Laproscopic/Robotic Diastasis Repair/Hernia repair - could this procedure be done to produce a favorable cosmetic effect?

Question

Do any surgeons here have experience with a laproscopic/endoscopic diastasis muscle repair (and hernia repair?)? I fully understand this does not allow for any skin removal or fat removal. But in a lean individual who has only weak/protruding abdominal muscles (and not much excess skin or fat), could this procedure be done to produce a favorable cosmetic effect? Would love to see before/after photos but having trouble finding any.

Adam Tattelbaum, MD · Answer

Thanks for your question. Yes this is a hard to find operation because the candidates are rare. Most patients with diastasis will benifit from at least some degree of skin tightening. It can also make the muscle tightening and hernia repair far more challenging.

For a very select group of patients in my own practice I will perform a full muscle tightening- which can allow hernia repair  with only a mini tummy tuck skin excision. The skin around the belly button is elevated to allow full tightening, but the umbilicus is put back right where it came from. I find it a happy medium  between a full and a mini in the right candidate.

Hope this helps. follow the link for more info.

Daniel Barrett, MD · Answer

Dear katek77,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. 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

Gilbert Lee, MD · Answer

Thank you for your questions. In general, this type of rectus plication is not done as most patients benefit from the removal of excess skin. As the rectus muscles are brought together creating a thinner waist line, external excess skin is created that will be removed during the tummy tuck portion. In most patients, just plicating the muscles will leave wrinkled skin down the middle of the abdomen. We do not do this type of procedure in our office as we want our patients to have the best possible result. I recommend you schedule a consultation with a board certified Plastic Surgeon who can assess your anatomy in person and put together a plan that is best for you. In our office we offer 3D imaging to give our patients an accurate idea of what their final result will look like. Good luck!

Mats Hagstrom, MD (license on probation) · Answer

Laparoscopic surgery is not a good way to correct diastasis recti.

Many plastic surgeons will bring the rectus muscles together by as much as 6 inches.  This is often what it takes to create a tight flat abdomen.

If you do that to the muscles and then don’t re-drape the skin it’s going to give a lot of horizontal skin redundancy.

If laparoscopic diastasis repair worked well it would be done on a regular basis.

It hasn’t caught on because it isn’t a good procedure.

Nobody wants to have a full tummy tuck but for some women who’ve had children that is what’s required to have a tight flat abdomen.

Half measures will leave you disappointed and looking for a second operation which seems counterproductive and pointless.

I recommend having multiple in person consultations with local board-certified plastic surgeons. During the consultation ask each provider to show their entire collection of tummy tuck before and after pictures. An experienced provider should have no difficulty showing you 50 or more sets of before and after pictures. Ideally providers can show patients with a very similar body characteristics to your own.   highly experienced providers will have many more before and after pictures than that some will have several hundred or possibly thousands.

Judge surgeons based on who gets the most natural looking belly buttons with low set  scars that follow anatomic contours evenly without unnatural fullness in the hip and flank area.

Best,

Mats Hagstrom MD

Laproscopic/Robotic Diastasis Repair/Hernia repair - could this procedure be done to produce a favorable cosmetic effect?

Answers (4)

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