Is biological mesh recommended to repair diastasis recti? (Photo)

Question

I'm planning a tummy tuck to repair my diastasis recti. One surgeon recommended the use of biological mesh, Galatea. Does the mesh offer better outcomes? If the fascia is super thinned, wouldn't a failure still occur even with the mesh because the fascia wouldn't be able to hold the stitching of the scaffold? My understanding is that the mesh is best used for breast augmentation. I've never had abdominal surgery and I'm at my ideal weight. Possible small umbilical hernia, no other hernias.

Ronald J. Edelson, MD · Answer

I have never found it necesssary to use mesh in a tummy tuck in thirty years of practice.  Some surgeons may use it from time to time but I suspect it is the rare case.

Kenneth Hughes, MD · Answer

Based on your picture you seem to be a good candidate for a full tummy tuck with muscle repair, an in-person consultation would be best for a detailed  exam and evaluation.Always see a board certified PS.

Gary M. Horndeski, MD · Answer

From your photograph, your abdomen is quite proturbent.  The strength layer of your abdominal wall is called fascia.  It is likely the the fascia is stretched or torn.  I routinely use polypropylene mesh known as marlex mesh.  It is less expensive (less than $400) compared to the biological mesh.  However, the greatest problem is going to be post-operative compression of your abdominal contents and elevation of your diaphragm.  I recommend you have your surgery done in the hospital and stay overnight for monitoring.Best Wishes,Gary Horndeski, M.D.

Farbod Esmailian, MD · Answer

Mesh is not necessary.  Diastasis is a separation not an actual opening which is then called a hernia.  With smaller hernias, a simple repair would be fine as well and mesh is not necessary.  In a tummy tuck, the muscles are almost always repaired by placing either long lasting sutures or permanent sutures from the xyphoid (breast bone) all the way down towards the pubis.  I like to do this two times for added reinforcement.I would recommend you see a board certified plastic surgeon to discuss your surgical options.

Gerald Minniti, MD, FACS · Answer

Hello,Diastasis recti, no matter how dramatic, needs no mesh. Be sure your surgeon is an ABPS certified/ASAPS member surgeon with at least a decade of experience. Best of luck!

Steve Laverson, MD, FACS · Answer

Mesh is an (expensive) option, and diastasis recti doesn't mean you have thin fascia.  You need quality abdominoplasty with short, low scar resulting in flat, naturally beautiful abdomen to be happy.  If fascial strength is a concern, have Galatea ready to use at time of your procedure, but would only use it to reinforce plication if added structure required to bolster fascial integrity.

Himansu Shah, MD · Answer

Thank you for the question and photo. It is difficult to answer your question without examining you. You can use biological mesh such as Stratice after plication. It is best to be examined by a board certified plastic surgeon to determine what is necessary for you. Good luck.

Daniel Barrett, MD · Answer

Dear 6KT,most plastic surgeons don't use mesh for diastasis recti repair. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. 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

Aric Aghayan, MD · Answer

Thank you for your question and for providing photos. A diastasis is separation of the abdominal muscles in the midline but is not a true hernia. The repair involves bringing the fascia overlying the muscles back to the middle like an internal corset and does not require mesh. It is also important to know that Galatea is an absorbable mesh but it is not a biologic mesh like alloderm or strattice. It has been used for abdominal wall repairs longer than it has been used in breast procedures but it is not likely necessary for your procedure. It would be reasonable to consider if the primary repair failed and required a revision, but that would be very unusual. Make sure that your are seeking consultation with an experienced plastic surgeon. Good luck.

Liana M. Lugo, MD · Answer

Hi! Thank you for the question and for your picture. Diastasis means separation. Recti refers to your abdominal muscles called the rectus abdominis. The distance between the right and left rectus abdominis muscles is created by the the linea alba. The linea alba is a connective collagen sheath created by the aponeurosis insertions of other abdominal muscles. Diastasis recti is defined as a gap of approximately 2.7 cm or greater between the two sides of the rectus abdominis muscle. This separation can be corrected during your tummy tuck by creating a plication or folding of the linea alba and suturing together. This will give you a tighter abdominal wall. Most plastic surgeons won't use mesh for diastasis recti repair. Get a second opinion with a board certified plastic surgeon. I hope this helps and best wishes!

Is biological mesh recommended to repair diastasis recti? (Photo)

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