Will MRI/CAT scan help determine if my fascia is too thin?

Question

Hi, a tummy tuck question to repair 3 inch diastasis recti after 4 pregnancies. One of my surgeon wanted to do an MRI or CAT scan before doing the surgery. He thinks my fascia is too thinned out for successful surgery. 1, will MRI / CAT scan help determine this? 2, If my fascia is too thinned out am I helpless? Thank you.

Gary M. Horndeski, MD · Answer

I have never done a MRI or CT scan to evaluate the fascia thickness.  However, if you are not planning future pregnancies I routinely do use mesh reinforcement for diastatis recti and abdominal wall protrusions.  The mesh is used to reinforce the fascia creating a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight.Best Wishes,Gary Horndeski, M.D.

Gerald Minniti, MD, FACS · Answer

Hello,Go visit a few ABPS certified/ASAPS member surgeons with at least a decade of experience in body contouring. You don't need an MRI. Best of luck!

Johnson C. Lee, MD · Answer

Occasionally a CT or MRI may be requested by the surgeon to evaluate the structural integrity of your abdomen. It is more likely that he wants to make sure that you do not have a hernia or bulge in which the fascia is absent or too weak to support the abdomen. This may require a more complicated reconstruction with mesh to tighten the abdomen during your tummy tuck but it is not hopeless. Hope this helps!
Johnson C. Lee, MD 
Board-Certified Plastic Surgeon
IG: @drjohnsonlee

Jon Ver Halen, MD, FACS (license suspended) · Answer

Dear Keijijunkmail,Hello and thank you for your excellent question. For patients who have a history of complex abdominal surgery and/or hernias, a preoperative CT or MRI is the standard of care. And even if your fascia is "too thin", there are ways to reinforce this with mesh. It is best to answer your question during a face-to-face evaluation, when you can discuss your goals and expectations for the procedure, and you can have a physical examination to evaluate for that procedure. I recommend that you find a board-certified, or board-eligible plastic surgeon with whom you are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your surgeon, and review before and after pictures of similar patients whom have had this procedure. If you have any questions, call our office for assistance. Good luck!
  
Best,
  
Jon Ver Halen, MD FACS
  
Harvard educated plastic surgeon
  
Texas “Top Doc” 2017, 2018
  
RealSelf100
  
America’s Top Plastic Surgeons, Consumer’s Research Council, 2010 - 2018

Ronald V. DeMars, MD (Retired) · Answer

In over 30 ears of practice I have yet to run across someone with a simple diastasis and the fascia is too thin to repair it. You may have misunderstood your surgeon and he is looking for a true hernia which may complicate the repair. You need to speak further with your doctor.

Will MRI/CAT scan help determine if my fascia is too thin?

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