Is it possible I have a hernia in the posterior sheath in conjunction with my DR? (Photo)

I get significant doming when laying back of my TVA's aren't properly engaged. If engaged it is reduced quite a bit. I have diastasis recti from the navel down. Can I have a deeper hernia from the navel to sternum?

Doctor Answers 5

Is it possible I have a hernia?

Dear Diastasis

You clearly have diastasis, to determine if you have a hernia, you would need an examination by your doctor. If I had to guess, you are likely to have a small umbilical hernia based on how you have hollowing and stretching of the area just above your umbilicus.
The entire area would be repaired at the time of an abdominoplasty. I will add that a component separation and or posterior and anterior fascia repair is usually unnecessary and even harmful. From the limited info in photographs and your previous posts, you will do very well with an abdominoplasty with rectus plication. On occasion, oblique muscle plication might be beneficial (not often at all).

Bay Area Plastic Surgeon
4.9 out of 5 stars 55 reviews

Is it a hernia?

From the photo what you have is typical for diastasis rectii.  A hernia is an actual hole in the muscle fascia.  A diastasis is stretching out of the fascia but without an actual hole.  A physical exam can easily answer this question.

Dev Wali, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 56 reviews

Hernias and diastis

Thank you for your question and photos.
I assume this happened after pregnancy or Massive weightl loss.
Both conditions result in the same presentation and anatomical deformity.
The two central muscles(rectus abdominis) will separate (like a expansion joint) 
during increased intraabdominal size (pregnancy or weight gain).
Upon returning to a normal state (postpartum or weight loss) the muscles often do not return to their prior position because of the stretched fascia= diastasis recti.
Unfortunately, excercise will not improve on this separation of the rectus muscles.
Diastis Recti can occur from the breast bone (manubrian) to pubic bone.
The cleft you demonstrate is quite common and is repaired during a abdominaloplasty.
Hernias can occur in various other areas...of the abdomen and usually readily found on examination.

I suggest seek a consultation with:
1) Bd. Cert. Plastic Surgeon
2) ideally fully trained in Gen. Surgery (trained to repair ALL abdominal hernias)
3) member of the Am. Soc. for Aesthestic Surgery (demonstrated experience in 
   focusing on Aesthestic Surgery is a qualification for acceptance)

I wish you and yours a Happy Mothers Day!!

Robert A. Hardesty, MD, FACS
Riverside Plastic Surgeon
4.8 out of 5 stars 98 reviews

Diastasis recti

Your diastasis appears quite significant.  The midline is one fused layer of tissue and the entire rectus can be tightened in one layer.  It doesn't need to be done in separate layers. It is possible you have a true hernia in addition to the rectus diastasis but that can be determined only by examination.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 27 reviews


Yes you could have a hernia. 

The way to diagnose it can be a simple medical examination ideally by a plastic surgeon or general surgeon. A CT scan or MRI may be needed as well.

The ideal way to fix it it to have a plastic surgeon approach it through an abdominoplasty incision in the lower abdomen.

John M. Anastasatos, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 29 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.