I Have a 1.5 Finger Width Diastasis Recti and an Outie Belly Button? (photo)

Exercise will not make you better and may make your hernia bigger. You appear to need full rectus plication and hernia repair. If a complete umbilical skin incision is made you may have loss of adequate blood flow to belly button and skin necrosis. Best option in my opinion is to do hernia repair as insurance procedure with a with mini tummy tuck with full rectus plication. You need to find someone who can do this with only a upper 1/2 belly button incision, I use a narrow lighted retractor and with a good assistant the procedure takes about 2 hours. Good Luck!

     You do not appear to have a lot of skin laxity.  As such hernia repair, outie to innie repair, and plication with small incision minitummytuck may be appropriate.

Thank you for the question and pictures.

You should be quite proud of the appearance of your abdomen ( thanks to your efforts through diet and exercise). Your options at this point include:

1. Repair of the umbilical hernia ( which will obviously address the appearance of the umbilicus, if done by a surgeon with an eye to aesthetics).

2. A full tummy tuck if you wish to achieve a flatter contour of the abdominal wall. Unfortunately, despite your commendable efforts, there's only so much that you will be able to achieve after twin pregnancy and spreading of the abdominal wall muscles.

 Be careful if you are offered the “mini” tummy tuck procedure. In my opinion, the mini tummy talk is an  operation that  produces very limited results and is very rarely indicated. It involves a shorter incision but does not address the majority of the abdominal wall issues present for most patients who present in consultation. For example, the area of skin excised is quite small. The abdominal wall musculature is addressed below the umbilicus leaving the upper number wall potentially lax. The appearance of the umbilicus is not necessarily addressed sufficiently.

 I hope this (and the attached link) helps.