers. I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 37 reviews

Diastasis Recti Repair is standard treatment during tummy tuck

+1

It appears from your photographs that you will need a repeat abdominoplasty.  You will need flap elevation all the way up to your ribs and the diastasis recti repaired.  At the same time, your skin incision can be lowered.  It is good that you are not in a hurry and waiting 6 to 12 months will make it technically easier to do and allows the skin to stretch more.  The key to an abdominoplasty is not sewing your muscles together but sewing the fascia that surrounds the muscles restoring them to the normal vertical course.  This should have been done at the 1st operation.  You are not a candidate for anything other than the repeat abdominoplasty by a board certified plastic surgeon.

Best of Luck,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
5.0 out of 5 stars 126 reviews

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Is Repair of Diastasis Recti Possible During Scar Revision? (photo)

+1

Thanks for the posted photos! You have a communication issue! Best to obtain in person second opinions. Also this demonstrates the need for a full understanding of the pre operative informed consent. 

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

Is Repair of Diastasis Recti Possible During Scar Revision?

+1

Your scar does appear high.  I see this not infrequently.  Some plastic surgeons will  raise the position of the scar so that they can get rid of the old belly button hole. In someone with enough loose skin above the belly button, the old belly button hole (from the release of the BB from the surrounding skin) will move down far enough to remove it with all of the excess skin.  If the skin above the BB is not that loose, then it will not advance this much.  I leave the long tummy tuck scar down low where it belongs and simply close the old BB hole with a short vertical scar. In my opinion, this is better than raising the whole long tummy tuck scar too high simply to avoid that short vertical scar.  That is my opinion, other surgeons may feel differently.

If you are having a scar revision in order to significantly lower the position of the scar, you will need to have a fair amount of skin laxity above the scar to get it to advance inferiorly.  You may develop some laxity over time (a year, a few years?) but I doubt if you have much right now. So, unless your skin above the scar is currently much looser than it appears in your photos, do not count on much lowering of that scar from a scar revision. 

In order to do a proper repair of your diastasis recti, the abdominal skin would need to be raised up near the ribcage again in order to expose the full length of your diastasis.  Also, you appear to have a fairly thick subcutaneous fatty layer contributing to your abdominal protrusion, at least by what I can tell without examining you.  Thick subcutaneous fat, as well as excess intra-abdominal fat, which can only be reduced by dieting, will work against you getting a flat tummy even with a revision and diastasis repair.  The thinner you are, the better muscle/fascial and skin tightening, the better advancement and lowering of your scar, etc.  Without that, do not count on a scar revision and diastasis repair doing that much.  Perhaps a second opinion with a thorough examination would be helpful.

Robert M. Grenley, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 70 reviews

Scar Revision

+1

Yes, the diastasis can be repaired at the same time as a scar revision.  If you post some before pictures as well as your after pictures, it may be much more informative.

 

Good Luck.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 57 reviews

Abdominal scar revision

+1

It is very hard to lower the scar if you had a tummy tuck.  To elevate the flap is relatively easy and certainly the disatasis can be repaired at the  same time.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Tummy Tuck and Diastasis Repair.......

+1

Yes.  Diastasis repair can be done at the same time as scar revision, but that means not just doing a scar revision, but instead, repeating the whole tummy tuck all over again.  This one will be more painful and have a longer recovery since the majority of the tummy tuck pain comes from muscle tightening. 
Lowering your scar might be possible, but that depends on how much skin laxity you still have.  This will also result in a short vertical scar beneath your belly button. 
And as already mentioned, it is still WAY TOO EARLY to make any decision as to whether or not you are happy with your results.  You are still swollen and will not see your final results regarding shape for at least 3-6 months, and you won't see your final scar for at least 1 year.

Be patient! 

Daniel P. Markmann, MD
Baltimore Plastic Surgeon
5.0 out of 5 stars 69 reviews

Abdominoplasty revision and rectus plication

+1

Thanks for your great question -

In reviewing your pictures it appears likely that you may benefit from scar revision.  Certainly rectus plication or even re-plication can be performed at this time.  It will require re-elevation of the abdominoplasty flap to the subcostal margin (up to the level of your ribs).

You may find the re-operation to require a longer recovery if it includes the plication.

Be sure you completely discuss your options with your surgeon and if you are uncomfortable with the response or plan be sure to get second or third opinions.

 

I hope this helps!

Steven H. Williams, MD
San Francisco Plastic Surgeon
4.5 out of 5 stars 24 reviews

Revision Tummy Tuck

+1

The first thing to ask is "why wasn't the diastasis fixed during the first procedure?". This is pretty standard, unless it was discussed before hand that you weren't going to get any muscle tightening. Lowering the scar and making it look good may not be so easy so be careful moving forward. You might want to get a second opinion.

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 27 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.