Can abdominal fascia laxity be repaired? (photos)

I was always taught in exams, more mistakes are made by not reading the question carefully than by not knowing the answer. 
1. I (and other thinking surgeons the world over) need to see decent before and after photos before we will accept your assertion 'just as distended, if not worse'. I'm not seeing a peri umbilical or lower abdo scar, so I'm presuming your 'hernia and diastasis repair' was done through the visible paramedian incision?? That was reusing the scar from your back surgery? By a general surgeon not a plastic surgeon? If all these guesses are correct, then I believe you have probably had a typical, not so thorough, general surgery style so called 'repair', and you need a full or mini tummy tuck and a proper, full length divarication repair. Get an ultrasound or other imaging to see just how much your recti are currently separated.
2. Dr Robert Frank's point, that divarication repair only addresses horizontal laxity of the recti, and not vertical laxity, is important. Presuming your repair is actually full length, and is not dehisced, now, 3 months after surgery, you can seriously start work (outs) on your recti (or core muscles in the vernacular) to strengthen + shorten them in the vertical plane. 
I hope this has been helpful, and good luck.
PS, if I'm correct about my guesses in 1., your belly button is at high risk of dying (necrosis) if you now have a full tummy tuck. 

Dear ChWchester,
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

Thank you for your question. Based on your photos you will achieve your body goal with a full tummy tuck combined with intense liposuction including abdomen, waist, laterals and upper and lower back to improve your body contour and get better curves, especially in your waist area.
Kind regards,Dr. Emmanuel Mallol Cotes.-

Thanks for your question. You appear to be a good candidate for a tummy tuck. Tummy tuck, also know as abdominoplasty, is a procedure to remove excess skin and fat from the lower abdomen and to restore the weakened abdominal wall, giving a firmer and smoother appearance.  We nearly always add liposuction to our tummy tucks to sculpt the body 360 degrees to achieve an ideal feminine figure.  Tummy tuck is a very powerful technique in the right hands, and can have dramatic results if done correctly.  You definitely have to choose your surgeon correctly and make sure that he/she has the training and experience to meet your goals with absolute safety.  Don’t settle for less than a Board Certified Plastic Surgeon with specialized expertise in this procedure.

Thank you for your question.
It appears that your abdominal fascia laxity / hernia was repaired through the vertical scar on your stomach. I do not see any signs of a full tummy tuck procedure. If that is the case you will need a Full Abdominoplasty with repair of the fascia. Occasionally a mesh may need to be used. Please find an experienced Board Certified Plastic Surgeon near you who can examine you and help you with your concerns. All The Best !

Hello and thank you for your question.  The best advice you can receive is from an in-person consultation. If you have diastasis (separation of muscles), this can be repaired with surgery.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.  

Best wishes and good luck.


Richard G. Reish, M.D.  FACS

Harvard-trained plastic surgeon
 

The technique I use to repair abdominal fascia is abdominoplasty with mesh reinforcement.  The mesh is large, approximately 10 inches x 14 inches, which reinforces the entire bottom half of the abdominal wall from about 1 inch above the umbilicus down to the pubic bone.  This technique 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.

Often the weakness to the abdominal wall after a tummy tuck is something that has to be improved through core muscle strengthening...that is to say, working out. Through your pregnancies and surgeries, your abdominal wall has "bowed", and flattening that bowing will take strengthening your abdominal muscles. Good luck.

I am sorry for your issues. Please realize that there are always potential problems with surgery and sometimes the surgery needs a revision. In your case, it appears that you will need a full abdominoplasty with rectus repair. The bulge needs to be assessed to rule out a recurrent hernia. I would follow up with your doctor and seek a second opinion if you are not comfortable.

Thank you so much for sharing with us your question and photos. I’m sorry to read that you recovery is not what you expected.
In this case when patients concern is about laxity is very important to have a physical examination, a photo consultation will not be the way. However, to answer your questions, a Tummy Tuck with muscle repair will help you to get the results what are you looking for. 
Please contact a Board Certified Plastic Surgeon who can help you.
Best regards,
Dr. Quiroz!