Is diastasis recti repair more difficult for a severe gap width (8cm) and length? Can good/lasting results be achieved? (photos)

Question

I'm considering a tummy tuck for repair of a severe diastasis recti that I have not been able to narrow with any conservative therapies. I also have the associated low back pain, minimal core strength and urinary leakage often found with diastasis patients. I've heard about use of mesh for repair of severe diastasis recti. What are the recommendations in this regard. Any risk of reoccurrences? I'm 5'8" and currently weight 164 lbs. 3 pregnancies with large babies. Thank you for your time.

Chad K. Wheeler, MD · Answer

Repair of significant diastasis does not mean you are more likely to fail.  Typically mesh is only used if there is a large hernia or failed repairs in the past.

Kenneth Hughes, MD · Answer

Suture plication is appropriate in primary diastasis repair without hernia. I have not used a mesh in about 1000 tummy tucks, but there may be a need in certain instances for mesh. Consult via email or Skype with a board certified PS to discuss your treatment plan.

Gary M. Horndeski, MD · Answer

As you can see from your side view photographs, your abdomen looks like you are still pregnant. This is from the damage to your fascia and the only way to correct this is with mesh reinforcement. If you are not planning future pregnancies, I recommend abdominoplasty with mesh reinforcement. The mesh creates a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear nursemama2011,
based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ronald J. Edelson, MD · Answer

8cm is a pretty wide diastasis but it should be able to be repaired without mesh especially since you are pretty thin. I would not say it is wrong to use mesh but I think you could get different answered from different surgeons on that issue.

Robert M. Tornambe, MD · Answer

I appreciate your concerns and frustrations, however it appears from your photos and the information you provided that traditional tummy tuck with abdominal wall placation would be the best option for you. It is doubtful that mesh repair would be needed in your case. Consult with a board-certified plastic surgeon in your area to explore the best options for you. Good luck.

Camille Cash, MD · Answer

Though an 8cm diastasis is more severe, you can still expect great results from a tummy tuck.  You should see significant improvement after repair.  Each surgeon will have his/her own method to address this including suture choice, mesh, etc.  I encourage you to visit a few board certified plastic surgeons in your area for consultations so that you can listen to varying opinions.  Select the one that best matches your goals and expectations and with whom you feel most confident.

Bradley Remington, MD · Answer

Hello,
Thank you for your very commonly asked questions about the post-pregnancy abdomen.  I agree that it is the abdomninal wall laxity that is the major issue and that the rectus muscles have separated, as well as significant stretching of the anterior abdominal wall.  I am not in favor of mesh in patients such as yourself, as I feel that I can obtain excellent results using your own tissue with judicious tightening of the recti and further plication of the fascia.  A physical exam is best to determine the best option for improvement.  Seek a board certified plastic surgeon with an extensive experience in abdominoplasties and consider the options.
Cheers,
Brad Remington, MD

Robert Singer, MD · Answer

Based on your limited photos and your 8 cm. diastasis, you appear to be anatomically a candidate for a full tummy tuck and liposuction of selective areas. It is difficult to tell whether you are a good candidate without a physical examination and complete medical history. It would depend on your anatomical findings, motivation, realistic expectations, and whether you are finished having children. An abdominoplasty should be delayed until you are within 10 pounds of your ideal weight and have a BMI less than 30. Lesser procedures will not produce a good cosmetic result in a patient with your anatomy.

If a member of my family underwent a tummy tuck, it would be performed by an experienced plastic surgeon who is board certified by the American Board of Plastic Surgery and a member of the American Society for Aesthetic Plastic Surgery (ASAPS) . If you are serious about undergoing these procedures, you should have a thorough consultation with a plastic surgeon having those credentials, who will fully explain what is entailed in the procedures, including both the positives and potential problems. You should be complimented on the fact that you are seeking valid information before jumping into any procedure.

Robert Singer, MD FACS

La Jolla, California

Paul B. Mills, MD · Answer

Thank you for your question. The good part about having a significant diastasis is that you will have a more dramatic improvement once this is corrected. Though 8 cm is considered significant, it does not necessarily increase your risk of recurrence. Likely your surgeon will use permanent sutures for the repair though mesh could be considered. However, I feel that it is unlikely that you will require mesh for the repair but this may be surgeon dependent. I hope this helps and good luck with your surgery.
Best, Paul Mills MD

Is diastasis recti repair more difficult for a severe gap width (8cm) and length? Can good/lasting results be achieved? (photos)

Answers (11)

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