What are my options for diastasis and upper skin laxity? (Photos)

Question

I am 37, female, 130 lbs, 5’7, I’ve had 3 babies via c section. I have an upcoming breast revision and I’m wondering how this could be addressed

Semih Yildiz, MD, FEPOBRAS · Answer

From the photos, you appear quite slim with very little excess fat, so the main issues to evaluate are skin quality and whether you have a true rectus diastasis. After three pregnancies and C-sections, diastasis or abdominal wall laxity is common and can make the abdomen protrude even when there is not much fat. Skin laxity around and above the belly button can also remain after pregnancy and usually does not respond dramatically to exercise or liposuction.

If you have a significant diastasis, the most complete treatment is usually a full tummy tuck with muscle repair, because that allows the surgeon to tighten the abdominal wall and redrape the skin. A mini tummy tuck generally treats only the lower abdomen and would not reliably correct upper abdominal laxity or separation above the belly button. Liposuction alone would not fix diastasis and could make loose skin look more noticeable in a thin patient.

If the exam shows only mild skin laxity and little or no diastasis, nonsurgical skin-tightening options such as RF microneedling or energy-based tightening may give some modest improvement, but they are not a substitute for muscle repair or removal of loose skin. Since you are already planning a breast revision, ask your board-certified plastic surgeon whether an abdominoplasty could safely be combined or whether staging the procedures would be better based on operative time, recovery, and your lifting restrictions at home.

Yasemin Aydinli, MD · Answer

After three pregnancies, diastasis recti with skin laxity is best corrected with a full abdominoplasty, which repairs the muscle separation along its entire length and removes excess skin. If your laxity is mostly above the navel, a reverse or fleur-de-lis pattern is occasionally considered, but standard tummy tuck with rectus plication covers most cases. Combining it with your planned breast revision as a single-stage procedure is often feasible if your surgeon and anesthesia team agree on operative time.

Sotirios Ioannidis, MD · Answer

Based on your description, you appear to be an excellent candidate for a full abdominoplasty . Although you are thin, a true diastasis recti following three pregnancies is unlikely to improve with exercise alone, and the presence of upper abdominal skin laxity further supports this approach.A full abdominoplasty would allow both repair of the separated abdominal muscles and removal of excess skin, providing the most comprehensive improvement in abdominal contour. Less extensive procedures, such as a mini abdominoplasty or isolated diastasis repair, would not adequately address upper abdominal skin laxity and would likely result in a less satisfying aesthetic outcome.Since you are already planning a breast revision, it is reasonable to discuss combining the procedures if your overall health, the complexity of your breast surgery, and the anticipated operative time make it appropriate. This combination is commonly performed in suitable candidates and can provide a more complete post-pregnancy rejuvenation with a single recovery period.

What are my options for diastasis and upper skin laxity? (Photos)

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