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.
Plastic surgeon should be able to fix both diastasis and umbilical hernia
You should seek an other opinion as a well trained plastic surgeon should be able to correct all of your problems at one operation. First, if you don't have enough skin for a standard tummy tuck with the incision around the belly button, you may consider a tummy tuck with an "Umbilical float". This allows the entire skin of the abdomen to be lifted and tightened and the excess trimmed off without having to make the closure too tight or incising around the belly button. The scar can be placed very low and be very well camoflouged. After the skin is elevated the diastasis and the umbilical hernia should easily be able to be repaired to flatten your tummy and restore its youthful contours. Seek out someone board certified by the American Board of Plastic Surgery.
A plastic surgeon who is also a general surgeon is what you need
What you have can be best repaired by a surgeon who is Board Certified in Surgery and also is Board Certified in Plastic Surgery. Wearing these 2 hats will enable the surgeon to best improve the aesthetics of your abdomen as well as repairing your hernia and tightening your rectus diastasis (the split between your rectus muscles). In fact, just last week, I repaired an abdomen and did a tummy tuck on a patient who is almost identical to what you describe.
If there are no surgeons who qualify with this degree of training in Idaho, there are several who do so in Washington state.
A tummy tuck is not a tummy tuck is not a tummy tuck....
A tummy tuck is not a tummy tuck is not a tummy tuck. While patients and surgeons alike use the term tummy tuck or abdominoplasty to indicate a particular procedure, in reality, it is best to analyze the anatomy of individual patients, discuss the desired results, and then design an operation to fit your particular needs. What you call the procedure is less important.
I have found that patients respond variably to pregnancy. Some have abdomens that are destroyed by one pregnancy and others, with five pregnancies, look virtually normal. You may have more muscle issues than skin, and it would be important to separate out the anatomical components of your concerns.
You may be a good candidate for a muscle repair to correct the diastasis recti and hernia without any skin excision or perhaps a so-called limited "mini" tuck or "modified" abdominoplasty.
Tummy tuck to repair muscles and hernia?
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.
Abdominal wall laxity after child-bearing
Diastasis rectus is a condition similar to a hernia, but not a true hernia. Pregnancy causes the tissue between the muscles to stretch leaving a gap when you contract the muscles. A hernia is a defect of the abdominal wall with herniation of the lining and contents. Hernias are in the realm of general surgery, but most plastic surgeons are also general surgery trained and you can ask them about their comfort level. Diastasis is considered cosmetic unless extreme, and even then is hard to get insurance to cover, because there is no medical risk if you do not have it repaired. Plastic surgeons can better address the skin excess if present to help maximize the contour of your abdominal wall, where general surgeons just fix the hernia.
Yes your hernia and your muscle separation can be repaired at the time of the tummy tuck, in reality that is what a tummy tuck is all about.
Plastic surgery fixes stomach muscles and umbilical hernias!
It is always a matter of performing the right procedure for the right patient. When a significant amount of excess skin is present, a full abdominoplasty together with muscle repair and hernia correction is routinely performed. If the skin redundancy is minimal, a version of a mini-abdominoplasty is performed where the small amount of skin is removed, the muscles are repaired and the hernia fixed. Where no excess of skin is present, an endoscopic approach may be used where the muscles are repaired and the hernia fixed through a very small, well hidden incision.
Tummy tuck to fix torn muscles and hernia
I would recommend that you see an experienced plastic surgeon. In the usual tummy tuck, the excess skin and fat is removed (you probably have some looseness after 5 children), the skin is stretched (to make it tight), and the underlying muscle separation is repaired (along with any hernia).
Get another surgical opinion
The separation of the abdominal musculature (diastasis recti) and an umbilical hernia are routinely corrected during Tummy Tucks. I find it hard to believe that after five pregnancies you do not also have enough loose skin to warrant a Tummy Tuck. I would advise you to obtain another surgical opinion!.