Can Plastic Surgery Fix my Torn Stomach Muscles and Umbilical Hernia?

For women who don't need a great deal of skin removed (and a hip to hip incision), but need their muscles tightened and an umbilical hernia repaired, they may be a candidate for a hybrid tummy tuck.
The hybrid tummy tuck involves a C-section-type incision with full tightening of the deep fascia, the structure that holds the muscles. Although doctors often refer to tightening the muscles, it is in fact the fascia that is tightened.
The hybrid tummy tuck is not for women who have a great excess of skin and fat. Good candidates are typically fit moms. But for women who have only been offered a full tummy tuck and in fact have primarily a problem of the fascia, the hybrid tummy tuck is just the right thing.

The tummy tuck is a very powerful tool to repair the muscles weakened by pregnancy.  An umbilical hernia can be repaired at the same time as a tummy tuck, but it has to be done very carefully in order to preserve the blood supply to the belly button.  If you do not have enough skin to perform a tummy tuck, it does become a more difficult question.  The general surgeon certainly can repair the umbilical hernia, but it is definitely not typical for them to reconstruct the abdominal wall musculature for your diathesis recti.

Yes, plastic surgery can indeed help address torn stomach muscles (diastasis recti) and an umbilical hernia. It is common for these conditions, especially after pregnancy, to be addressed simultaneously during a tummy tuck procedure. A tummy tuck can repair the abdominal muscles by bringing them back together and also fix an umbilical hernia.
While the standard approach to a tummy tuck often involves removing excess skin, the surgery can be tailored to focus on muscle repair and hernia repair, even if there's not much extra skin. In some cases, a "mini tummy tuck" can be performed with a smaller incision if there is not a significant amount of excess skin. The umbilical hernia can be repaired at the same time, sometimes using a general surgeon for more complex hernia cases.
It is advisable to seek another opinion from an experienced plastic surgeon to explore the best options for your specific case.
Krishna Vyas, MD, PhD, MHSHarvard, Hopkins, & Mayo Clinic Trained Aesthetic Plastic SurgeonNew York, New York

Hello maria7474,

Thank you for reaching out with your concerns. It's not uncommon for individuals, especially mothers who have had multiple pregnancies, to experience muscle separation and umbilical hernias. Fortunately, these issues can often be addressed through plastic surgery procedures like a tummy tuck.

During a tummy tuck, it's quite common for plastic surgeons to repair muscle separation, also known as diastasis recti, and hernias. Some plastic surgeons, like myself, are trained in general surgery techniques and can perform these repairs simultaneously with the tummy tuck procedure.

Muscle separation and umbilical hernias can indeed be valid reasons for considering a tummy tuck, especially if they are causing discomfort or aesthetic concerns. I don't see any issue with addressing both issues during the same surgery, as it can streamline the process and provide comprehensive results.

However, it's always wise to seek a second opinion if you have any doubts or concerns about the initial recommendation. Consulting with another plastic surgeon experienced in abdominal wall reconstruction can provide you with additional insight and options for addressing your specific needs.

I hope this information helps, and I wish you all the best on your journey to a more comfortable and confident abdomen.

Sincerely,
Dr. Katzen

The Mommy Makeover is a combination of procedures to bring a woman’s body back to the way she looked prior to pregnancy. Most commonly some variation of a #TummyTuck and #BreastSurgery are performed. Additional procedures can include liposuction, umbilical hernia repair.  The most common #breastprocedures include #mastopexy or #breastlift, #breastaugmentation, or #breastreduction.    Healing after a  #tummytuck will require time. Some patients are out of bed and walking the night of surgery and every hour while awake. I allow my patients to return to work at one to two weeks with 14 days preferred.  However, no lifting or straining.  At three weeks, increased level of activity and full with no restrictions, at 6 weeks. #MummyTummy is a term given to modified tummy tucks which can use liposuction and skin tightening with radiofrequency such Vanquish, Vela3, thermage, thermiRF and others.  The actual fat contouring can be done non-surgically as well with #UltraShape or Cool-Sculpting.The costs of a #Mommy Makeover will depend on several factors. Such include the geographic location, the skill and experience of the surgeon, and operating room and anesthesia fees.  Also, such #combined operations are often performed with our Gynecology colleagues. Tubal ligation is a common post pregnancy procedure which is done at the time of many of the surgeries included with Mommy Makeovers. Therefore, if you require a gynecologic operation or study (laparoscopy) and are considering a plastic surgery procedure, discuss these issues with your doctor. If your surgeon feels you are a candidate, it may be possible to add additional procedures such as those you mention. #Combining these procedures decreases anesthetics, costs, and recovery time.  Most importantly, your procedures should be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, without the need for a revision surgery. It is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.

An abdominoplasty can be tailored to address some or all of the problems that a patient may have, as long as it is not intraabdominal.  Hernias can be repaired, some lower abdominal scars removed, muscles tightened, and skin and fat removed, within certain limits.  From your description, I suspect you would probably need an abdominoplasty type incision with abdominal wall tightening (full undermining would be necessary) and probably a limited skin excision.  Of course, a formal consultation with an experienced plastic surgeon is going to be necessary to determine what you can/should have.

Thank you for your question.  While you may not have enough excess skin for a full tummy tuck to be a viable option, the same approach (low abdominal incision) can be used to access your abdominal wall, repair your umbilical hernia, and bring your abdominal muscles back together in the midline (repair your diastasis).  Any excess skin that you may have can then be removed, if necessary.  Repair of diastasis, as well as that of small, uncomplicated umbilical hernias, is routinely performed by qualified plastic surgeons, as part of the tummy tuck operation.  Good luck to you.

Your concerns are legitimate. An Abdominoplasty in a patient with an umbilical hernia requires a few considerations that do not exist in other patients. However, this is a very common scenario and it is a subset of patients that most board certified plastic surgeons encounter regularly and should not hinder you from expecting a fabulous result. If  the belly button is high, and the stretch marks are limited to the lower portion of the abdomen, the surgeon "floats" the belly button downward--like lifting the shirt out of one's pants, pulling it tight, and cutting off the tissue below the pant line. The hernia is repaired along with the muscle separation,  with very little risk to the belly button and rarely with the need for any type of mesh. If the stretch marks extend up to or above the belly button and one wishes to get rid of as much damaged (stretched) skin as possible, then the plastic surgeon repairs the hernia with as little trauma as possible, completes the standard tummy tuck, and assesses the integrity of the belly button at 24 hours. If it is dusky, too pale or too cool, the patients is treated with daily hyperbaric oxygen to increase the blood flow and viability of the umbilicus (for a week or so).If, despite these considerations, the belly button "dies" anyway, it usually heals in adequately (as a depression) or can be reconstructed in the office under local anesthesia. Either way, articulate your concerns and go for it. This helps you and your surgeon get the best possible result. One MUST STAY CLEAR OF TOBACCO AND NICOTINE, which increases the likelihood of healing problems. Take off two weeks or so from work and be cognizant of your caloric intake (especially white alcohols and carbohydrates).   

Hi, this is not an uncommon scenario.  Although an abdominoplasty may be the best option, it may leave you with an unacceptable high scar.  Other options include a lower mini abdominoplasty.  General surgeons are very capable of fixing umbilical hernias through short incisions but repair of split muscles is a different matter- you may end up with a not so acceptable cosmetic result.  It would be reasonable to get a couple of opinions from different plastic surgeons- ask about their experience with this condition.

Thank you for your question!!  While loose skin is typically a prerequisite for a tummy tuck, in some instances, we would approach a person who has your problems with a tummy tuck incision to correct the resulting weakening of the rectus muscles and umbilical hernia.  Another technique would be to perform tightening of the rectus muscles through a smaller incision and use well lit retractors to expose the muscles to allow for tightening without an expanded incision.  What you refer to  in your question about torn muscles is really a stretching of the fascia that does not completely heal after having kids, thus you develop a pooch that will not go away, even with exercise.    So, to answer your question, plastic surgeons would be well adept to correct your concerns.  There are different techniques to do so and your surgeon will be able to help make you aware of your options. 

It is common for me to repair hernias and torn muscles when I perform a tummy tuck.  In some cases insurance will help to cover the medically necessary portion of the procedure, such as an umbilical hernia.  If you are considering a tummy tuck in the future, it is wise to consult with a plastic surgeon first before undergoing a hernia repair.