Is it possible to “heal”/close diastasis recti gap as much as possible but still have a protruding stomach?

Question

I have had 4 kids (ages 6,4,2,1) I have a diastasis along with umbilical hernia. I have tried for just over a year now to heal the diastasis and have what I feel now to be a “functioning diastasis” (no incontinence, back pain, pain during sex, etc) but I still have a small pooch and my stomach ends up looking 5 months pregnant come by mid/end of day. I am “fit” everywhere except stomach is very squishy. Is it “is what it is” at this point and the fascia is just irreplaceably overstretched?

Rady Rahban, MD, FACS · Answer

Thank you for your question!  Diastasis recti is a condition that is a result of internal pressure leading to the stretching of the connective tissue responsible for holding the left and right abdominal muscles in the midline. Circumstances such as weight gain, and pregnancy are culprits to the development of diastasis recti. The good news, there are treatment options. However, the most sustainable treatment option is surgery to manually plicate the abdominal wall. Although it's always a good idea to strengthen the accessory muscles as much as possible pre-surgery, diet and exercise alone will not be able to "cure" the damaged fascia.  Surgery becomes the most viable option to address the root of the issue.

I highly recommend seeking a Board Certified Plastic and Reconstructive surgeon and schedule an in person consultation. I have extensive experience with diastasis recti repair ranging from mild to severe with excellent results. I've attached a link with some information pertaining to diastasis recti repair that can be helpful as you navigate this process.

J. Jason Wendel, MD, FACS · Answer

Thank you for your question regarding your abdominal muscle separation.

It might also be helpful if photos were included.

Based on the information you provided, it does not sound like you have had any surgery. By your description, it sounds like you would be a great candidate for a tummy tuck which would repair your abdominal muscles separation.

To be sure, I recommend having an in person consultation with two or more experienced board-certified plastic surgeons in your area.

Adam Kinal, MD · Answer

Although exercise is necessary and recommended with or without surgery, it cannot repair skin that has been damaged or lost its ability to spring back. Typically, the more children, the more the skin has been stretched and potentially has Stretch marks (striae). Once the skin has striae, it usually does not spring back, the same as healthy skin. Some doctors will suggest some abdominal exercises to tighten the abdominal wall. Still, if the abdominal muscles (six-pack ab muscles) separate too much, they may need surgery to correct them. I recommend having several in-person consultations with a Board Certified Surgeon specializing in these procedures. Good luck.

Adam Bauermeister, MD · Answer

Hi, 
It is most likely that what you're describing is rectus diastasis. This often occurs following pregnancy, especially multiple pregnancies, or significant weight fluctuations. This occurs naturally as the body makes room for the growing uterus (and developing baby) during pregnancy, but impacts woman differently. 
The "six pack" muscles (rectus abdominis) stretch apart at the midline, and the fascia (connective tissue) becomes weakened. Oftentimes this causes a bulge of the lower abdomen leading to a loose, sagging abdominal appearance or "belly pooch" postpartum, once the uterus returns to its pre-pregnancy size. 
Some women don't have muscle separation or they don't get loose skin. The vast majority, however, experience changes to their bodies from pregnancy, to varying degrees. 
Rectus diastasis will NOT go away with diet and exercise, and it is not "baby weight". Rather, it is torn and stretched fascia. The muscles require a physical repair to bring them back together. Rectus diastasis repair is usually performed in conjunction with a tummy tuck to address loose skin, excess skin, and excess fat. 
Hope I was able to answer your question. If you want to learn more about abdominal muscle separation repair (aka rectus plication). Feel free to reach out to my office to book a consultation. 
Dr. Bauermeister.

Daniel Barrett, MD · Answer

Dear LuckyMamaTo4,
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. Flanks liposuction would give you a better shape. 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

Is it possible to “heal”/close diastasis recti gap as much as possible but still have a protruding stomach?

Answers (7)

Answer: Is it possible to "heal" a rectus diastasis without surgery?

Answer: Is it possible to "heal" a rectus diastasis without surgery?

Answer: Tummy tuck

Answer: Tummy tuck

Recommended reading

Everything you need to know about Diastasis Recti Repair

Our mission is to create a world where every investment in modern beauty is Worth It.

Is it possible to “heal”/close diastasis recti gap as much as possible but still have a protruding stomach?

Answers (7)

Answer: Is it possible to "heal" a rectus diastasis without surgery?

Answer: Is it possible to "heal" a rectus diastasis without surgery?

Answer: Tummy tuck

Answer: Tummy tuck

Browse related questions

Recommended reading

Everything you need to know about Diastasis Recti Repair

Our mission is to create a world where every investment in modern beauty is Worth It.