Is this diastasis recti? (Photo)

Question

I've been trying to lose this bulge on my lower stomach through diet and exercise for years. Recently had a virtual consultation for abdo liposuction to get rid of it, but the dr told me he thought it was Diastasis recti. I'm having a hard time physically examining myself to determine if there is abdominal muscle separation. If it is DR, is there anyone in Ontario, Canada that performs laparoscopic/DR repair without TT? I really don't want a TT scar and don't have extra skin to remove. Thanks!

Jerimiah Mason, MD · Answer

The best way to assess diastasis recti is to try and do a sit up. If you see or feel a noticable ridge running up and down in the midline, that is likely diastasis recti. I'm not sure if a general surgeon can fix this laparoscopically, it would be challenging at best. You can potentially get it repaired through a mini tummy tuck incision which is much smaller than a traditional tummy tuck scar.

Andrew Ray, DO · Answer

I agree with the surgeon that it is likely a diastasis recti. Mostly located in the lower abdomen. I don't think you need a full tummy tuck but doing a modified mini tummy tuck would possibly fix almost everything. Additional the scar for that is a little larger than a c-section.
I used to do a lot of abdominal wall reconstruction. Repairing the diastasis laparoscopically is possible but often times leaves a visible ridge down the center of your belly. I think the benefits of the mini tuck would be great enough to do that over the laparoscopic repair.

Lucian Ion, FRCS · Answer

Thank you for your question and photo.

A way to evaluate whether you are troubled by diastasis recti is use this examination:

- lie down on you back
- place the tip of your fingers over the midline of the tummy above the umbilicus and press with moderate strength
- holding the pressure start to sit up

I f you can feel the rectus muscles coming together against you hand, it suggests that you may have a diastasis recti.

This problem can also be diagnosed via ultrasound or MRI scan. If you have  an MRI scan, I would suggest a sitting MRI as sitting puts more tension on the abdominal wall and demonstrates the problem better.

In the presence of elastic skin, apart from the laparoscopic repair there is an option of trans-umbilical repair which is carried out without entering the abdomen. It is the endoscopic assisted abdominoplasty. It involves some liposuction to the central abdomen to help create a nice contour when the muscles are brought closer together. The scar can be confined to the belly button.

Adam Kinal, MD · Answer

Hello LMC, The photograph doesn't show enough of your abdomen to determine if it is diastasis recti.  A surgeon can physically examine you to feel if you have a widening abdominal muscle, which is most common in women who have had childbirth. You will need to search for an experienced surgeon, or several, in your desired location to set up a consultation in person to get the correct answer and solution. Good luck on your journey

Daniel Barrett, MD · Answer

Dear L.M.C,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Vincent Gardner, MD · Answer

Hi L.M.C.
Based on your photo it is hard to tell if this is a DR. Sometimes you can tell on a virtual exam....but if is a subtle or small DR then It might not be detectable on virtual. So what I'm saying is you really need an in person exam with someone what does a lot of abdominoplasties to give you their opinion. Sometimes I use ultrasound (in the standing position) to see what the abdominal wall looks like if it is questionable. Ultrasound is very good at visualizing the underlying musculature. With regards to Laparoscopic repair I'm not well versed in the procedure. Having said that if you need a TT then sometimes choosing a lesser procedure leads to a lesser result. I hope this helps. Good luck!

Leland Webb, MD · Answer

First and foremost, one question is, have you had children? If you have, then, it is likely that this shape is representative of the spread of the abdominal musculature in the lower abdomen. Therefore, one of the options for you is an abdominoplasty which would tighten these muscles. And abdominoplasty does come with scars. However, it appears as though you may be an excellent candidate for this.

Derek Fletcher, MD · Answer

Your photo is consistent with diastasis recti. An in person exam is necessary to determine if you are a candidate for endoscopic repair vs. combined short scar tummy tuck and DR repair.

Camille Cash, MD · Answer

It's really difficult to tell from your photo if the contour that concerns you is from diastasis.  It may be amenable to liposuction.  I encourage you to visit with a board certified plastic surgeon near you for an examination.  This should reveal what is causing the protrusion and the best way to address it.

Edgar Serrano, MD - Account Suspended · Answer

Endoscopic lipoabdominoplasty (ELAP) is good option .ELAP is the surgical technique utilizing endoscopy to repair acquired abdominal wall defects, such as diastasis recti or ventral hernias.An internal corset (muscle plication) is performed .Only three mini incisions are used, a large wound is not made as in conventional abdominoplasty.

Is this diastasis recti? (Photo)

Answers (10)

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