Can Plastic Surgeon Do Diastasis Recti Repair with a Hernia in One Surgery?

Umbilical hernia is a relatively common problem associated with the stretching of the belly wall that can occur with pregnancy. If it is an uncomplicated hernia, it can be fixed at the same time as the rectus diastasis repair, if your plastic surgeon is comfortable doing this. I am fully trained in general surgery in addition to plastic surgery and so do this procedure when indicated. I am not sure that I understand what a "detached" belly button is, but reconstructing a pretty belly button is usually part of a tummy tuck. A general surgeon fixing the hernia only might not be as sensitive about the way the belly button looks after the surgery.

It’s not
surprising that you have developed an umbilical hernia, a rectus diastasis,
weakened abdominal muscles and loose saggy abdominal skin following three
pregnancies. During pregnancy, the
abdominal wall becomes stretched by the rapid expansion of the intra-abdominal
contents. In many cases, this results in
separation of the paired rectus muscles in the midline with the formation of a
diastasis and possibly an umbilical hernia.
This separation extends from the pubis to the rib cage, and is especially
noticeable when the abdominal muscles are flexed. Flexion typically results in a midline bulge
that extends from the rib cage to the pubis.
It’s important to realize that forces that cause torn abdominal muscles
and hernia formation usually create redundant abdominal skin as well.

Correction of a diastasis recti and
associated umbilical hernia involves suture repair of this gap from the rib
cage to the level of the pubic bone.
Both of these maneuvers can be performed at the same time as abdominoplasty
surgery.

If you have redundant abdominal
tissue, a diastasis and umbilical hernia it’s reasonable to correct these
problems simultaneously. Under these
circumstances, it’s appropriate to consult a board certified plastic surgeon with
experience in this area. This surgeon
should be able to formulate a treatment plan that addresses your anatomic
findings and achieves your aesthetic goals.

Most plastic surgeons are general surgery trained prior to entering a plastic surgery residency. I would check the credentials of the plastic surgeon you consulted with as there are other routes to plastic surgery. A plastic surgeon with Board certification in both General Surgery and Plastic surgery can do this operation for you. If they are uncomfortable with the case a general surgeon can be brought in to surgery to repair the umbilical hernia.
You should not need a complicated umbilical creation. Repair of the hernia and rectus diastasis will resolve this issue. There is a slightly higher chance of delayed wound healing or partial loss of skin of the belly button do to the need to enter the belly button to repair the hernia but the risk is low.
Good luck.

Most plastic surgeons are also board certified general surgeons. You need to find one that is comfortable performing both operations. There are surgeons out there that do both.
One note is that the is a likelihood that you will be left without a belly button if you desire to have a tummy tuck. It looks like the hernia has resulted in a detachment of the belly button. In a tummy tuck the incision is made all the way around the umbilicus and if there is not attachments to the underlying fascia then the umbilicus will not surrvive.
Good luck.

Most patients to some extent have a diastasis and plastic surgeons routinely repair the fasica during a full abdominoplasty. In some cases, if you have a hernia or other internal abdominal issue, a general surgeon may be asked to assist during the surgery. However, many plastic surgeons are board certified in both General Surgery and Plastic Surgery and feel comfortable performing the entire procedure. Good luck.