Is It Safe to Have Laser Liposuction if I Have Diastasis Recti?

Question

Is it safe to undergo laser liposuction if I have Diastasis recti? If not, is that something the surgeon should check for when you go in for a consultation?

Thomas Wright, MD · Answer

Diastasis recti, is a condition that occurs when the rectus abdominis muscles separate, or stretch apart, in the middle of the abdomen. It not a concern for abdominal liposuction.  However Diastasis Recti is sometimes associated with abdominal hernia.  Abdominal hernia are a problem and should be fixed before liposuction.  Your sugeon should examine your abdomin closely at your consultation. If there is any question of a hernia I would recommend an abdominal ultraosound.  There are liposuction chains where consults are done by sales people and not finding hernia in the consultation is a real concen.  Wishing you the best.

Eric Chang, MD · Answer

an abdominal diastasis often occurs after pregnancy. the rectus muscles (the ones that make the six pack) slide apart to allow the abdomen to enlarge so that the baby has room to grow. after pregnancy, the muscles often do not slide back together and there is a seperation between them. this is different from a hernia, in which there is a "hole" in the fascia of the abdomen. it is dangerous to have liposuction when one has a hernia, since it is theoretically possible for the cannula which removes fat to enter into the abdominal cavity and cause damage. since, in a diastasis, the fascia is intact, iiposuction is safe here. that being said, if the diastasis is bad enough, you may be better off having a tummy tuck, since this layer can be tightened.

Evan Sorokin, MD · Answer

I have to agree with Dr. Cambre's excellent answer.  I would just like to add that many laser liposuction docs are not plastic surgeons.  I see ladies over and over that go get Smartlipo (or the equivalent) done somewhere else and then are unhappy with the results because truly they needed a tummy tuck.
I also see many ladies who come into my office initially requesting Smartlipo when they need a tummy tuck.   My advice would be to go see a doctor (plastic surgeon preferably) who performs all of these procedures.  If he only offers Smartlipo, then you will probably be offered that procedure.  Go see someone who can evaluate your abdominal wall and give you an honest, thorough recommendation.
A diastasis is never repaired or improved with liposuction of any type.

Athleo Louis Cambre, MD - Account Suspended · Answer

Diastasis Recti refers to a separation of the paired Rectus Abdominus muscles, which run vertically down the center of the abdomen from the lower ribs to the pelvis.  Diastasis Recti typically develops as a result of relaxation of the abdominal wall fascia (the fibrous tissue between the muscles), most commonly as a result of pregnancy.  Diastasis Recti is not a true hernia, since the abdominal wall muscle and fascia remain intact but functionally weak, and there is no protrusion of abdominal contents through the diastasis, even though a paradoxical "bulge" (which looks like a hernia) may be present when patients with diastasis perform a sit-up or straight-leg raise, tensing the abdominal wall.
By itself, Diastasis Recti should not prevent a surgeon from performing liposuction, either laser or traditional liposuction.  However, before performing liposuction, your surgeon should carefully evaluate your abdominal wall musculature.  Many patients have an umbilical hernia, which usually involves protrusion of a small wad of fat (pro-peritoneal or omental) from inside the abdomen.  Umbilical hernias and other abdominal wall hernias may also include loops of intestine in addition to the intra-abdominal fat.  These hernias CAN present problems if liposuction is done without making note of, or correcting the hernia first, since bowel injury may result.  Patients with Diastasis Recti also typically have relaxation of the (hypogastric) lower abdomen below the belly button, which will not be corrected by liposuction in any case
If Diastasis Recti is severe enough, and there is diffuse laxity of the abdominal wall, liposuction may in fact be the wrong choice of operation.  If there is excess skin and fat in addition to laxity of the abdominal wall, an Abdominoplasty or Tummy Tuck is most likely the better option.  During this procedure, the wide separation between the rectus muscles is sutured together, strengthening the abdominal wall and narrowing the waistline in the process.
If you have Diastasis Recti, do the right thing.  Consider Abdominoplasty rather than liposuction alone, if weakness of the abdominal wall is the problem.  Correct the Rectus.

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