Diastasis recti and umbilical hernia repair using mesh?

Question

I am 37 years 157 cm height and 150lb. I have severe diastasis recti ( 10cm separation) and umbilical hernia.my surgeon told me that he will use mesh for strengthening my muscle and I will not have a bellybutton after surgery. I am totally confused pls help?

Jason Hess, MD · Answer

Rectus diastasis and umbilical hernia repair can often be repaired without the use of mesh. I personally prefer to avoid the use of mesh when possible.  When we can get by without the use of mesh or foreign materials, we prefer to do so.  Additionally, the umbilicus is generally able to be preserved during umbilical hernia repair, abdominoplasty, etc.  However, nothing will substitute for a good physical exam.  If you trust your physician to deliver your best results, I would proceed with surgery.  If you have questions about the recommended surgical approach, I would suggest seeking a second opinion from a board certified plastic surgeon.

Jeffrey E. Schreiber, MD, FACS · Answer

Even though it's hard to give you an exact answer without seeing first, I frequently repair hernias with a tummy tuck.  If you're concerned about it, check with your plastic surgeon to see if a general surgeon needs to be present.  When the hernia is large, I have a general surgeon assist me with the case.Dr. Jeffrey E. SchreiberBaltimore, Maryland

David Shafer, MD, FACS · Answer

Without seeing you in person or reviewing your case or seeing "before" pictures it is impossible to give specific advice.  However, unless you have a complicated surgical history or some other unusual condition, it would be very unusual to require the use of mesh for the repair of rectus diastasis and umbilical hernia repair.  I would suggest that you seek consultation by a board certified plastic surgeon that is also board certified in general surgery and who specializes in body contouring surgery.  Unless absolutely necessary, you want to avoid the use of mesh as it could lead to problems down the road.  Once again, we do not know anything about you and have not seen you, so there may be more to your medical condition that we do not know, but in the vast majority of cases, a 10 cm separation does not justify the use of mesh or the loss of your belly button.Good Luck.

Gregory T. Lynam, MD · Answer

I agree with the other posts that mesh especially prolene or non absorbable mesh will be a potential future problem and is not usually needed if this is correction from the ususal pregnancy induced rectus diastasis. If you are a male or have other history that we are not aware of then maybe. Please seek out a few board certified plastic surgeons for other opinions

Robert Singer, MD · Answer

Generally mesh is not needed to repair a diastasis, nor is removal of the belly button routine even if there is an umbilical hernia. Keep in mind, that following the advice from a surgeon on this or any other website who proposes to tell you what to do without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure may not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. If you live outside of the United States, the surgeon should ideally be a member of the International Society of Aesthetic Plastic Surgery (ISAPS).  You should discuss your concerns with that surgeon in person.  Robert Singer, MD  FACS La Jolla, California

Tom J. Pousti, MD · Answer

Difficult to give you good advice without direct examination or at least viewing pictures. Generally speaking, it is possible to repair even wide diastasis recti and umbilical hernias without the use of mesh. It is even more rare to have to “sacrifice” the umbilicus altogether.It may be best, even if it is just for your own peace of mind, to seek additional consultations with well experienced board-certified plastic surgeons.Best wishes.

Diastasis recti and umbilical hernia repair using mesh?

Answers (6)

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