SEVERE Diastasis Recti and umbilical hernia, caused by fibroids and childbirth.

Thank you for your question and photographs.  My advice is to wait a full six months before considering your mommy makeover procedure.  Cost of surgery does vary per geographical area.  Best to seek care and consultation with a board certified plastic surgeon to discuss risks, healing time and check with your employer regarding coverage.  Best of luck.

If the fibroids occupy or occupied a great deal of space, have the fibroids been removed or hysterectomy performed?  Is the hernia more extensive than just the umbilicus?  Kenneth Hughes, MDLos Angeles, CA

You will want to wait until your weight has been stable for six months and have finished breastfeeding for at least 3 months before considering surgery.  Visit with a board certified plastic surgeon in your area for a consultation.  During that time you will receive an explanation of the procedures and an evaluation of your candidacy for surgery.  A price quotation will also be given based on your surgical plan.  Due to your other health concerns, you should also meet with a general surgeon.

Congrats on completing your family.  Agree that your priorities should be directed to nurturing your baby, getting into the best physical condition, including loosing any baby fat and arranging childcare options for your recovery.  Multiple pregnancies and fibroids have exerted a tissue expansion effect on your abdominal wall (skin, fat and muscle), diastasis recti and umbilical hernia.  Regrettably, most insurance companies exclude repair of a diastasis recti as this is considered a "cosmetic" condition.  By contrast, umbilical hernias are usually "covered benefits" and should be submitted for FMLA coverage, so conceivably your MM (mommy makeover) recovery period could be partially covered.  Given your extreme skin laxity and probable fascial laxity, as evidenced by the protuberant umbilicus, you may require mesh reinforcement, however this is best addressed by your PS consultant. Assuming that you are healthy, this combination of procedures should be safe, however be prepared to follow all instructions.  Good luck.

Hello and thank you for your excellent question. You are a great candidate for a mommy makeover. Given your past medical history, however, your surgery is likely to be more involved than a typical mommy makeover. This will significantly extend your time to recovery, etc. I suggest that you meet with a surgeon face to face, for a physical exam, to discuss your goals and expectations in detail, and to make a plan that fits your needs. This decision should be based on a detailed discussion with equal input from both you and your surgeon.    Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation in person with a qualified board-certified plastic surgeon. Good luck! 

Best,

Jon Ver Halen, MD FACS 
Harvard educated plastic surgeon