Large Diastasis. My Surgeon is Board Certified, Yet Not a Plastic Surgeon?

I have a large diastasis, conservatively, the size of a nerf ball. The doctor I am considering is a board certified general surgeon whom specializes in nothing but abdominal repairs and at a university. my concern is, he seeming has great credentials yet is NOT a plastic surgeon. He said he can push it through my insurance, yet not likely through a plastic surgeon. Is it unheard of, that a doctor of his nature being able to perform the full diastasis repair and tummy tuck properly or not?

Doctor Answers 9

Repair of Diastasis

General surgeons can perform hernia repairs.The end point for a successful repair for a general surgeon and plastic surgeon are two different things. The general surgeon will typically define success as elimination of the risk of strangulation of the contents through the hernia while a plastic surgeon will define success as a return to the pre-pregnant shape and position

Chicago Plastic Surgeon
4.6 out of 5 stars 14 reviews

Board Certification in WHAT SPECIALTY?

You are basically hoping this American Board of Surgery-certified General Surgeon can "push it through" insurance. What is the "it" he's pushing through? Tummy tuck with diastasis repair? Or will he be stretching his ethics and calling it a "ventral hernai repair?" (This is called insurance fraud.)

Are you sure he's planning a low transverse incision (abdominoplasty incision), appropriate skin flap dissection, preservation of the umbilicus with adequate blood supply, rectus sheath plication (that will be coded as a ventral hernia repair to get insurance to "cover" this part), excision of the proper amount of skin (see how often THIS topic comes up on this site), subscarpa fat excision without devitalizing the flap circulation, proper plastic surgical closure in layers (no visible extrenal sutures), and is he charging you cash "on the side" for the cosmetic aspect of this surgery? Sounds attractive--part of your surgical fee and anesthesia/operating room fees "covered" by insurance, and you get a "bargain" tummy tuck!

Trust me; they're on to you and every patient who thinks this is a "good deal."

You actually get charged hospital rates(much higher becasue of insurance pass-through costs) for the non-hernia parts of the operation (most of the operation), as well as the majority of the operating room and anesthesia charges. Total these charges up, plus what your general surgeon is charging you for the "skin tuck" and I'll bet you spend more than if you simply had an American Board of Plastic Surgery-certified plastic surgeon do the whole operation (including the diastasis repair, which is part of every tummy tuck) as an elective cosmetic operation.

First of all, diastasis repair is not covered by insurance unless insurance fraud is being committed by coding this as a ventral hernia. If this is discovered by the insurance company's review of your records, nursing notes, anesthesia records, etc., then NOTHING IS COVERED!  YOU get stuck with the HUGE bill, and your would-be "cosmetic surgeon" says, "Insurance didn't cover it; Sorry!"

And if he's not really doing a tummy tuck but simply using a vertical incision and taking out a little skin to allow a charge for "cosemtic surgery," then you have really messed your cosmetic options up, and paid a hefty cost to boot!

Please realize that many ABPS-certified plastic surgeons completed their General Surgical residency and were certified by the American Board of Surgery before plastic surgery fellowship and ABPS certification. I received my American Board of Surgery certification (certificate 31302) on 04/04/86 (have not recertified as I do not practice as a general surgeon), and my America Board of Plastic Surgery certification (certificate 3770) on 11/10/89. The latter is a lifetime certification, and even though I and many of my similarly-trained plastic surgical colleagues never practiced as a general surgeon once we completed specialty training in plastic surgery, we did not "forget" our training in abdominal surgery as we still operate on this area every week.

Thus, a completely-trained plastic surgeon (ABPS-certified) who may have also received certification by the American Board of Surgery will be the BEST surgeon to fix your diastsis and give you the proper cosmetic tummy tuck result you seek.

Do not try to get this "on the cheap" as you may regret not only the result, but the fact that you end up paying even more for it than you ever thought.

Please rethink this. I've seen far too many patients go down this road and rue the day they thought they could "get a deal." Please also read the web reference link below. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

Board Certification and Competence to Perform Specific Surgeries


Although this general surgeon may be certified by the American Board of General Surgery, and he should be able to fix an abdominal wall hernia and diastasis, performing the rest of the abdominoplasty is out of his scope of knowledge and practical skill-set. It is unlikely he has performed few if any abdominoplasties, and you wouldn't want to be one of his first, would you?  

If you want an abdominoplasty, you should go to a surgeon that is certified by the American Board of Plastic Surgery, is a member of the American Society for Aesthetic Plastic Surgery, and has performed hundreds of abdominoplasties.  The same surgeon can address any midline diastasis and/or hernia.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 89 reviews

General surgeon

A general surgeon hasn't really trained in repair of diastase. I feel that you should get another opinion from a board certified plastic surgeon in your area

Sanjay Lalla, MD, FACS
West Orange Plastic Surgeon
4.8 out of 5 stars 48 reviews

General surgeon performing tummy tuck

A diastasis is not covered by insurance, regardless of who is doing the operation. If you have an actual ventral hernia, then this may be covered. My concern would be that, notwithstanding the general surgeon's ability to perform a hernia repair, which is as basis a procedure as they come, he has not had the additional training in performing abdominoplasties which occurs during the plastic surgery residency. I would recommend that you see a board certified plastic surgeon in consultation prior to proceeding. Good luck!

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 40 reviews

Choosing Surgeon for Tummy Tuck?

 Thank you for the important question. Unfortunately, differentiating the credentials of the variety of physicians who wish to provide "cosmetic surgery" services, can be very confusing to patients. Also unfortunately, there is no strict regulation set up to protect the consumer by state or national medical regulatory organizations. Therefore, patients must take the responsibility to ask the question: what are you board-certified in?
The American Board of Plastic Surgery is the only board recognized by the American Board of medical specialties. Confirming that your surgeon is certified by the American Board of plastic surgeon is very important; this will assure you that your surgeon's undergone rigorous training, testing, and continued medical education necessary to become and remain board certified by the American Board of Plastic Surgery.
Plastic surgeons who are certified by the American Board of Plastic Surgery are then potential candidates to join the American Society of Plastic Surgery and/or the Aesthetic Society of Plastic Surgery. These societies will have lists of their plastic surgeon members; these lists may be helpful when patients are seeking a board-certified plastic surgeon. in the process of selecting a plastic surgery I also encourage patients to ask to SEE lots of examples of their work AND preferably speak/see patients who have had similar procedures done.
Be very careful with your decision-making. You will find, while doing your due diligence, that there are many different “specialties” who will offer their services to you; again, I strongly recommend you concentrate on surgeons certified by the American Board of Plastic Surgery. Be very careful with your decision-making. You will find, while doing your due diligence, that there are many different “specialties” who will offer their services to you; again, I strongly recommend you concentrate on surgeons certified by the American Board of Plastic Surgery.
Again, I cannot overemphasize the importance of careful selection of plastic surgeon when it comes to concerns such as safety, achievement of the desired outcome, and ability to manage complications that may arise (even in the best of hands). Keep in mind that revisionary surgery may be more costly in many ways. I hope this, and the attached link, helps. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Rectus diastasis repair

My suggestion would be to see a board certified plastic surgeon in your area for a consultation.   It does not sound like you have an abdominal wall hernia.  If you are seeking repair of your muscle separation and an abdominoplasty, then you need to see a surgeon certified by the American Board of Plastic Surgery and who is also a member of the American Society of Plastic Surgeons.  Accept no imitations (no matter what  titles, university appointments,  or confusing advertising might suggest).   Best of luck.

C. Bob Basu, MD, FACS
Houston Plastic Surgeon
4.7 out of 5 stars 210 reviews

General surgeon to fix diastasis?

I certainly wouldn't quit bowl about the qualifications of this general surgeon's (who specializes in abdominal wall repairs at University) qualifications to fix a diastasis. 

However without knowing who he is I certainly would not comment on his qualifications to do a tummy tuck. If you have any question I'm sure he has colleagues in his hospital or plastic surgeons with whom he could consult. 

Best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Rectus diastasis treated by general surgeon

Great question!  The answer will depend on your medical history and your exam. Separation of the rectus muscles (6 pack muscles) in the midline of your abdomen is called a diastasis. If this diastasis is wide enough, then it can be a hernia.  Have you had surgery through a midline abdominal incision before?  Have you lost a lot of weight, such as after gastric bypass surgery?  If you do have a very wide diastasis and it is creating a hernia, then a board certified general surgeon, especially one who specializes in abdominal repairs, is probably very qualified to perform your rectus diastasis repair. However, if you want a full tummy tuck, then I would get an opinion from a board certified plastic surgeon.  Sometimes I will work with a general surgeon when a patient has a large hernia ... he repairs the hernia, and I do the tummy tuck.  I hope this helps and wish you all the best!

James Knoetgen, III, MD
Fresno Plastic Surgeon
4.8 out of 5 stars 59 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.