Should I Wait to Have More Kids Before Fixing Diastasis Recti and Hernia?

Question

I have a 9 month old and 2 year old, both C-sections. I would like 1 or 2 more children, but am concerned about my combination of diastasis recti and a hernia which make me look like I am 6 months pregnant.  The General surgeon wants to install a patch, and would have the plastic surgeon fix my excess skin (no abdomen fat). But I feel I should wait until I’m done having kids. It's getting worse, bigger. Maybe because I work out a lot. Any suggestions? Do I wait? Not do ab work? What are the dangers?

Leslie H. Stevens, MD, FACS · Answer

Although fixing a prominent diastasis recti and hernia will not interfere with future pregnancies, the pregnancy  may reverse or compromised  the end result. I have seen women who have had more children after an abdominoplasty without an adverse effect on the flattened tummy, but this I believe, is the exception. 
Exercise and ab work will not make it better, but it should not make it worse either. The dangers on having a hernia this size are minimal. If you chose to have the tummy tuck either before or after more children, there would probably be no need for mesh, just a solid repair of the muscle separation. Plastic surgeons do this all the time. Good luck with your decision.

Pat Pazmino, MD, FACS · Answer

Tummy tucks are a very popular and effective way to contour the abdomen. During this procedure, we commonly repair the separation in the abdominal muscles known as a diastasis. If you have additional children after a diastasis it is possible that future pregnancies may stretch out this repair. If you don't want to assume this possible risk, your best bet is to wait until you have completed all of your pregnancies and received a single surgery and a single muscle repair.

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Lisa Lynn Sowder, MD (retired) - Account Suspended · Answer

If you can stand it, I would wait until you are done with children.  Tummy tuck is a procedure you only want to have done once!  If you can't stand it, go ahead and get fixed up.  I have had several patients have a surprise baby after a tummy tuck and their pregnancies went fine and their abdomens actually snapped back pretty well.  But you need to be prepared for a revision or even a full redo.As for the hernia, I commonly repair these at the time of tummy tuck.  I slit the belly button down the middle from the center to the 6:00 position, find the hole in the fascia and stitch it up with a few stitches and sew the belly button back up.  I'm super careful with the blood supply to the stalk of the belly button and haven't lost one yet (knock on wood).   I know some plastic surgeons like to have a general surgeon help with hernias but I did full training (6 really long years!) in general surgery prior to doing specialty training in plastic surgery so hernias don't scare me.Aren't children the best?  I would have gone for number 4 but I was too old!

Richard P. Rand, MD, FACS (retired) · Answer

Obviously you should follow the advice of the doctors who have seen you however, from your photo it appears that you have a moderate rectus diastasis and an umbilical hernia. I would normally recommend that you finish having children and repair these later.  In my practice as a Board Certified general surgeon as well as a Board Certified plastic surgeon, I would plicate the diastasis in 2 layers, avoid any mesh and repair the umbilical hernia at the same time.  I would advise that you find a plastic surgeon who also wears both hats so the best option will be available for you.  Fewer and fewer of the younger plastic surgeons have had both board certified training experiences unfortunately.

Should I Wait to Have More Kids Before Fixing Diastasis Recti and Hernia?

Answers (4)

Answer: Wait if possible

Answer: Wait if possible

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Everything you need to know about Diastasis Recti Repair

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Should I Wait to Have More Kids Before Fixing Diastasis Recti and Hernia?

Answers (4)

Answer: Wait if possible

Answer: Wait if possible

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Recommended reading

Everything you need to know about Diastasis Recti Repair

Our mission is to create a world where every investment in modern beauty is Worth It.