Endoscopic Diastasis repair? (photos)

Question

After I had my daughter I realized my abs had deprecated quite a bit. I did the proper exercises and brought it much closer to being a one finger gap when I lay on my back and lift it off the floor. The problem is that I have a dent above my belly button and some saggy belly button skin. I do not want a tummy tuck at all. I don't want that scar. Is it possible to fix this with very minimal scaring? Possibly with and endoscopic repair and belly button repair??? Help!

Ryan Hoffman, MD · Answer

Having a one finger breath distance between your abdominal muscles is great and you should be commended for exercising appropriately. Your main issue is skin and not really fat removal or muscle repair.That being said you have a few options. One is for non surgical skin tightening- I have a Viora machine (radio-frequency) that tightens skin. It does take multiple treatments (4-6) and then requires biannual maintenance treatment.A second options is a mini- abdominoplasty. A C-section like scar is made. The skin in then undermined up to the rib area. In your case the belly button is not cut out and there is no scar around the belly button. The skin is then removed and the incision closed. This does lower the belly button.  There are other variations that can be done based on skin laxity and the patients wishes.Schedule a consultation with a board certified plastic surgeon and they will help you in your journey.

Gregory T. Lynam, MD · Answer

Be careful, yes one could use a c section incision to perform endoscopic tightening of muscles. If the skin were also widely undermined you might have less redundancy of skin. You however are missing the fat under the area that bothers you which I have seen many times and this is hard to fix even with fat grafting. You look great and in my opinion the risks are greater then the benefit in your case to undergo surgery. Good Luck!

Richard Wellington Swift, MD · Answer

Dear Mommy, Thank you for posting your photos with your interesting questions. I see that you have a moderate amour of wrinkled and loose skin above your belly button and have well developed abdominal muscles. You should be commended for exercising. One finger gap is not much when you flex. Your main problem is the wrinkled skin that will not be improved with an endoscopic diastasis repair, because it will only tighten the abdominal muscle core and recruit more loose wrinkled skin! In other words, you will result in having more loose skin with a smaller tighter core and this, most likely, is not your goal. I understand that you do not want the scar associated with a tummy tuck. However, you must decide on your abdominal contour goals and decide if you can accept a low abdominal scar that is concealed within the usual V cut bikini. I recommend that you have a consultation with an experienced Board Certified Plastic Surgeon who can take your medical history and examination, answer your questions, discuss your goals and discuss your surgical options. Carefully review many of the surgeon's before and after photos before you decide. Best wishes, Dr. Richard Swift

Keith J. Attkiss, MD · Answer

The problem is really the loose skin around the belly button, not the small muscle separation. Even if the muscle could be fixed via an endoscope, it wouldn't make any improvement. There is no scarless way to tighten the skin around the belly button. Fortunately or unfortunately, depending on your perspective, you fall into the category of someone who looks too good for a tummy tuck and the required scar.

Jourdan Gottlieb, MD · Answer

One finger width is a pretty normal amount of separation of the rectus muscles--they do not normally touch. At any rate, an attempt to bring the muscles closer together will likely cause more redundancy of the skin. It is unusual to be able to correct laxity around the navel with only an incision around the navel, but an in person consultation with a plastic surgeon is the only way to find out.Best wishes.

Endoscopic Diastasis repair? (photos)

Answers (5)

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