What Are My Options? I'm A Fit, Thin Woman With Rectus Diastisis And Umbilical Hernia (photo)

I Am 5'4 1/2 " Tall, 108lbs.  I Have Had Two Children (5 and 1).  I Have a Full Rectus Diastisis from Sternum to Pubis with the widest part at the umbilicus (atleast 3 fingers width). The abdominal muscles are no longer flat. I have an epigastric and an umbilical hernai (according to a general surgeon). I also have some extra skin when I bend over. Which surgery is best for me?  How do I find a plastic surgeon in my area that has done the most abdominoplasties on fit, active, thin women with rectus diastisis and umbilical/ventral hernia and minimal extra skin after two pregnancies?

Doctor Answers 18

Tummy tuck with diastasis and hernia

Though a thorough examination would be needed, it appears from your photos that a full tummy tuck would be the procedure of choice for you. The diastasis and hernias are common issues that can be addressed concurrently with the latter often repaired by a general surgeon.

Most plastic surgeons have performed numerous tummy tucks as you have described. There is never any guarantee with regard to results or the results from a given plastic surgeon. You should seek one or more  consultations from reputable board certified plastic surgeons in your area and then try to arrive at a decision based on several factors.

Scottsdale Plastic Surgeon
4.9 out of 5 stars 30 reviews

Diastasis without skin laxity

The issue of a diastasis without skin laxity is a not uncommon one. Often it is hard to find a plastic surgeon who can see to a repair without tummy tuck, though a good approach is through a short low transverse incision much like a C-section, with exposure of the muscle from chest to pubis. The umbilicus stays with the skin, and is reattached right where it started after the repair is complete.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

Fit, Thin Woman With Rectus Diastisis And Umbilical Hernia

Thanks for your question in the attached photos.

I am not sure that I am seeing much in the way of skin excess in these photos. If I am mistaken, a small incision much like for a C-section could be used to tighten the entire abdominal wall and repair of the hernias. To do this the navel might be detached from the abdominal wall then reattached at the conclusion. Whatever small amount of skin excess would be excised. RRR

I am correct, you might want to consider just having the abdominal wall corrected and this can be done endoscopically, with minimal incisions. The appropriate surgeon to your community maybe a plastic surgeon. In many communities, the surgeon with the most experience, judgement, and skill at this type of surgery may well be a general surgeon.

Reluctant best wishes

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Thin, fit but diastasis recti and umbilical hernia

Thank you for your question and pictures.

You are one of a small number of individuals who appears to be an excellent candidate for an endoscopic tummy tuck. The endoscope allows the diastasis recti to be fixed through a belly button incision and a small cresent of skin can be removed from the lower tummy similar to a mini-tummy tuck. The umbilical hernia can also be fixed at the same time through the belly button incision.

You would likely get an excellent result with a minimally invasive approach and limited incisions.

I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 182 reviews

Abdominoplasty on thin women

Hi there-

I would agree with Dr. Johnson, and have had great success with this technique- Low transverse scar (very inconspicuous), complete exposure and muscle repair from ribs to pubis, with umbilical float.

Good luck!

Armando Soto, MD, FACS
Orlando Plastic Surgeon
4.8 out of 5 stars 157 reviews

What Are My Options? I'm A Fit, Thin Woman With Rectus Diastisis And Umbilical Hernia

While you are not the typical abdominoplasty candidate you are by no means rare. Here in Vancouver we see many fit, trim women who present with unavoidable changes after childbearing.

You would require repair of the hernias, rectus diastasis repair as well as removal of the excess skin. It is difficult to tell from your photos alone whether you would be a candidate for a modified procedure or whether a full abdominoplasty would be appropriate. This decision would be based on the laxity of your skin as assessed at the time of consultation.

If it appears that a general surgeon is needed to deal with a hernia we strive to organize a combined procedure so everything is dealt with in one sitting.

All the best!




Eric Pugash, MD
Vancouver Plastic Surgeon
4.9 out of 5 stars 136 reviews

Is there a one size fits all tummy tuck?

Your best option depends on your goals.  A standard abdominoplasty gets your tummy flatter and your skin envelope tighter.  An endoscopic abdominoplasty could correct your abdominal wall laxity and repair your umbilical hernia, but not tighten your skin envelope.  A consultation with a board certified Plastic Surgeon to examine you and discuss your goals is your best bet.

Craig Harrison, MD, PA
Tyler Plastic Surgeon
5.0 out of 5 stars 28 reviews

Mini tummy tuck with floating the belly button

Your are in excellent shape and extra skin over the abdomen will improve any more with exercise as you have noticed. I would offer mini tuck. This will include repair of the diastesis ,repair of the umbilical hernia ,lowering belly button to new position( to tighten the skin above the belly button) and remove excess skin in lower abdomen. There will be no incision around belly button. Please check my web site for examples similar to yours.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.8 out of 5 stars 122 reviews

Fit woman with muscle separation and hernias of the abdomen. Options?

Thank you for the photos. You are not the typical abdominoplasty patient seen by most plastic surgeons. Your problem is straightforward: need an abdominiplasty with muscle plication and repair of hernias. You do not need liposuction or other procedures which might increase the potential complication rate. As most plastic surgeons have a general surgery background (including myself), repair of the hernias can be done at the time of the abdominoplasty. You do not need a general surgeon involved unless you pick a surgeon who feels uncomfortable with your presentation. This year alone I've done about 8 very similar cases to yours (these women are athletes, yoga teachers and runners). Good luck.

George Marosan, MD
Bellevue Plastic Surgeon
4.8 out of 5 stars 38 reviews

Repair of hernia and abdominoplasty

I would recommend a tummy tuck with correction of the diastases. Everyone has excess skin when they bend over but I do see the bulge in the midline and a tummy tuck, even though you don't have much excess skin, would improve your abdomen.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 40 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.