How Do I Determine when if I Should Have Surgery for Diastasis Recti?

I am a 36 years old male. 5feet 5inches, 145 lbs, and 31 inch waist. I was diagnosis with a 2cm diastasis recti. A lump pops out when I am doing activities. I cannot play basketball and exercise due to pain and weakness. Some doctors think it is not a big deal. Some doctors tell me you cannot do your normal activities with out the surgery because you can form a hernia if not treated properly. One doctor think physical therapy will fix and reverse the problem. What are your opinions? Thanks again

Doctor Answers 11

Abdominal wall diastasis or hernia?

Thank you for the question.

I realize it may be frustrating to receive different advice from different doctors.  One thing is certain: no degree of physical therapy will correct the “anatomic defect” whether it be diastasis  recti  or hernia.

Your best bet is to be evaluated by well experienced board-certified plastic surgeons.  Generally, a  good history and physical examination is all that is required to make a good diagnosis and treatment plan.

I hope this helps.

San Diego Plastic Surgeon
5.0 out of 5 stars 1,486 reviews

Diastasis recti requires surgery. Physical therapy will not fix the problem.

It is not necessary to fix a diastasis of the abdominal wall (large gap between the 2 rectus muscle).  However, some patients want it corrected for aesthetic reasons.  The fascia that joins the muscle needs to be tightened and this can only be done with an operation.  An endoscopic repair can be accomplished in those patients that do not need any removal of skin.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

Make the right diagnosis before scheduling surgery

Mr. Glass: Consult with either a General Surgeon or PS who has experience in abdominal wall reconstruction to get the correct diagnosis before opting for surgery.  Where does the painful lump "pop out" during exercise? Is it centered over the belly button or the area between the "six pack" muscles (i.e. diastasis recti) or is it somewhere off the midline? Does the lump stay or disappear when you aren't exercising?   The answers to these questions may assist your consultant determine the nature of your affliction and assist his/her plan to correct it. 

A hernia may develop in continuity with a fascial weakness, diastasis recti, but hernias can also occur in other parts of the abdominal wall.  Making the right diagnosis is essential before proposing surgery.  Given your current height and weight, it's unlikely that you would need a tummy tuck, which generally is suitable for individuals with excess skin, fat and fascial weakness.  Good luck.

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 58 reviews

Tummy tuck for a male patient

In my practice we do a number of abdominoplasties on male patients. Typically, it is some one that has lost significant amount of weight. In addition to excess skin, these patients also have a diastasis recti, which is weakening of the junction between the two "six pack" muscles. In your particular case, sounds like you might have a discreet ventral hernia already, if in fact as you say "a lump pops out". You should see a competent plastic surgeon that has experience in assessing your condition.

Boris M. Ackerman, MD
Newport Beach Plastic Surgeon
4.7 out of 5 stars 56 reviews

Diastasis Recti or Hernia

It sounds as if you have a ventral hernia rather than a diastasis recti which is a separation in the midline muscles most commonly caused by pregnancy.  It is also very uncommon for a diastasis to cause the pain which you have described.  I think you should obtain a consultation with a board-certified General Surgeon who should be able to tell you if have a hernia as well as what is involved with its repair.

John Whitt, MD (retired)
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

Tummy tuck, Diastasis Recti


Diastasis Recti is a recognized change in the abdominal wall after pregnancy or other stresses in life.

When the abdominal wall is lax, there could be protrusion of the intestines and through the weakening. This may appear as a bulge or fullness.  With persistent stress to the area, this may get worse over time.  Usually any exercises will not help this situation.  If you do any abdominal exercises all the stress will first go to the weakness in the middle and put more stress and strain on an already weak area. This may aggravate the problem.

Unfortunately, insurances don't cover this operation routinely.  If this condition becomes symptomatic with pain and discomfort or if the problem is worsening, or if you don't like the appearence of a bulge or fullness, then surgical correction will be recommended. Usually this is a tummy tuck or an abdominoplasty.

Hope that helps.

Shashidhar Kusuma, MD
Plantation Plastic Surgeon
4.8 out of 5 stars 28 reviews

Diastasis recti after pregnancy

Mostrar people develop diastasis of the rectus muscles after pregnancy or weight gain. Diastasis recti is a separation of the six pack muscles at the midline. This is not the same as a hernia, but When it is symptomatic (causes pain), it is repaired by performing an abdominoplasty or tummy tuck.

Frank Agullo, MD
El Paso Plastic Surgeon
4.9 out of 5 stars 140 reviews

Diastasis Recti vs Hernia: Repair and Possible Tummy Tuck

Diastasis recti occurs when the vertical tissues separating the paired abdominal muscles thins after pregnancy. It may appear as a vertical bulge when a women strains as in doing a sit up. A hernia is generally more focal and involves abdominal contents pushing out through the weakness. If the hernia has a tight, narrow opening, the risk is that abdominal contents can get stuck in the opening. That would be an emergency. Your symptoms of pain should be further investigated. Whether it is a hernia or diastasis recti, physical therapy would not be a good option. Even strengthening the muscles, through exercise or physical therapy, will not repair the thinned tissues between the muscles. A general surgeon and/or a Board certified plastic surgeon can listen to your symptoms and perform a physical exam to determine the difference between these conditions. It would be wise to repair the weakness given that you  are having symptoms of pain. Many board certified plastic surgeons are also fully trained in general surgery. If you have completed your childbearing, you may want to consider a tummy tuck with repair of the diastasis recti or hernia. The advantage is in rejuvenating the abdomen while fixing the abdominal wall weakness and placing the scar below the bikini line.

Behzad Parva, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 7 reviews

Diastasis Recti vs. Abdominal Hernia

A diastasis recti is a gradual stretching out of the connective tissue layer (fascia) between the two vertically running abdominal muscles (rectus abdominis). This commonly occurs in women during and after pregnancy.

A hernia is a tear in the connective tissue layer, with fat from below migrating above, in response to increasing  intraabdominal pressures, as with straining.

Your description is more suggestive of a hernia. Hernias only become larger with time. A hernia should be repaired when diagnosed. Smaller hernias are easiest to repair when small.

You should seek the advice of a hernia expert.

Stephan Baker, MD
Miami Plastic Surgeon
5.0 out of 5 stars 5 reviews

Repair diastasis if it is symptomatic

Physical therapy and/or exercise will not help a diastasis of the rectus muscles. If you have a bulge that comes out with contracting the abdominal muscles then there may already be a hernia forming.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 52 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.