What is the best treatment for diastasis recti and umbilical hernia? (photos)

Unable to see your anatomy clearly from the photos.  Unless the defects are very small where I would recommend umbilical and diastatis recti repair, a small scar TT would address both the loose skin and the lax abdominal wall as to give a nice, flat youthful contour to the abdomen and a more youthful belly button.  The umbilical hernia can also be repaired with the small scar TT.Kenneth Hughes, MD, ABPS Board Certified Plastic SurgeonLos Angeles, CA

Thank you for your questions and expressing your valid concerns.  The most important decision you will make is to find a highly skilled board certified plastic and reconstructive surgeon who is a diastasis recti expert.  Both the umbilical hernia and diastasis recti can be corrected simultaneously which is ideal to lower the chances of hernia re-occurrence. If you qualify for a tummy tuck, it will address these areas as well as remove excess skin, and the belly button is reconstructed. Both functionally and aesthetically this procedure is highly rewarding. Unfortunately, any surgery will leave a scar, however, a highly skilled surgeon will be able to minimize the appearance of the scar based on their closure technique.  It's also important the incision be low and hidden under the bikini line.    I would highly recommend scheduling an in person consultation to come up with a customized plan for your individual needs.

It is possible to repair the diastasis recti and the umbilical hernia through a trans-umbilical access. It is usually referred to as endoscopic assisted abdominoplasty.
The procedure also involves liposuction to the central abdomen to ensure there is no central volume in excess after tightening the muscles.
The procedure is only suitable for good skin elasticity patients, so a consultation in person with be necessary to determine if you are a good candidate.
An alternative would be to have a small amount of skin reduction in the lower abdomen through a C-section scar combined with the endoscopic approach. It still requires reasonable abdominal skin elasticity but produces a degree of tightening for the abdominal skin.

Dear ajricc00, 
Based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

You should not trade a tummy tuck scar if you do not want the tighter skin that comes along with it.Your hernia could be fixed laparoscopically with minimal scarring.  The diastasis recti may not need to be fixed at all unless you have symptoms.

ELAP is the surgical technique utilizing endoscopy to repair acquired abdominal wall defects, such as diastasis recti or ventral hernias.An internal corset (muscle plication) is performed .Only three mini incisions are used, a large wound is not made as in conventional abdominoplasty.

The short answer is- both can be treated with an abdominoplasty (or tummy tuck) which incorporates a diastasis recti repair (midline muscle repair through a muscle plication). At the time of the surgery, your surgeon can also correct the umbilical hernia in an open fashion - with or without a mesh - depending on the size of the hernia. Rule of thumb is less than a 2cm hernia can be repaired primarily without mesh. This will not only act like an internal corset at tighten you internally, it will fix your umbilical hernia and eliminate all of the redundant skin of the upper and lower abdomen. The trade off is an incision within the bikini line (depending on who your surgeon is), and a neo-umbilicus (new belly button). I strongly urge you to look at before and after pictures of the surgeon you choose- incision placement and the creation of an innie-belly button are crucial.
If you absolutely don't want to have a large scar within the bikini area, your option will be to have an umbilical hernia repair alone (without repair of the diastasis recti). This can be performed either open, through an incision around the bellybutton, or laparoscopically, through a few small poke hole incisions. Best, Dr. Satey.

From your photos I suspect the surgeon your was right. If you want a flat stomach that is both functional and aesthetic you must shop around. See a board-certified plastic surgeon who operates at a certified facility and does a ton of mommy makeovers and you will be in good hands. Do not shy away from asking; how many tummy tucks have you done on women that look like me, last year doctor? Do not settle for vague answers