2 Cm Diastasis and Thickening of Fascia Around the Abdominal Wall

I am getting mixed opinions from surgeons.(General and Plastic) I have weakening in my stomach, small bulge in the middle when standing or doing sit-ups. The MRI shows I have approximately 2cm diastasis recti without herniation. I was told 2 cm diastasis recti is nothing. But what causes the small bulge? Is the thickening of fascia causing the pain and weakness? I am very active. I have not been able to do 100% of my workouts since September 2010. I am a Male, 5ft 5inches, 147 lbs.

Doctor Answers 9


Without photos and an examine it is difficult to give an opinion.  If the small bulge in the middle is do to a diastasis or weaken fascia or both then a repair would be benefit.  If there is excess fat in addition liposuction may be needed to provide the optimal result.  I would get a second opinion from another plastic surgeon.

Buffalo Plastic Surgeon
4.7 out of 5 stars 35 reviews

Male abdominoplasty

It is in your best interest to seek consultation with a well trained–experienced board-certified plastic surgeon. Based on your history and physical examination you will be given good advice. As mentioned before, the radiographic findings are of secondary importance.

Having said that, you should be aware that abdominoplasty is a major operation with significant potential risks and complications and should only be undertaken if clear indications exist.

I may be able to be more helpful if you're able to send pictures in the upright and bent forward (flexed)  positions. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,485 reviews

Rectus sheath diastasis and need for a repair

Quite simply, if you notice a bulge in the middle on standing or while exercising, it will improve with a repair. The MRI done with you lying on your back will not show the actual weakness of the muscles, which is likely to be wider than 2cm to produce a visible bulge. This repair can be done through a small incision or endoscopically.

Anindya Lahiri, FRCS (Plast)
Birmingham Plastic Surgeon
4.8 out of 5 stars 32 reviews

2 cm diastasis

Clinical exam is really the key here.  If you have a bulge that shows up in the sit-up position, then I would recommend repairing it at surgery, regardless of what the MRI (taken at rest) shows.  It could also represent fat, as other surgeons here have mentioned.

The repair does not make the operation significantly longer, and it does make the result look better - so "do it if you need it" is our approach.


Hope that helps!

Thomas Fiala, MD
Orlando Plastic Surgeon
4.9 out of 5 stars 79 reviews

Tummy Tuck San Diego

It is impossible to tell without examining you.  Diastasis recti is usually associated with pregnancy, which you obviously have not endured.  You may have a localized weakening of the abdominal wall.  Any history of trauma or surgery in the area?  If not, and there is a bulge on examination that becomes worse with increased abdominal pressure, and this is symptomatic (e.g. interfering with your activities), either this represents a hernia or an abdominal fascial attenuation.  The good news is that it should be amenable to surgical repair.  The approach to these problems can be controversial, so it is not surprising you have heard different opinions from different physicians.

Steve Laverson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 46 reviews

Repair of abdominal bulging

The bulging will be corrected by abdominoplasty, regardless of its cause. At examination, which in this case is much more important than radiographic findings, your surgeon can discuss the best way to design the procedure to maximize your overall aesthetic result result.

Stanley G. Poulos, MD
Greenbrae Plastic Surgeon
4.5 out of 5 stars 29 reviews

Abdominal Buldge

To answer you question we really need before pictures and also to examine you.  It sounds like you had imaging studies which identified a diastasis recti.  You did not mention any other findings.  However, if it really bothers you, they you may want to consider diastasis repair.  With photos and more information, we may be able to give you more specific advice.  


Good Luck.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 75 reviews


Without an exam it is difficult to say what can ot can not be done for you.  If you have a true hernia( which should show up on MRI) it shoudl be fixed.  If just a weakeness, difficult to say without an exam.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Abdominal muscle laxity

A 2cm diastasis of the rectus abdominus muscles is usually nothing, but not when there are specific problems associated with it (like a bulging abdomen)

The phrase "clinical correlation required" comes in to play here. The MRI images must be considered in light of the physical findings you have. 

A laxity of the abdominal wall, or rectus diastasis, is a widening of the "linea alba" or connective tissue between the rectus muscles. No amount of sit ups or core work will ever improve your condition. It is not a muscular problem, it is a connective tissue excess. I see this a lot in women that have had one or more pregancies, the growing baby stretches out that connective tissue. 

This can often be easily repaired by a plastic surgeon.

William A. Wallace, MD, FACS
Jacksonville Plastic Surgeon
4.8 out of 5 stars 45 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.