Thinking mommy makeover - diastasis recti? Mini or full? Can diastasis be fixed in mini? (photos)

I am a religious exerciser doing "extreme" workouts 6x per week and I eat "clean" 90% of the time. when I do the "test" for diastasis recti lifting my head off the floor I can get three fingers in there. Would that be worth fixing in a TT? My belly button looks the way it does because I had an umbilical hernia repair when I was 19 which was again repaired at 23. This repair ripped apart and my body filled the hole with scar tissue. Add two pregnancies and voila. Any advice? Thank you!

Doctor Answers 11

Thinking mommy makeover - diastasis recti? Mini or full? Can diastasis be fixed in mini?

You seem to be a good candidate for the full tummy tuck.

Kenneth Hughes, MD

Los Angeles, CA...........

What is a Tummy Tuck?

A tummy tuck is a wonderful procedure to contour the abdomen, hips and into the back. It consists of three main components:

  1. Removal of excess or loose skin
  2. Repair of stretched muscles of the abdominal wall
  3. Removal of subcutaneous fat of the abdomen and hips
Every tummy tuck is individualized to each person, no two tummy tucks are the same. Some people need muscle repair and no skin removal, some with skin and fat removal and no muscle repair. Also, the length and position of the scar varies based on the anatomy of the patient. Here are some examples of names and types of tummy tucks:

  • Mini tummy tuck
  • Tummy tuck with an umbilical float
  • Tummy tuck with a "T" extension
  • Standard tummy tuck
  • Extended tummy tuck
  • Circumferential or belt tummy tuck (also know as a lower body lift)
  • Fleur De Lis tummy tuck
This is a major operation and should only be performed on healthy patients in ideal situations. Child bearing will need to be finished (permanently) as any future pregnancy will ruin the results. Smokers are not invited as smoking damages the blood vessels necessary for proper healing and the cigarette smoke deprives the cells of much needed oxygen to survive.

A major break through in pain control after tummy tucks has occurred recently, the use of Exparel. Exparel is a long acting local anesthetic that is injected into the muscle and skin at the end of the tummy tuck procedure. It lasts 3-4 days and allows the patients to be almost pain free in the immediate post operative period. This allows for less narcotic use, better ambulation, decreases the potential incidence of blood clots in the legs and quicker return to normal activity and work. It also allows for this procedure to be performed as an outpatient in an ambulatory surgery center.

Tummy tucks can also be combined with other procedures such as liposuction, Brazilian Butt lifts, breast implants, breast lifts, breast reductions, arm lifts and thigh lifts. These combination procedures are referred to as the "Mommy Makeover". Of course, mommy makeovers are all customized to each individual and may require just liposuction to the abdomen and not a tummy tuck. The cost and recovery will vary from each combination procedure, there is not a set price for the "Mommy Makeover".

Based on the demographics and photos presented I would recommend the following: a standard tummy tuck.

Good Luck!

David Finkle, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 70 reviews

Thinking mommy makeover - diastasis recti? Mini or full? Can diastasis be fixed in mini?

There are a variety of tummy tucks that can produce a good cosmetic result in the appropriate patient: a mini tummy tuck, a modified with an umbilical float, or a variety of a full abdominoplasty, all of which may, or may not, include tightening of the muscle, repairing a diastasis recti, and liposuction. Generally if there is significant loose skin above the umbilicus (belly button), a full tummy tuck will result in a greater correction and better outcome.

Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you what to do based on two dimensional photos without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Mini or not

You work out 6 days a week and eat healthy 90% of the time. You are not the type of person that is willing to accept "MINI" results which is what you will get with a "mini". You knew the answer to your question when you wrote it but wanted someone to confirm it's confirmed, you need the full abdominoplasty

William Aiello, MD
Orange County Plastic Surgeon
4.9 out of 5 stars 30 reviews

Mini TT vs Full TT

Hello,  Thank you for your question.   The ideal patient for mini TT is the one that  only have excess of skin below the belly button and no diatasis recti above the belly button.  In your  case I  wouldn't offer you a mini TT because of    the  diastasis.   I recommend a full TT.  

Derby Sang Caputo, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 59 reviews

Thinking mommy makeover - diastasis recti? Mini or full? Can diastasis be fixed in mini?

Thank you for the question and pictures. Based on your pregnancy history, photographs, and stated goals, you will do best with a full tummy tuck operation. In my practice, I would not offer you a mini tuck operation.

Generally speaking, the “ideal” patient for tummy tuck surgery is one who has completed pregnancies, is psycho socially/emotionally/financially stable, has an excellent social support system surrounding him/her, is capable of arranging enough recovery time, does not smoke and who has reached a long-term stable weight.

In my opinion, the mini tummy tuck is an operation that produces very limited results and is very rarely indicated. It involves a shorter incision but does not address the majority of the abdominal wall issues present for most patients who present consultation. For example, the area of skin excised is quite small. The abdominal wall musculature is addressed below the umbilicus leaving the upper number wall potentially lax. The appearance of the umbilicus is not necessarily addressed sufficiently.

For the vast majority of patients who have had pregnancies and/or weight loss a full abdominoplasty is necessary to achieve the desired results. When the time is right, seek consultation with board-certified plastic surgeons who can demonstrate significant experience helping patients achieve the types of outcomes you would be pleased with.  You may find the attached link, dedicated to tummy tuck surgery concerns, helpful to you as you learn more. Best wishes.

Tummy tuck options with mommy makeover

The pictures are very helpful but really there is no substitute for an in-person evaluation. From what I see you probably do have a diastasis (muscle separation) which as you have proven is not correctable with exercise. That would most likely be a part of the tummy tuck plan regardless of whether it is a mini or one of the variations. 

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 45 reviews

Full tummy tuck

From these photos, you seem to be a great candidate for a mommy makeover and should get a result you are very happy with. A full tummy tuck would address your areas of concern. Definitely seek out a board certified plastic surgeon in your area with an expertise in Body Contouring and Aesthetic Breast Surgery for a consultation. Be sure to express your expectations and goals to the surgeon your choose. Good luck, Dean Vistnes.

M. Dean Vistnes, MD
Bay Area Plastic Surgeon
5.0 out of 5 stars 40 reviews

Abdominal laxity

Properly  done a modified abdominoplasty can easily address most of the issues you've raised.  Stretched bellies with minimal upper laxity will benefit from a limited incision with lowering of the umbilicus (umbilical float) , and tightening of the muscles. I have done this many times with very good results and happy patients.  The previous umbilical scarring may need to addressed at another time.

Fred H. Siegel, MD
Chesapeake Plastic Surgeon
4.0 out of 5 stars 1 review

There is almost never an indication for a mini tummy tuck.

If you can deal with the resulting incision you would be an excellent candidate for a full abdominoplasty. Don't waste your money on a mini tummy tuck. It's a waste of money.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 32 reviews

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.