Tummy Tuck for Diastasis Recti, What Risks are there with thie Surgery? (photo)

I have 2 children the youngest being 5 months, both were long babies for what was a small frame. I was told that I have a small hernia and Diastasis Recti. What are the risk if I do not have surgery to repair these issues being that the surgeon made it seem like it wasn't necesary. I was told that doing the abodemonplasti is the best thing but I am scared my insurance will not cover it. This has given me severe back problems and I constantly hold my belly feeling like things are loose inside.

Doctor Answers 15

Repair of Rectus Muscles With Tummy Tuck

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As Dr. Aldea pointed out most, if not all, women who have ever been pregnant have diastasis recti and don't undergo surgery to correct it.  Functionally it may help your back but I think your back issues are due to other concerns.  So we're talking about a cosmetic surgery.  Your insurance company isn't concerned about diastasis recti.  If it's not fixed it really won't change anything and your surgeon is correct. 

The umbilical hernia is another matter.  Depending on the size of it the tissue that is herniated could get pinched, become swollen and not be able to be reduced.  This can be quite painful and problematic.  Most insurance companies will pay for repair of the hernia.  It is often possible to repair the hernia at the time of the tummy tuck.

What are the Risks of NOT having a Tummy Tuck to repair Muscle Separation After having 2 Children?

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For pregnancy to continue to full term your tummy muscles MUST be stretched and split. If they could not, the uterus could not grow to normal size and none of us would be here. As a result normal pregnancy = muscle stretching and separation AND well over 99.9999% of the mothers in the world have  diastasis recti (muscle separation) and do NOT undergo abdominoplasties (Tummy Tuck).

A Tummy Tuck WILL correct the muscle separation and flatten the tummy BUT it is a purely cosmetic operation (it will not improve function nor save lives). As a result, no insurance company would pay for you to have it done. Like everything else in life, if you want it you will have to pay for it out of your pocket.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Diastasis Recti and Tummy Tuck

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Diastasis Recti, separation of the muscles from pregnancy is corrected during a tummy tuck.  This is an elective cosmetic operation and not something that is covered by insurance. It is an operation to make your tummy look better.

An umbilical hernia is a medical concern and does pose some risk of medical problems; therefore, it is often covered by insurance.

You can choose to have umbilical hernia repair and tummy tuck done separately or together.  It's up to you. Get more than one consultation if you would like more opinions.

Risks of not having a tummy tuck to repair muscle separation

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Based on your photographs, a full abdominoplasty would correct your diastasis, excess skin and adipose tissue. During an abdominoplasty, the muscle is tightened to correct the diastasis, and your umbilical hernia should be repaired as part of the procedure. Tummy tuck surgery is a cosmetic procedure and is not medically necessary, as almost all women have diastasis to some extent. You should be able to obtain an awesome result if you pursue the procedure.

Umbilical hernias, diastasis recti, and tummy tucks.

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These terms are often confusing for folks reading about tummy tucks or abdominoplasty. An umbilical hernia is a true defect or hole in the abdominal wall which can lead to protuberance of the intra-abdominal tissues. These are medically concerning because if that tissue gets stuck (goes through the hernia, but cannot get back in) they can cause serious problems. Therefore, true umbilical hernias are typically covered by insurance. A diastasis recti on the other hand is simply the normal separation of the rectus muscles which occurs from pregnancy or obesity. This is not a "true" hernia. Although a bulge may appear, it is not considered a hernia. Both of these issues are addressed during an abdominoplasty procedure.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 26 reviews

Tummy tuck and hernia

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Thank you for all the informtion. If you decide to have a tummy tuck, you will have to repair the hernia, my guess it is umbilical hernia. I  usually repair it during tummy tuck. I must stress here, that the umbilica hernia must be repaired during or before having tummy tuck. There are risks associated with these hernial, including, but not limited, incarceration, strangulation( loss of blood supply to the hernia content) and may become more visible after tummy tuck. Tummy tuck is not a procedure covered by insurance companies.

 While abdominoplasty, or tummy tuck, surgery is not an alternative to a healthy weight loss program, it can be a great option for those looking to trim down their midsections and give the abdominal area a tighter, more toned aesthetic. Patients requesting abdominoplasty are often relatively physically fit but suffer from loose, excess skin brought on by pregnancy, weight loss, or a genetic predisposition. A tummy tuck addresses these stubborn leftover fat deposits in the abdominal region that you simply can't get rid of, no matter how hard you try. 

A flat and toned abdomen is something many women strive for through exercise and weight control. These methods help reducing the fat and toning the muscles, but will not get rid of the excess skin.

Moneer Jaibaji, MD
San Diego Plastic Surgeon

Tummy tuck, muscle separation, and an umbilical hernia

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The photographs that you have provided, along with your history, indicate that you have a number of different issues that are affecting your abdomen.  Separation of the rectus muscles (diastasis recti) commonly occurs with pregnancy and can be improved or completely corrected with an abdominoplasty.  You also appear to have relatively loose skin and adipose tissue that can be improved with an abdominoplasty.  Unfortunately, an abdominoplasty is not a procedure covered by insurance.  You also state, however, that you have an umbilical hernia.  The hernia is a small (or large) defect (or hole) in the muscle/fascial layer of your abdominal wall that can allow intra-abdominal contents (for example: fat, intestines) to protrude through the muscle layer and into the subcutaneous fat.  These can be dangerous if not treated and also can be painful.  Insurance will cover the hernia repair.  Most Board Certified plastic surgeons are comfortable treating the hernia at the same time as they perform the tummy tuck.   You may check out the following web link for further information.  Good luck.

Insurance Very Unlike To Cover TT & Diastasis Repair

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It is extremely unlikely that your health insurance will cover a tummy tuck with or without a diastasis repair regardless of the symptoms that you claim.  All women who have had a pregnancy will some degree of diastasis recti which had no risks of bowel entrapment, etc.  A true hernia may present reasons for coverage, but the tummy tuck still would not be covered.

John Whitt, MD (retired)
Louisville Plastic Surgeon

Insurance issues and risks regarding an abdominoplasty and umbilical hernia

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A tummy tuck is a cosmetic surgical procedure, not a medical necessity and, therefore, would not be covered by your insurance. The same is true of muscle separation that is the result of pregnancy, known as diastasis. On the other hand, an umbilical hernia is considered to be a medical issue and its repair should generally be covered by your insurance.

With an umbilical hernia, tissue can get "stuck" or strangulated in the small, restrictive defect resulting in pain and even necrosis (death) of some of the tissue which commonly is bowel. This is a severe medical emergency. However, just because you have an umbilical hernia doesn't mean that an incarceration will inevitably occur - but it is a risk.

Need for tummy tuck

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I would get a 2nd opinion about the umbilical hernia.  If it is sufficiently large, then paradoxically the risk of bowel strangulation is lower than if the hernia is small.  It would certainly be more convienient to do a tummy tuck and hernia repair at the same time in your case since you would only need one surgery.  However, you can do both separately as well.  It really depends on your personal goals.  Others have explained that an abdominoplasty is never covered by insurance so I will not repeat that information.  Also note that a diastasis recti is simply a description of the widening of your abdominal muscles and not a true hernia.  Furthermore, it is recommended that you are not going to have any more children after a tummy tuck since you could potentially have to repeat the surgery in order to regain a flat tummy.

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.