What is the cause of my round belly c7 months post partum? DR is not too big and I do not have any excess fat. Stretched wall?

Hi fantastic 217913 in Zürich,
Thank you for reaching out with your concerns about your round belly seven months postpartum and the possibility of a stretched abdominal wall.
A more thorough medical evaluation is recommended based on your history and photos. I suggest getting a CT scan and comprehensive bloodwork, including liver function tests, to rule out any internal causes. Additionally, knowing your body fat percentage would be beneficial in understanding the overall situation.
Even though the diastasis recti (separation of the abdominal muscles) you mentioned is relatively minor at 2 cm, it indicates weakened abdominal muscles. A tummy tuck, known medically as abdominoplasty, is often considered for three main reasons: excess skin, excess fat, and weakened abdominal muscles. In your case, the primary issue seems to be weakened abdominal muscles.
Thus, a tummy tuck with rectus abdominis muscle repair or tightening could be the appropriate course of action to address your concerns. However, it's crucial to have a comprehensive evaluation first to ensure this path is right for you.
I hope this provides clarity on your situation and helps you take the next steps towards addressing your postpartum abdominal concerns. Best of luck with your journey.
Sincerely,
Dr. Katzen

it may be a good idea to discuss this with your OB/GYN doctor. Maybe this problem has to be explored further. Other problems are excluded, than may be a trip to a plastic surgeon might help.

The abdominal wall has two components: fascia and muscle. Everybody knows what muscle is but fascia is the lining of the muscle. After having a pregnancy, the fascia was most likely stretched and torn and that is why you still look pregnant. If you are not planning future pregnancies, I recommend abdominoplasty with mesh reinforcement. The mesh creates a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight.

Best Wishes,

Gary Horndeski, M.D.

Absent an examination in person a definitive opinion cannot be provided to you, however there are probabilities and possibilities. It would be best to be examined by your OBGYN, as well as an experienced board certified plastic surgeon. That said, a post pregnancy change in the tummy, especially after carrying a large baby, can result in an overall losing of the abdominal wall musculature and fascia such that the result is protrusion of the belly and its contents. What must be ruled out is other causes of an expanded belly, which may require an abdominal CT scan, above and beyond a good physical examination. If all proves to be normal and the diagnosis is indeed a loosening of the tummy muscles, this can be addressed with an abdominoplasty by a skilled board certified plastic surgeon.

I hope this information is helpful to you. Best of luck.

The contour that concerns you is likely a result of abdominal wall laxity after carrying a large baby. An in person evaluation is needed for the best recommendation. If you are finished having children you can consider a tummy tuck which will correct the abdominal laxity. I've included a video I hope you find helpful.

Your pictures help.

This is abnormal.

See your primary doctor for evaluation. organomegaly, ascites. Tumor.

You need some bloodwork and probably a MRI or CT scan.

There are four tissue variables that determine what the abdomen looks like.
Those variables are as follows.
Abdominal skin laxity due to previous pregnancies for weight loss.
Excess subcutaneous fat.
Muscle separation from previous pregnancy.
Excess visceral or intra-domino fat.
Based on your pictures, you don’t have a lot of subcutaneous fat and you don’t have a substantial skin laxity. That means that the problem is either or muscle, separation or excess visceral fat guided.
Most likely it’s a combination of both.
Differentiating the difference between visceral, fat and muscle separation is fairly straightforward, but is sometimes missed by both patients and plastic surgeons.
There are a couple of ways of differentiating to determine which is the primary culprit.
One way is to lay on your back and see if your abdomen goes completely flat.
Muscle separation will not show bulging when you lay on your back.
If your abdomen goes completely flat when you lay on your back, and the problem is more likely related to muscle separation from pregnancy.
Another way to differentiate it by comparing pre-pregnancy, abdomen and weight.
If you’re at exactly the same weight as you were pre-pregnancy, that most likely the problem is related to muscle separation.
If you’ve gained weight than visceral fat, may very likely be contributing or maybe the primary issue.
Another way to differentiate to your non-dominant hand and press your abdomen until it’s flat.
A flat abdominal wall should make a B line between your sternum and your pubic bone.
If you can easily press your abdomen flat with your non-dominant hand, then the problem is most likely more related to muscle, separation, and less related to excess visceral fat.
if it takes a substantial amount of pressure and you feel like you can’t take a deep breath when you press your abdomen flat then the problem is more likely related to access visceral fat.
My best guess is that you have both.
Vital can only be reduced with weight loss.
Muscle separation can only be corrected with a full tummy tuck. you cannot determine muscle separation by an external examination.
Putting your fingers between your rectus, muscles is not a good indication of how much muscle separation you have.
The bulging of your abdomen is an excellent way to assess muscle separation once you’ve excluded this fat as a corporate.
To get a more accurate assessment and better understanding of treatment options I suggest having multiple in person consultations with plastic surgeons in your community.
A thorough examination should assess patients for all four of the above stated variables.
Understanding which variable is causing the problem helps direct treatment recommendations.
The first step in quality medical care should always be to make an accurate diagnosis.
Best,
Mats Hagstrom, MD.