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Can Plastic Surgery Fix my Torn Stomach Muscles and Umbilical Hernia?

I have had 5 kids and I have an umbilical hernia and my stomach muscles are split down the middle. There is a two inch separation. I have some exess fat but not much. I weigh 118 lbs and I am not overweight, but I want my stomach fixed.

I went to a plastic surgeon and he sent me away saying " you don't have enough extra skin for a tummy tuck, and you need to talk to a general surgeon about the hernia and muscle split."

Does that sound right to you plastic surgeons? Is that a standard response in this type of situation or should I get a second opinion?

Asked 41 months ago by maria7474 in idaho

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stomach after pregnancy muscle umbilical hernia

Hybrid Tummy Tuck

For women who don't need a great deal of skin removed (and a hip to hip incision), but need their muscles tightened and an umbilical hernia repaired, they may be a candidate for a hybrid tummy tuck. The hybrid tummy tuck involves a C-section-type incision with full tightening of the deep fascia, the structure that holds the muscles. Although doctors often refer to tightening the muscles, it is in fact the fascia that is tightened. The hybrid tummy tuck is not for women who have a great... more

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Brent Moelleken, MD

Beverly Hills Plastic Surgeon

ASAPS ASPS

Plastic surgeon should be able to fix both diastasis and umbilical hernia

You should seek an other opinion as a well trained plastic surgeon should be able to correct all of your problems at one operation. First, if you don't have enough skin for a standard tummy tuck with the incision around the belly button, you may consider a tummy tuck with an "Umbilical float". This allows the entire skin of the abdomen to be lifted and tightened and the excess trimmed off without having to make the closure too tight or incising around the belly... more

Jeffrey M. Darrow, MD

Boston Plastic Surgeon

ASAPS ASPS

ABdominoplasty (tummy tuck) for muscle repair

SEE VIDEO BELOW FOR MUSCLE REPAIR: A timmy tuck involves differential repair and treatment of: localized fat redundant skin separated muscles (rectus diastasis) In your instance you may need more aggressive treatment of the muscles with less attention to the skin and fat. This may result in a mini-tummy tuck or your own customized version of a tummy tuck. I certainly would get a second opionion and maybe three to be made fully aware of your options. Choose the operation that fits your needs more

Otto Joseph Placik, MD

Chicago Plastic Surgeon

ASAPS ASPS

Unless there is something else going on, you should get a tummy tuck.

After 5 children and having a rectus diastasis, I'd be very surprised if your skin has not stretched out enough to warrant an abdominoplasty. As a matter of fact, I'd be very impressed if you did not show overt laxity. You should really get another opinion by a board certified plastic surgeon who does abdominoplasty surgery. see video

Michael A. Bogdan, MD

Dallas Plastic Surgeon

ASAPS ASPS

Tummy tuck to fix torn muscles and hernia

I would recommend that you see an experienced plastic surgeon. In the usual tummy tuck, the excess skin and fat is removed (you probably have some looseness after 5 children), the skin is stretched (to make it tight), and the underlying muscle separation is repaired (along with any hernia).

Randy J. Buckspan, MD

Austin Plastic Surgeon

ASPS

A tummy tuck is not a tummy tuck is not a tummy tuck....

A tummy tuck is not a tummy tuck is not a tummy tuck. While patients and surgeons alike use the term tummy tuck or abdominoplasty to indicate a particular procedure, in reality, it is best to analyze the anatomy of individual patients, discuss the desired results, and then design an operation to fit your particular needs. What you call the procedure is less important. I have found that patients respond variably to pregnancy. Some have abdomens that are destroyed by one pregnancy and others,... more

Robin T.W. Yuan, MD

Beverly Hills Plastic Surgeon

ASPS

What you likely have is what is called a "rectus...

What you likely have is what is called a "rectus diastasis", where the two rectus muscles of your abdomen (the muscles that make a "six pack") have widened and moved away from the midline of your body. This is quite common after pregnancy, and certainly after 5 pregnancies. Having an umbilical hernia as well is very common and we often fix them during tummy tucks. Without having examined you personally, my guess is that while you may not have a lot of extra skin, you probably have some,... more

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Shahram Salemy, MD

Seattle Plastic Surgeon

ASPS

Abdominoplasty with umbilical hernia repair

A board certified plastic surgeon with underlying training in general surgery can perform this procedure. In some areas, the hospitals address turf wars between specialties by trying to restrict the scope of practice. However, I perform the procedure in an accredited ambulatory surgery facility routinely. Many patients requesting abdominoplasty have diastasis rectus, or spreading of the musculature, but an umbilical hernia is more extensive.

Robert L. Kraft, MD

New York Plastic Surgeon

ASPS

Second Opinion on Tummy Tuck

I would recommend that you get a second opinion for a Board Certified Plastic Surgeon. I think it would be highly unusual to not have loose skin following 5 pregnancies. Make certain the Surgeon you choose is reputable and experienced. Best wishes!

Christine Sullivan, MD

Columbus Plastic Surgeon

ASPS

Is tummy tuck for me?

The simple answer to your question is NO, this does NOT sound right to me. You seem like the PERFECT candidate for abdominoplasty (tummy tuck) because of your multiple pregnancies, ideal body weight, and diastasis recti (muscles spread apart). The umbilical hernia will be corrected as part of the procedure. Tummy tuck was designed for women like you. You are welcome to come to San Diego, non-stop from Boise, but would need to stay a while after the procedure. more

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Steve Laverson, MD

San Diego Plastic Surgeon

ASAPS ASPS

Most Plastic Surgeons Routinely Fix Hernias and Diastasis Recti

I agree with most of the surgeons on this question. Repairing hernias and rectus diastasis (the two inch spread of your tummy muscles that you describe) are the standard level of care. I have referred these patients out to hernia specialists only if there is a complicated history of recurrent hernia(s) and failure of traditional repair techniques. Sounds like you should get a second opinion. Claudio DeLorenzi MD FRCS

Claudio DeLorenzi, MD

Toronto Plastic Surgeon

ASAPS

Tummy Tuck after childbirth

Definitely get a second opinion. The umbilical hernia can be repaired during the surgical procedure. If the hernia is too big sometimes a general surgeon can assist in the operating room. The split can definitely be fixed by suturing the fascia surrounding the muscle. Usually after having that many children you would be an ideal candidate for the tummy tuck procedure.

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Miguel Delgado, Jr., MD

San Francisco Plastic Surgeon

ASAPS ASPS

Loose muscles tightened with tummy tuck

We regularly tighten loose abdominal muscles with a tummy tuck. Most often we will remove excess skin as well, though I have seen patients who have such elastic skin, that they do not have a lot of excess. Still, in those cases, we can treat the muscle looseness and just trim a small amount of skin, doing what used to be called an endoscopic abdominoplasty. It never hurts to get a second opinion.

Mario Loomis, MD

Middletown Plastic Surgeon

ASAPS ASPS

Full correction with a tummy tuck

It seems to me that you are an ideal candidate for a tummy tuck. An experienced and talented surgeon should be able to assess your abdominal wall anatomy and decide what needs to be fixed. Even if you don't have enough skin, the entire muscle diastasis (splitting) can be fixed. There is not one "cookie cutter" approach to a tummy tuck. In my practice we tailor each tummy tuck for every patient, only in this fashion one can obtain an... more

Boris M. Ackerman, MD

Newport Beach Plastic Surgeon

ASPS

Get a second opinion for your tummy tuck

Thank you for your question. It sounds like you would be an excellent candidate for an umbilical hernia repair, a repair of the diastasis recti, and most definitely a tummy tuck. In your case, you would benefit from lifting up the skin and underlying fact and an assessment of the muscles. The plastic surgeon at that time can repair the umbilical hernia and the diastasis recti. Excess skin and fat can then be removed at that time as well as any stretch marks or extra skin. If the hernia... more

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B. Pat Pazmino, MD

Miami Plastic Surgeon

ASAPS ASPS

Get another surgical opinion

The separation of the abdominal musculature (diastasis recti) and an umbilical hernia are routinely corrected during Tummy Tucks. I find it hard to believe that after five pregnancies you do not also have enough loose skin to warrant a Tummy Tuck. I would advise you to obtain another surgical opinion!.

David A. Ross, MD

Chicago Plastic Surgeon

ASPS

Tummy Tuck with repair of hernia and split muscle after pregnancy

I agree that you should seek a second opinion. Even if all you needed was the hernia repair and repair of the widened abdominal muscles, this would be best accomplished through a tummy tuck type of incision to avoid a more visible scar. However, it would be unusual to not have any loose skin after 5 pregnancies, even in women who are thin. The umbilical hernia and widening of the muscles is a common complaint after pregnancy, and can easily be addressed at the time of the tummy tuck.... more

Anita Patel, MD

Beverly Hills Plastic Surgeon

Tummy tuck and hernia

WIthout examining you, I couldn't be sure, but many women who have had several pregnancies usually have enough skin laxity to performe a tummy tuck. Sometimes, plastic surgeons combine the umbilical hernia repair with a tummy tuck and get the asisstance of a general surgeon.

Steven Wallach, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Tummy Tuck - Umbilical Hernia Repair after 5 Babies

The vast majority of members of The American Society of Plastic Surgeons (ASPS) were trained and certified in both Surgery and plastic Surgery. Speaking for myself, I love fixing hernias and have no problem working on complex abdominal reconstructions. Many of my Plastic surgery colleagues share my likes - others who do not always operate with a general surgeon who fixes the hernia and they expose the hernia, allow him to do his part and then perform the tummy tuck. As a woman who had at... more

Peter A. Aldea, MD

Memphis Plastic Surgeon

ASPS

Tummy Tuck and hernias

You sound to be the ideal person to do a tummy tuck after 5 pregnancies and repair the hernia at the same time. Plastic surgeons are trained to repare the abdominal wall more than any other specialty. I think because of the severe seperation of the muscles and the protrusion of the abdominal content it looks as if you do not have excess skin. but once the muscles are repaired there is a lot of skin to be removed and tightened. Personally, I have seen this many times, where my patient looked... more

Samir Shureih, MD

Baltimore Plastic Surgeon

ASAPS ASPS

Hernia and Tummy tuck

Maria- I see hernias all the time...some I (and the patient) identify prior to surgery because they are large enough to feel, others are small and I find them during a tummy tuck. Not all plastic surgeons are comfortable fixing hernias, some are. I am Board Certified in both General and Plastic Surgery and therefore am comfortable fixing them due to my extensive extra training. I suggest you seek out a surgeon with the same board certification (certified in both specialties by the Amercian... more

John Philip Connors III, MD

Atlanta Plastic Surgeon

ASAPS ASPS

A combination procedure would be best

My preference (as a general and plastic surgeon) is to fix the hernia using your own muscle tissue and tighten/repair the msucles at the same time. After that, the tummy tuck is done as usual. I do not like to use plastic mesh to fix hernias because of problems with recurrence and infection, and my preference is to have control over the muscle repair because that is an important part of getting a nicely sculpted result.

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John LoMonaco, MD

Houston Plastic Surgeon

ASPS

It sounds as if you WOULD benefit from a tummy tuck

I would be surprised if after 5 children you would not benefit from some skin tightening. If you do not, you may still benefit from a tummy tuck with a shorter scar to visualize and repair the separated muscles (diastasis recti) while at the same time repairing the umbilical hernia through the same incision. Many plastic surgeons would feel comfortable repairing a small umbilical hernia at the time of a tummy tuck.

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York Jay Yates, MD

Salt Lake City Plastic Surgeon

ASPS

Tummy tuck for separated muscles and hernia

Getting two opinions for any major surgery is a good idea. From the concerns you describe, you need a tummy tuck to address the separated muscle and umbilical hernia. If you do not have enough skin for a full tummy tuck, you can do a modified tummy tuck and still repair your separated muscles and address your umbilical hernia - depending on how large it is. I would suggest getting a second opinion from a board certified plastic surgeon.

Bahram Ghaderi, MD

Chicago Plastic Surgeon

ASAPS ASPS

Maybe a modified tummy tuck would be helpful

A tummy tuck can include the removal of skin, fat and/or muscular repair. You don't have to have all these things done at the time of the operation. It can be modified to suit you. The condition of your tissues can be an issue at surgery. These are things to discuss at consultation. See a few surgeons to get several opinions.