Stomach hernia or muscle seperation?

Question

I'm 22 and have had two children via C section. I was considering a tummy tuck (especially after just having my breasts done) as I always look bloated and despite best efforts in working out. My stomach remains the same. If I'm laying down or leaning back I have this protruding thing above my belly button? I should note aswell, I had an inguinal (spelling? Groin) hernia that I had repaired when I was 14 years old, it would pop out like a golf ball after any small movements

Thomas P. Sterry, MD · Answer

You are asking the right questions.  Based on photographs it is simply too difficult for any clinician to say for sure what is happening here.  You really need a simple physical examination to tell the difference.  BUT, in my opinion, it really doesn't make any difference which entity you are dealing with.  In this region, the tummy tuck can be done and if there is a hernia, you can fix it at the same time.  Either way, you will get the flat tummy with tight skin you want.I am attaching a link to a patient of mine who had a hernia after C-section.  We did her tummy tuck and fixed the hernia at the same time (she also had an umbilical hernia).  She did very nicely.  I encourage you to watch the movie at the bottom of the page.Good Luck to you!

Vincent N. Zubowicz, MD · Answer

It looks as though there is significant diastasis of the abdominal wall and an umbilical hernia. These would both be fixed at the time of and abdominoplasty.

Kenneth Hughes, MD · Answer

Hernia and diastasis should be diagnosed by physical exam, but you have the suggestion of at least diastasis and a tummy tuck would be reasonable in that scenario.Kenneth Hughes, MDLos Angeles, CA

Gary Lawton, MD, FACS · Answer

Based on the photographs, it appears that you have a separation of the abdominal wall muscles with or without an umbilical hernia.  A full tummy tuck with muscle reconstruction would address this weakness.

Larry Weinstein, MD · Answer

After pregnancy, when the muscle fascia is stretched a diastasis rectus occurs which is widening of the fascia between the rectus muscles. Umbilical hernias are also associated with the process as well. The fascia needs to be fixed, tightened, the extra skin can be removed and a pre pregnancy tummy can be approached. My case #32584 exhibits a woman before and after tummy tuck, diastasis repair and umbilical hernia repair.

Andrew P. Amunategui, MD · Answer

Ashlee, congratulations on your children and your working out.  Your situation, however, is not amenable to even the most vigorous workout program (sometimes strenuous activity can even be counter-productive with your situation).  Many women can have separation of the abdominal muscles after child bearing.  They will usually present with curvature of the tummy (like "pot-belly" or like early pregnancy tummy) and not with the focal, or discreet, bulging you seem to have.   This is a more significant attenuation or thinning or the fascia (strength layer) of muscles, usually called a "pre-hernia" (though a true hernia may definitely be present).  The good news is that either can be treated by a BCPS at the time of tummy tuck!  good luck :)

Arnold S. Breitbart, MD, FACS · Answer

You seem to at least have diastasis, which is separation of the muscles and not a true hernia.  A physical exam would be the best way to determine if there is any hernia present.

Robert Singer, MD · Answer

Whether you have a significant separation of the abdominal muscles called a diastasis recti and/or a ventral hernia can only be determined through an in person examination.Following
the advice of anyone on this or any other website who would presume to tell you
exactly what to do based on two limited dimensional photos without taking a
full medical history, examining you, feeling and assessing your tissue tone,
discussing your desired outcome and fully informing you about the pros and cons
of each option would not be in your best interest. Find a plastic surgeon that
you are comfortable with and one that you trust and listen to his or her
advice. The surgeon should be certified by the American Board of Plastic
Surgery and ideally a member of the American Society for Aesthetic Plastic
Surgery (ASAPS). If you live outside of the United States, the surgeon should
ideally be a member of the International Society of Aesthetic Plastic Surgery
(ISAPS).You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Pouria Moradi, MBBS, FRACS · Answer

Thanks for sharing your story and images.It appears that you have quite severe muscle separation, and unfortunately no amount of core strengthening can bring the muscle together.You would be an ideal candidate for a tummy tuck, to tighten the muscles and also remove the loose lower abdominal skin.I hope this helps and good luck.

Stephen M. Davis, MD, FACS · Answer

Thanks for writing,Based on your photos and history it appears as thought you have a rectus diastasis; a separation of the rectus muscle where they come together in the mid-line. A formal tummy tuck would allow your operating Plastic Surgeon to manage this problem for you. Could there be a hernia associated with this? Maybe, but many of us will encounter  these while we are working and will adapt at the time and repair either. You should do well. Good LuckStephen M.Davis, MD, FACSGreen Hills Plastic Surgery

Stomach hernia or muscle seperation?

Answers (12)

More Tummy Tuck Questions

How do I obtain my operative report from my ps? How important is it to have when consulting for a tt/scar revision? (Photo)

Umbilical hernia mesh repair. Swelling, hard lump, pain, feeling of fullness and weight loss. What can I do?

I was diagnosed with hep C all my liver functions are normal. Do you think the surgeon will still be willing to proceed?

Do you recommend removing a lapband before having a tummy tuck? Will there be a bulge from the port in the stomach area?

My d dimer came back slightly elevated 0.51 reference range 0-.49. TT in 2 weeks! What does this mean?

I'm still feeling dizzy 3 weeks and 2 days post TT. Is this normal?

WE SEND PRETTY
EMAILS