Do I have an abdominal hernia, diastasis recti, or both? (Photo)

After 4 c-sections my stomach is a mess of fat and loose skin. It also is extremely protrudent. Is a hernia causing my stomach to protrude like this or diastasis recti? What kind of tummy tuck would best benefit me as I am desperate to get rid of as much fat,loose skin and stretch marks as possible.

Doctor Answers 11

Tummy tuck

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I appreciate your question.
You most likely have severe rectus diastasis and excess skin which would benefit from a tummy tuck with plication. However, I would need to examine you to see about a hernia.

The best way to assess and give true advice would be an in-person exam.
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative plastic surgery.

best of luck!

Dr Schwartz

Hernia versus Diastasis Recti

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It is difficult to say for sure without a physical exam. With your history of 4 previous pregnancies, there is a high likelihood that you may have some degree of diastasis recti.

Before considering a tummy tuck, I would like you to compute your body mass index (you can google this term and there are websites where you can plug in your height and weight to calculate your body mass index (BMI)). If your BMI is 30 or more, I would strongly urge you to trying losing weight first through diet and exercise before considering surgery.

Kenty Sian, MD
Fresno Plastic Surgeon

Most likely diastasis recti

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Hi, tanee32.  Given your history, you probably have diastasis recti.  During the pregnancy, the rectus muscle stretches to accommodate for the baby growing inside.  After the pregnancy, the rectus muscle does not come back in the middle, allowing for the intra-abdominal content to protrude.  Please consult a board-certified plastic surgeon to see whether you are a good candidate for tummy tuck.  You seem to have excess intra-abdominal fat that will not be improved by tummy tuck.  Best regards.

Hernia or DR?

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Given that you have had several children, it is much more likely that you have a rectus diastasis (muscle separation) rather than an actual hernia.  A physical exam would be necessary to conclude definitively.  It looks as though you would be a good candidate for an extended tummy tuck but it will not unfortunately remove all your stretch marks.  You likely could benefit from flank liposuction also. Best of luck!

Jeffrey A. Sweat, MD
Sacramento Plastic Surgeon
4.9 out of 5 stars 51 reviews

Diastasis Recti vs. Hernia

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Thank you for your question.  It appears that most of the bulging is due to intra-abdominal fat.  The only treatment for this is diet and exercise.   Once the weight has been decreased, you may benefit from a tummy tuck to addresss the remaining loose skin and muscle.   All the best.

Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
4.8 out of 5 stars 94 reviews

Rounded tummy

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suggests advanced diastasis, especially if your tummy bulges badly when relaxed compared to when you hold it in.  In addition, when doing a crunch, if you run your fingers up the midline of the tummy and can fell a 'valley', you have confirmed diastasis.   A hernia can only be diagnosed with an exam or obvious protrusion of your belly button.  You can improve your contours but I would not expect a perfect result and anticipate needing revisions to achieve the best outcome possible.  Find a surgeon near you and explore this further.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Do I have an abdominal hernia, diastasis recti, or both?

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I think that a tummy tuck with muscle repair along with liposuction of the sides and back is likely to give you the best result.  A hernia can usually be repaired at the same time.

Kenneth Hughes, MD

Beverly Hills, CA

Tummy Contour

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It does look protuberant, in that the rectus muscles have been stretched. I would need an examination to see if a hernia. Is present. Discuss this in detail with your surgeon. 

Do I have an abdominal hernia, diastasis recti, or both?

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Thank you for the question and the photographs. With your history it would not be unreasonable to assume that you have a diastasis recti. Having said that it would not be possible to discern between a hernia or a diastasis recti without an in-person examination. I suggest that when you feel ready consult with a Board Certified Plastic Surgeon for an in-person examination and a discussion of your goals. I hope this helps. Best wishes.

Standard tummy tuck best

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Thank you for your question and photographs. Based on your photos alone, I do not see a hernia or a significant diastasis, however, it is best to perform a formal exam for a true diagnosis.  Based on your photos, I believe that you would get the most from a standard tummy tuck with muscle repair. Be sure to see a board certified plastic surgeon.

James McMahan, MD
Columbus Plastic Surgeon
4.8 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.