I Have Rectus Diastasis Along with a Ventral and Umbililical Hernia. Do I Need a TT Too? (photo)

I Have Rectus Diastasis Along with a Ventral and Umbililical Hernia.  I Am Really Struggling with the Decision to Have a Tummy tuck along with the repair. I have a small frame, weigh around 123 pounds. I do not have stretch marks or extra skin, but I obviously have a pooch from the approx 1-2" diastasis. I am afraid of having extra skin after the repair. However, I am really struggling with paying thousands of dollars if it is not necessary. I am very active and workout regularly. Is this something that you I could tone up after the repair, or do you feel that I will have extra skin there following the repair?

Doctor Answers 9

Tummy tuck changes the location of the scar for some hernia repairs

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for your question and the photos. Yes, your umbilical hernia and ventral hernia can be repaired directly on the abdomen by a general surgeon.  However, if it is done directly this way then you will have the scars on your abdomen to prove it.  It appears from your photos that the diastasis goes from down low all the way up to your rib cage. You also have hernias in the same area All of this can be addressed through a low transverse tummy tuck scar by a board-certified plastic surgeon comfortable doing this if you want the scar to be more concealed. To be sure, see two or more board-certified plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery.  Rectus diastasis does not get better on its own.  I hope this helps.

Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews

Extra skin after hernia repair

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Without actually examining you and your skin, it is impossible to judge how likely it would be to shrink back after repair and removal of the underlying "pooching" tissues. If your skin elasticity is good, there may not be a problem and you would look fine. If your elasticity is poor, that probably won't happen. Toning your muscles postoperatively will improve the muscles but not the skin. You should discuss your concerns with your surgeon and plastic surgeon. Good luck to you.

Margaret Skiles, MD (retired)
Sacramento Plastic Surgeon

Ventral and Umbilical hernia repair and Diastasis Recti Repair through an abdominoplasty approach

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

If you have a ventral hernia, an umbilical hernia and diastasis recti, you can have them repaired through the classical midline approach and be left with a very unattractive vertical scar, which cannot be covered up by a bathing suit.  There has been a recent article published on doing a hernia repair through the abdominoplasty incision using mesh to support it.  I highly recommend this procedure.  It is most likely after your abdominal wall is repaired with the mesh for the ventral hernia, umbilical hernia and diastasis recti that you will have hanging skin.  You will be much happier with the result if you combine both procedures.  The insurance company will pay for the ventral and umbilical hernia repair but they will NOT pay for the abdominoplasty.  Being active and working out regularly will NOT tone up sagging skin, but will help your muscles.  You are an excellent candidate for the combined procedure of herniorrhaphy (hernia repair) using an abdominoplasty approach.

Best Wishes.

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

I Have Rectus Diastasis Along with a Ventral and Umbililical Hernia. Do I Need a TT Too? (photo)

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Good posted photos. Based upon only a review of the photos you COULD benefit from abdominal lipectomy. But you need to have the hernia surgeon and PS discuss with you the risk/benefit of this combination of surgeries. 

Is Tummy Tuck Necessary After Muscle Repair

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Without a true physical exam I think itn is  unlikely I could tell you what your skin will be like after the hernia repair. It depends and the character of the skin and its elasticity. You can always just do the repair and give the skin several months to retract, like after a pregnancy, and if it contracts you are done. If it doesn't then you can get the tummy tuck at that time.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Hernia plus tummy tuck

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

If improving the cosmetic aspect of your stomach is a concern to you, then a tummy tuck is warranted. The hernia repair will not make you look better.

Tummy Tuck Candidate?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Give for the question and pictures.

If you are concerned about the presence of “extra skin there following the repair”,  then a tummy tuck will help you. The tummy tuck operation is designed to repair the diastasis recti  and remove the “excess” skin and adipose tissue. Obviously any  hernias present will be repaired at the same time. I do not feel that you will be able to “tone up after the repair”.

I hope this helps.

Tummy Tuck Needed After Repair of Ventral Hernia,Umbilical Hernia and Diastasis Rectus

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Based on your photographs you will have excess skin after repairing your umbilical hernia and diastasis recti. this skin pooch is best corrected with a tummy tuck.

Rondi Kathleen Walker, MD
Washington Facial Plastic Surgeon

Is tummy tuck needed with hernis repair

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Yes, based on your photos I would recommend getting the tummy tuck. Although you only weigh 123 lbs you have extra skin that can be removed and quite a relaxed abdomen. Once the diastasis and hernia get repair the amount of skin redundancy will be worse.

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.