47 Yo Male. Had Umbilical Hernia Repaired 5+ Yrs Ago. Abdominal Muscles Now Separating. Next Step? (photo)

Question

I'm in good physical shape. Frequently lift 100+ pounds in my job. Train in martial arts seminars as time allows. I'm finding that when doing situps & leg lifts, there's a bulge along my midline. Also, I'm not able to absorb/handle strikes and kicks to the belly w/out my insides feeling hollow/empty hurting. This may sound strange but this bothers me to no end. I'm looking to correct this by year's end. Also, I'd like direction in possible insurance coverage (Aetna Choice POS) Thanks- Dave

Erez Sternberg, MD · Answer

This is classical diastasis recti (separation and loosening of the muscles) and is repairable with a procedure similar to a tummy tuck.  I would recommend making the lower abdominal incision and lifting the skin up to the rib margin, then the surgeon will tighten the muscles and repair the belly button.  If some skin needs to be removed it can be done from the low incision, otherwise, when there is no excess skin the incision is closed over a drain. This is a basic diastasis repair and is not considered a hernia repair.  Most insurance companies would not cover this procedure, but I have had this surgery covered once before on a member of our armed forces. Good luck.

David J. Levens, MD · Answer

Your prior umbilical hernia repair may have little to do with your current situation.  There appears to be separation of your rectus muscles which is much more common in women due to pregnancies or in men who had previously been obese.  You do appear to be in good shape now.  Lifting 100+ lbs frequently and taking kicks and strikes to the abdomen will certainly put a severe strain on your abdominal wall as well as causing discomfort.

	If you decide to consider "correction", it will be essential that you avoid such trauma for many months or permanently after surgery to minimize recurrence.

	You could consult with a general surgeon with a lot of experience in abdominal wall/hernia reconstruction to explore your options.

Darryl J. Blinski, MD · Answer

Thanks for detailed posted photos. There is most unlikely any relationship to the umbilical hernia and your diastasis recti effect. So do not count on any health insurance offering coverage. A predetermination letter with photos can be sent but again I believe this is a non covered event.

Robert L. Kraft, MD, FACS · Answer

GIven that you lift large amounts of weight on the job, you have either sustained a recurrent hernia or a diastasis.  GIven the photograph, this will probably be considered reconstructive and will be covered by your insurance.  Based on a physical exam and the insurance requirements, you made need to have a scan to corroborate the clinical findings. In my area, general surgeons perform this operation.  See your internist who can recommend a surgeon.

Jourdan Gottlieb, MD · Answer

This looks like either an abdominal hernia or a diastasis rectus (separation of the rectus muscles). See a surgeon with expertise in hernia evaluation and repair, usually a general surgeon.  The surgeon may order  CT scan to help plan any surgery that my be recommended.

	 

	Best wishes.

47 Yo Male. Had Umbilical Hernia Repaired 5+ Yrs Ago. Abdominal Muscles Now Separating. Next Step? (photo)

Answers (5)

Answer: Recurrent abdominal hernia

Answer: Recurrent abdominal hernia

Answer: Abdominal Muscles Now Separating

Answer: Abdominal Muscles Now Separating

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47 Yo Male. Had Umbilical Hernia Repaired 5+ Yrs Ago. Abdominal Muscles Now Separating. Next Step? (photo)

Answers (5)

Answer: Recurrent abdominal hernia

Answer: Recurrent abdominal hernia

Answer: Abdominal Muscles Now Separating

Answer: Abdominal Muscles Now Separating

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Recommended reading

Everything you need to know about Tummy Tuck

Our mission is to create a world where every investment in modern beauty is Worth It.