Diastasis recti repair and removal/tightening of skin above the belly button: how do I avoid hip to hip scarring? (Photos)

When the abdominal skin has relatively good elasticity it is possible to use and endoscopic assisted approach for correction of diastasis recti. It involves creating a tunnel under the skin to allow the repair and liposuction to the central abdomen to avoid volume excess in the midline when the muscles are brought together.

The surgery can be carried out through the belly button but it can also be carried out through a different midline scar that measure at least 3 cm.

Laparoscopic correction by the general surgeons is also a possibility. Without external contour correction, this approach may leave some central abdominal fullness.

Hello Anatsasia7, I recommend consulting with several Board Certified surgeons who specialize in these procedures in person to give you their opinions and evaluations. Good luck.

Dear Anatsasia7,
it is hard to tell for sure without an examination. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD

Thank you for submitting your photographs.Based on your photographs and what you are looking for I would suggest you consult with a Board-certified plastic surgeon for optimal results. Best of luck. 

If the only skin the bothers you is above the belly button, you theoretically could consider a reverse abdominoplasty. That would avoid a hip to hip scar, but instead would have a scar running across the front of the chest under the breast crease. This is not commonly done, but it is an option. Otherwise, in order to complete a muscle plication, you are going to need the classic hip to hip scar to create enough access to tighten the abdomen muscles and remove enough skin to have a great result. There are some surgeons that describe using a laparoscope to complete the muscle plication, but I am not sure about the utility of such an approach. 

One of the biggest concerns for my patients is post-operative scaring. The length of the scar is directly proportional to the amount of redundant skin that is removed. Larger scar more skin removal tighter you will be. It is not possible to perform the muscle plication through the small scar above your belly button as you will need to undermine the tissues to have adequate view of the underlying muscles to safely perform the procedure. There are things like silicone scar management (that we offer in my practice), and IPL lasers which help lighten the scar, and camouflage it to the surrounding tissues. If this is a definite no for you, another option to address the loose skin in a minially invasive manner is Morpheus8 Body. You will likely require 6 sessions (minimum of 3), spaced 6 weeks apart. Another potential option is Renuvion J plasma skin tightening; however, to see your candidacy for it, you would need a physical examination. It is also noteworthy to mention that Morpheus8 and Renuvion will address the skin laxity - and not the diastasis recti. Best, Dr. Satey, Beverly Hills, Ca.

I don't think it will be possible to do the two things that you want done without a full abdominoplasty incision.  You must get access to the abdominal wall to tighten the muscles.  And you have to make the full abdominoplasty incision to tighten the skin above the bellybutton.  A mini-abdominoplasty wouldn't really tighten the skin above the bellybutton very much.  In order to tighten the skin above the belly button and tighten abdominal wall muscles you have to do a full abdominoplasty.

What you're asking for (muscle plication without an access incision) is really hard to execute well. You could best accomplish this by making a c-section type scar and working all the way through that to do your muscle plication rather then struggling through a old laparoscopic scar. In my hands, I'd probably offer you a "mini abdominoplasty" kind of approach to this and remove a little skin as the way to aproach the muscle work you need.