No diastasis recti but still bulging of the abdominal wall. Which kind of surgery will help? (Photo)

Question

I am a 31 y old fit mother of three. My last pregnancy was really rough on me. I gained about 18kg, have stretch marks on my lower abdomen and, this is what really bothers me, my flat belly is history. I do not have diastasis of the rectus muscle. Just a bit at the belly button level (I can fit in my index) but still my abdomen is protruding (sup.+inf.)especially after meals. I am already working out but it doesn't seem to help at all. Is there a special kind of surgery to fix this?

Kelvin Eusebio, MD · Answer

Dear Alighnt,Thank You for sharing pictures with your question. You are a great candidate for a tummy tuck. You have saggy skin and some muscle separation.  A TT will remove the fat-skin excess and fix the muscle for a flatter belly. I would recommend you some lipo to improve the body shape. Best wishes

Glenn Vallecillos, MD, FACS · Answer

Hello and thank you for the question.I would have to examine you to give you a recommendation. Additionally, the photos you posted are incomplete. I am concerned that you may have lordosis which can give the appearance of a protuberant abdomen, even in the face of a lack of diastasis - this will absolutely have implications on your final desired result of a " flat abdomen".  Additionally, the abdominal protrusion is accentuated after eating, and especially if your diet is leading to bowl inflammation which contributes to " bloat " - a very common occurrence, by the way.  I would review the aforementioned with your doctor before considering a tummy tuck, as you may be disappointed with the results otherwise. Best of luck,Glenn Vallecillos, MD, FACS

Larry Lickstein, MD · Answer

Sorry to hear that your pregnancy was so rough, and that it has caused such a dramatic change to your figure.  While nothing substitutes for a thoughtful physical exam, your images suggest that you would be a great candidate for an abdominoplasty, likely with some adjuvant liposuction.  The tummy tuck would permit tightening of the abdominal muscles, even in the absence of a diastasis.  Think of it as if you are putting on a corset, but the corset is on the inside.  In addition, the skin and fat on the lower abdominal wall would be removed.  The remaining soft tissue could be contoured and the skin redraped smooth.  Consider a formal consultation, and be reassured that significant improvement can be achieved!

Mark Edinburg, MBBCH, FRACS (retired) · Answer

Hello and thank you for your question.It would appear that you would benefit from a tummy-tuck(abdominoplasty). This will assist in correcting the layers that contribute to the bulge and slight droopiness. It's hard to tell but some liposuction may also help. I generally offer some in the abdominal area as  a part of my tummy-tucks, and then some people require additional liposuction.Nothing ever substitutes for a face-to-face consultation so please remember I don't believe you can make any decisions about planning until you have seen a a Specialist Plastic Surgeon.That's the only way I can accurately assess the specific nature of your concerns, and make an accurate assessment which will help me put together a surgical plan for you. In my many years of doing this surgery, if I have learned anything, it is that patients are always slightly different from each other, and that my surgical plan is tailored slightly differently to each person.I hope this has been of value for you. Good luck in your journey.

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