Is a Procedure Possible? RA, Diastasis, and Hernia

I have had 3 pregnancies; the last with twins. I have diastasis with a 3 finger gap. I have terrible 1/4" thick stretchmarks throughout my belly. I am 5'2", and around 95lbs. I am tiny everywhere, but my belly, which leaves me looking pregnant. I was told I have a hernia, and want that and the diastasis repaired. Will a general surgeon repair it, or will I need two Drs.? I also have RA and take methotrexate injections and Rituxan infusions. Will anyone work on me? Will I have a "normal" belly?

Doctor Answers 5

Tummy Tuck and Hernia Repair?

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Thank you for the question.

Based on your description, you sound like you are an excellent candidate for tummy tuck surgery.

“Optimization” of your RA  will be helpful prior to surgery; perioperative management of your medications by a rheumatologist will also be helpful.

Depending on your plastic surgeon,  the  hernia can be repaired  by many plastic surgeons at the same time as tummy tuck surgery ( without the need for a general surgeon).

Best wishes.

Tummy Tuck With Rheumatoid Arthritis

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You probably can have a tummy tuck with either diastasis repair or herniorrhaphy, although you should ask your rheumatologist for his/her opinion.  It sounds as if you have a very wide diastasis rather that a true hernia.  If so a plastic surgeon should be able to perform your pricedure alone.  On the other hand, if you do have a true hernia, it is usually appropriate to have a general surgeon perform that portion of the procedure.  You are at a somewhat increased risk of wound healing problems because of your anti-arthritic medications.

John Whitt, MD (retired)
Louisville Plastic Surgeon

Tummy Tuck San Diego

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Congratulations on twins!  Your plastic surgeon should speak with your rheumatologist regarding perioperative management of the RA.  The methotrexate and Rituxan will probably need to be changed to alternative medications before and after the procedure, until you heal.  If the RA can be controlled with other medications, temporarily, it sounds like you are otherwise an excellent candidate for tummy tuck.  Your small hernia can be fixed by the plastic surgeon at the time of the tummy tuck, and will be imbricated anyway with rectus abdominis plication.

Steve Laverson, MD
San Diego Plastic Surgeon
4.9 out of 5 stars 50 reviews

Tough tummy in PA

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You sound like you have a tougher than normal situation.  Many of us experienced plastic surgeons have also been Baord Certified in Surgery so would feel very comfortable with your hernia also.  I'd suggest you contact Dr. Ken Shestak in Pittsburgh as he is excellent and could give you great advice.

"Can I have an abdominoplasty?"

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It sounds like you have a couple issues, but with a proper medical workup (and depending on the location and size of the hernia), most patients in your situation should be able to safely have a tummy tuck by a plastic surgeon. A small umbilical hernia can often be repaired by your plastic surgeon at the time of abdominoplasty, but a large hernia located in your abdominal wall may require a general surgeon to repair the hernia first or at the time of the abdominoplasty.

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.