Have I developed diastasis recti? (photos)

Question

I had laparotomy 13 months ago with colostomy, then 5 months later had colostomy reversed with another open abdominal incision. My belly is bulging out, more so on the right, so there's asymmetry. I understand that after two abdominal surgeries I didn't expect my belly to look great but it seems to really bulge out much more than I expected. I'm 5'2" 128 lbs.

Daniel Careaga, MD · Answer

anytime a patient has multiple abdominal surgeries, especially those involving colostomies, there is a risk of hernia formation. The difference between a hernia formation stasis is that a diastasis is a weakness of the abdominal wall while a hernia is an actual hole in the abdominal wall. Looking at your pictures, I’m concerned that the area to the left of your incision appears to be a hernia. I would recommend seeing the surgeon that performed your colostomy reversal and possibly a CT scan. If there is indeed a hernia repair options can be discussed with the general surgeon. It would be very unusual to get diastasis located in one particular part of the abdomen.

Jerimiah Mason, MD · Answer

There's a big difference between a hernia and diastasis recti, and in your case, with the larger operation you have had, it's almost definitely a hernia you have.  This is an actual hole in the fascia (the muscle layer) in which bowel and fat can get stuck in, which can turn in to a surgical emergency.  I would notify the surgeon who did your colostomy as soon as possible, they can very likely manage hernias as well.

Chad Deal, MD · Answer

While there could just be cosmetic reasons for the bulge, it would be best to have a CAT scan done first to make sure that you don’t have a hernia from the previous surgeries. If there is a hernia, this needs to be fixed first before you do any cosmetic work. If it’s truly just uneven fat and tethered scarring this can easily be fixed with advanced liposuction techniques, certain technologies, like the Vaser, and scar revisions. It is very impossible for you to have a final beautiful result.

Daniel Serralta, MD · Answer

Dear Ann, I'm sorry to communicate you that this looks an incisional hernia, not a diastasis recti. To consider DR we need the midline of the abdomen to be untouched. If there is a previous surgery the diagnosis, management and expectations are different.
Good luck

Vincent Gardner, MD · Answer

Hi AnnC69,Based on your photos and background information I think you may have an abdominal wall hernia also called an incisional hernia. These are common after abdominal surgery. Could be related to your midline incision or where you had the colostomy. This really needs to be assessed prior to considering anything cosmetic. Work up would include a good physical exam by a surgeon possibly followed by some imaging such as a CT scan. If a hernia is identified then you would need repair most likely with mesh. Once that is complete then I would reassess your symmetry. If you still have some issues you could consider liposuction and possibly a tuck if needed. Again, that would be my my recommendation based on the info and pics you provided. I hope this help. Good luck!

Have I developed diastasis recti? (photos)

Answers (5)

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