When is Mesh or AlloDerm Necessary in Diastasis Repair?

I'm 5'2" and 120 lbs. A year ago, I had twins weighing 6lb 7oz and 6lb 14oz. My skin was stretched to the max, which resulted to  "twin skin" and severe diastasis recti. I've consulted two cosmetic surgeons. One said I need AlloDerm or mesh, and the other said I don't. In what cases can you say that AlloDerm or mesh is necessary with Tummy Tuck for diastasis repair? Do I really need it at $2000? I need to schedule this for next week; please help.

Picture was taken in a tub, so the separation is more noticeable.

Doctor Answers 12

You don't need mesh or Alloderm

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If your surgeon undermines up to the xiphoid, he/she should be able to correct the diastasis with sutures alone.

Since you are thin, you might be able to see or feel the mesh; Alloderm may be useful in some surgical situations, but not here.

With this wide a diastasis, just make sure the extent of undermining of the abdomen is to the xiphoid and rib cage.

Boston Plastic Surgeon

No need for mesh or Alloderm

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Since your diastasis is from pregnancy and you do not have a true hernia, it would be very unusual to need a mesh and certainly not Alloderm. Some surgeons might consider it to reinforce the closure but I doubt if that is necessary. If you were to have a failure of repair or a large hernia, it might be considered. You also look like you are not boese and the muscle should be able to be brought back to its original position.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Mesh or Alloderm not usually needed

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Your picture shows pretty severe diastasis, but in 13 years I have not needed to use AlloDerm or mesh in a diastasis repair. Mesh comes with its own risks. Make sure you understand the risks and benefits before you proceed.

Best Regards.

John P. Di Saia, MD
Orange Plastic Surgeon

Mesh is not my first choice for diastasis repair

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It is quite interesting how so many plastic surgeons agree that they would not use mesh. I must say that in 20+ years the only time I have used mesh was on a breast reconstruction for a TRAM flap in the early 90's. I don't think you would need mesh or alloderm in doing a tummy tuck and just repair of the diastasis would give you a very nice result.

I use Alloderm or allograft material in breast reconstruction because it has elasticity and stretch which is just the opposite of what you would want in a diastsis repair. Good luck on your surgery.

Mesh or AlloDerm not necessary in diastasis repair

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Absolutely, NOT. The use of mesh should be a LAST recourse when the muscles (or their fascial lining) are destroyed.

I have operated on women such as yourself many times and never had to use a mesh. One, which I believe was much worse than yours, posted her pictures on this website, at http://www.realself.com/review/Full-Tummy-Tuck-w-o-lipo. See for yourself.

I would delay and consult with another Plastic surgeon (www.PlasticSurgery.org)

Good Luck.

Peter A. Aldea, MD
Memphis Plastic Surgeon

When is Alloderm usage indicated

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Alloderm and Strattice (second generation biologic mesh made by same manufacturer) have a role in complex abdominal hernia reconstruction. Utilization of these products have been shown to result in lower hernia recurrence rates.

You do not have a complex abdominal hernia. Diastasis recti, although unsightly, represents midline separation of the rectus abdominus muscles - there is still intact abdominal wall fascia. As a result, treatment is geared toward sewing the muscles back together - that's pretty much it.

You definitely need to make sure your surgeon is a board-certified plastic surgeon. Best of luck.

Repairing rectus diastasis

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From your history and your photos you definitely do not need Alloderm or mesh.   Also you do not need a cosmetic surgeon - you need a Board Certified Plastic Surgeon, preferably one who is also Board Certified in Surgery for the extra experience in surgery of the abdomen.

Diastasis recti repair doesn't usually require alloderm or mesh

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I agree with all the other consultants that your case should be able to be repaired, using your own fascia, providing the loose abdominal skin is raised from the pubis to the rib cage (xiphisternum). Several post-op factors may contribute to failure of the repair of your diastasis recti. These include constipation, coughing, overly strenous activity undertaken too soon. As long as you have adequate time to convalesce, you should have a satisfactory convalescence and a great result! good luck.

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

No need for Mesh and definitely not Alloderm

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Diastasis is usally repaired directly specially in someone who has lost all their pregnancy weight. If you have a true hernia, then you may require a mesh. Alloderm stretches and you can get recurrent protrusion of your abdomen. Discuss with your surgeon your options again and most likely the only thing required in the repair of your rectus muscle is your own fascia which is the covering of the muscle. Good luck.

Bahram Ghaderi, MD
Chicago Plastic Surgeon

No mesh

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Not necessary.  All it does is increase the risk of infection and mesh in particular can give you the sensation of having a dinner plate on your belly -- it can be very firm and uncomfortable.  Make sure your surgeon is certified by ABPS - the American Board of Plastic Surgery and good luck!

Robert S. Houser, DO
Columbus Plastic Surgeon
5.0 out of 5 stars 17 reviews

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