35f 5ft 2inch 114lbs. I have diastasis recti 5cm and umbilical hernia. What's the best surgical approach? (photos)

Thank you for the question. An umbilical hernia repair and diastasis recti correction can be performed as part of a tummy tuck, without floating the belly button. As you said, floating it will lower the position of the belly button and is not recommended.

Hello Thrifty96679 in Marlton,

Thank you for your question regarding the best surgical approach for your diastasis recti and umbilical hernia. After reviewing your history and the photos you provided, it's clear that you are facing a complex issue that needs a thoughtful surgical plan.

Given your description, the umbilical float technique indeed seems to be a viable option for you. This method is particularly advantageous in cases where there is not an excess of skin and the belly button already sits low, as it allows for the correction of the hernia and diastasis without needing to relocate the belly button significantly. The umbilical float technique will enable the belly button to be repositioned slightly without detaching it completely, which helps maintain adequate blood supply and reduces the risk of complications.

Moreover, the use of mesh, approximately 8” x 10” in size, is recommended to reinforce the weakened abdominal wall. This approach not only supports the area but also reduces the likelihood of recurrence. The mesh acts as a scaffold, allowing your body's tissue to integrate with it over time, which can provide a durable solution to your abdominal wall weakness.

It's important to consider the potential for a small vertical scar from where the original belly button was repositioned, as this is sometimes unavoidable with the umbilical float technique. However, this is often a good trade-off for the comprehensive correction of both the hernia and the diastasis recti without compromising the function and aesthetic appearance of your abdomen.

As always, it's crucial to discuss all these details with your plastic surgeon, ensuring that you understand all the implications of the chosen surgical technique and how it fits into your specific anatomical and aesthetic needs.

Thank you for trusting in this process, and I wish you the best in your upcoming surgery and recovery.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic Surgeon

If you want your insurance to cover the hernia repair, have this done first using the scope to assist in the repair. Six months later, have the tummy tuck and you should do well. However, I have repaired small hernias at the time of the tummy tuck with usually no problems. There is some extra risk to the umbilicus when this is done. I am not a fan of the floating umbilicus because it is often out of place.