I have a large fist sized diastasis and a mild bladder prolapse. The prolapse has almost completely resolved through physical therapy and pelvic floor muscle training. I am 5 feet tall and weigh 100 pounds. I have no loose skin or extra abdominal fat. I understand diastasis recti can lead to a multitude of back, posture, pelvic instability problems etc. if left untreated. Would it make sense to have it repaired as a preventative measure?
Should I have diastasis recti repair surgery?
Doctor Answers 8
Diastasis Recti simply means a separation of the paired midline abdominal muscles also called the Rectus Abdominis muscles. Although not dangerous this condition makes your tummy stick out even if you have good core strength. Paradoxically with greater separation of these muscles, when you try to tense your muscles to tighten your tummy the center part bulges between the separated muscles.
Should I have diastasis recti repair surgery?
An exam would be imperative, but diastasis repair seems like a reasonable course of action.
Kenneth Hughes, MD
Los Angeles, CA
Indications for Diastasis Recti Repair
Hello 'Alice marie', thanks for your question. Diastasis recti is a condition where the fascia surrounding the rectus abdominis muscles get stretched out and separate, usually due to pregnancy or massive weight gain. Once the fascia is damaged, no amount of sit-ups or exercise will restore the normal tone and this can be a permanent condition. It is important to weigh the risks and benefits of every surgical procedure in order to determine whether it needs to be addressed, and this can vary from individual to individual. Unless the condition is leading to significant clinical problems and is symptomatic, I would say the risks of surgery would probably not outweigh the benefits, and insurance will definitely not cover this. Most people with diastasis recti are asymtpomatic, and surgery as a 'preventative measure', in my opinion, is not indicated. If this were the case, we should all have surgery to remove our appendix to prevent acute appendicitis, gallbladders to prevent acute cholecystitis, carpal tunnel release to prevent acute carpal tunnel syndrome, etc. Thus, if you are not experiencing any problems and your bladder prolapse is resolved with therapy, I would say leave it alone. On the other hand, if aesthetically you do not like the way your diastasis looks in a bikini, then you may decide that the benefits outweigh the risks and decide to pay out-of-pocket for a cosmetic corset abdominoplasty +/- minor skin excision. Be sure to seek consultation with a board-certified plastic surgeon if you decide to go that route. Good luck!
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Rectus diastasis repair
I do recommend having this repaired as it may improve many of your symptoms. Best to determine this after a consultation.
Dr. Kimberly Henry
Hello, thank you so much for your question! Yes, you are a perfect candidate for this surgery, and sometimes insurance will cover this procedure, too.
Diastasis Recti Repair... and more
The simple answer to your question is "yes". You should be aware that when the diastais is repaired many patients will have excess skin even when they did not appear to have excess skin to start out with. Don't be surprised to receive the recommendation of a mini or full tummy tuck to accomplish all the repairs at the same time.
I have posted below a link to a similar patient
Diastasis recti repair can help a fist-sized split between your abdominal muscles
Thank you for your question. It sounds from your description that repairing your split muscle would make you more comfortable.
Although you do not have loose skin and do not need a Tummy Tuck a diastasis repair can certainly be done.
Be certain to consult a plastic surgeon who is certified by the American Board of Plastic Surgery, experienced inTtummy Tuck, and who has an excellent reputation in your community.
Abdominoplasty and Rectus Diastasis
Pregnancy causes a wide variety of effects on the female abdomen: some (lucky) women revert to their pre-baby tummies, other women develop significant stretch marks and a persistent bulge in the abdomen. There are also women who are somewhere in the middle in terms of these changes.
In general, there are two main options for women who develop changes to the abdomen after childbirth:
- one is a full abdominoplasty, where the incision is essentially "hip to hip", the entire abdominal wall muscles are tightened (from the ribs down to the pubic bone), and a large portion of excess skin is removed (often, all of the skin from the belly button to the pubic hair line can be taken out).
- The second option is a mini-abdominoplasty. In this procedure, the scar is still side-to-side, but is limited to just beyond the width of the pubic hair line. Only the lower abdominal muscles are tightened. The belly button is pulled down slightly to tighten its appearance (a small umbilical hernia can be repaired through this approach), and a small amount of stretched skin can be removed (about half of the skin from the pubic hairline to the belly button.
- A third option (I know I only said I would discuss two!) is an endoscopic abdominoplasty. This procedure is rarely performed. I would only recommend this to patients who have absolutely no stretch marks, excess skin or fat. This essentially is close to zero women following childbirth (sorry). The endoscopic abdominoplasty can be used to tighten the muscle through a small incision in the belly button without removing skin or fat.
While I feel that repairing rectus muscle diastasis (widening) can lead to remarkable changes in the appearance of the abdomen (not to mention dropping dress sizes), I do not routinely recommend it as a means to prevent back pain and pelvic instability. Some of the beneficial effects of abdominoplasty on posture may in fact be achieved, but it should not be the major reason for pursuing the abdominoplasty procedure.