Is there any other way to access the upper abdomen to repair the DR?

Question

I had a TT with MR of the lower abdomen and lipo of the flanks. I had a mild diastasis recti of the upper abdomen but PS decided not to repair. I now have an upper abdominal bulge. He wants to go back through the same scar to access the upper abdomen to repair the DR. The thought of doing this all over again makes me nauseous. Is there any other way?

Camille Cash, MD · Answer

In order to access the upper abdomen your surgeon can use your existing tummy tuck scar.  This way she/he can address the correction above the belly button as well as make sure all looks good from the previous repair.  She/He can also access it from the top of the abdomen but this will involve another long incision extending from under one breast to the other.  The best way is probably the way your surgeon is suggesting.

Robert M. Lowen, MD · Answer

No, you would have reoperate to have access to the upper abdomen and tighten the upper abdominal rectus fascia to the midline.  Having left the upper diastasis untightened and pulling in the bottom just makes the bulge worse and is a possible outcome even if the upper and lower diastasis are repaired at the same time, as they should be.  Gauging how tight to pull the muscles together, particularly the upper abdomen is a problem, compounded by the fact that the patient is lying supine during surgery, but any uncorrected laxity in the upper abdomen may not be apparent until later when the patient is in the standing position.  There are various techniques to avoid this outcome, but if the upper abdominal bulge was not uncorrectable due to intra-abdominal fat, then the treatment would be to re-operate, and through the tummy tuck incision.

Zoran Potparic, MD · Answer

Without in person consultation or, at least, series of photos, it is very difficult to comment on this problem. Unfortunately, if diastasis repair is indicated, the best approach would be through an existing abdominal scar. However, not the entire incision/scar needs to be used for the approach and repair. Good luck.

Connie Hiers, MD, FACS · Answer

If your surgeon uses the scope, it could be done through small incision, otherwise you will need to opened to get access to it.

Douglas Taranow, DO, FACOS · Answer

Sadly, the only way to plicate the rectus fascia is to incise the skin. You must either open the lower abdomen as in an abdominoplasty incision or a vertical midline incision (not aesthetically acceptable ). 
Why didn’t your surgeon plicate The entire rectus fascia originally?

Is there any other way to access the upper abdomen to repair the DR?

Answers (6)

Answer: Abdomen

Answer: Abdomen

Answer: Revision abdominoplasty

Answer: Revision abdominoplasty

Recommended reading

Everything you need to know about Tummy Tuck Revision

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

Is there any other way to access the upper abdomen to repair the DR?

Answers (6)

Answer: Abdomen

Answer: Abdomen

Answer: Revision abdominoplasty

Answer: Revision abdominoplasty

Browse related questions

Recommended reading

Everything you need to know about Tummy Tuck Revision

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