I am an athletic mother with DR. Scarring is almost a deal breaker but my DR and extra belly button skin really bothers me. I believe I am a candidate for endoscopic DR but would a mini be more beneficial? My scar is 4" long and I really don't want it much longer than that. If a mini is a better option, would it be better to find a surgeon that is more experienced with endoscopic DR to perform the mini so that they can better reach above my navel? Any feedback would be appreciated!
Am I a Candidate for Endoscopic Diastasis Repair and Would a Mini/modified TT Be Better? (photo)
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Doctor Answers 3
Am I a Candidate for Endoscopic Diastasis Repair and Would a Mini/modified TT Be Better?
Thanks for the posted photos. My take is slightly different. I would recommend extending the scar by 2 inches on each side to do a mini TT with inferior muscle repair. Also incise above the umbilical fold edge to dissect the superior abdomen allowing directed or endoscopic repair of the superior abdominal recti diastasis. I would recommend drains be used also. Just my thoughts based upon only the posted photos and your description, no in person examination was done.
If you already have a scar you don't need an endoscope
You've got fairly impressive diastasis. As you already have a scar to work through, there's really no reason to consider an endoscope in your case. I think you are in fact a good candiadte for a mini abdominoplasty with floating (lowering) the belly button a little. You'd have plenty of exposure to do the rectus though.
"Endoscopic" Tummy Muscle Repair
Two photographs are not a substitute for a physical examination. However, from your photographs several things are obvious:
- despite your lack of under skin fat and excellent fitness, you have significant stetching of the abdominal muscles with separation
- some excess tummy skin (including over the belly button)
- indented ? C-section scar
To obtain a flat tummy and narrow waist, the stretched muscles must be well "taken in" by a well done plication (muscle repair). In my opinion, this cannot be done well through an endoscopic approach.
As regards the length of the scar, it ALWAYS depends on the amount of excess skin which needs to be removed. In your case, it does not appear to be substantial. You will most likely be trading your shorter but indented C-section scar for a longer but much less conspicuous tummy tuck scar.
Peter A Aldea, MD
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