Is a Vertical Incision Required for Repair of Diastasis Recti with Umbilical Hernia?

Looking at your picture, I would guess that you would not need a vertical incision and that you would see very nice improvement with a traditional low transverse abdominal incision.  The main reason for the vertical incision is to address significant mid-abdominal laxity that simply cannot be addressed with the traditional incision.  That being said, I generally reserve these incisions for my massive weight loss patients who present with not only significant excess skin but also poor tissue quality.

I hope that helps!

I obviously have not examined you but by your picture I would not consider a vertical incision for your abdominoplasty.  You would probably end up with standard horizontal incision with a small vertical closure of your old belly button site.

Dr. ES

An umbilical hernia is easily repaired at the time of rectus diastasis repair. This can all be done through a low horizontal incision as with tummy tuck. There is no reason for vertical incision in this setting

It is not necessary to have a vertical scar to repair your umbilical hernia.

If you undergo a tummy tuck to remove extra skin, the incision will be horizontal.  Most plastic surgeons will repair the umbilical hernia at the time of the tummy tuck.

You may be a candidate for a limited incision tummy tuck. 

From the appearance of your abdomen, it appears that a vertical is not the only solution, Therefore, I would get other opinions prior to proceeding.

A vertical scar is not required and should be avoided in rectus repair with umbilical hernia. This procedure can be for through a low bikini incision. Even without a full tummy tuck an endoscopic can be used to assist in the procedure. Unless there is an existing vertical scar i would not use a vertical approach.

Unless there is something else about your situation that we don't know, most Board Certified plastic surgeons should be able to repair your umbilical hernia, correct the rectus diastasis and remove your loose skin through a horizontal incision in your bikini line.

However, it is possible that the surgeon you saw meant that there may be a small vertical scar (between your pubic area and your belly button) in the skin where your belly button used to be after the loose skin is pulled down and a new opening is made for your belly button. If that is the case (which is likely based on your picture), then this type of scar tends to heal very well.

It may be a good idea to go back to your plastic surgeon and ask for a clarification on this.

This is what a tummy tuck or abdominoplasty is for; plication or sewing together of the diastasis (and any hernias) and redraping/resection of the skin and umbilicus to give back the youthful/straight abdomen.  One thing to consider is if you are going to have more children...Then you may wish to defer definitive repair until your childbearing is complete.  Also, are you having any symptoms from the hernia (pain, hard lumps in hernia that are hard to reduce).  That would also have a bearing on how quickly all these issues are addressed.  Good luck, and do not get a vertical incision.

Certainly an umbilical hernia repair can be performed at the same time as an abdominoplasty, but I would not use a vertical incision.  An important part is to preserve the blood supply to the umbilical stalk which can be approached from a small vertical incision within the exposed area below the skin and fatty tissue and fixing it from inside.

If you were my patient and based on your pictures I would not advise a vertical scar.  A modified mini-tummy tuck with diastasis repair and repairing the hernia through the umbilical and lower abdominal incision is all that is necessary.  If you are going to have the surgery for the hernia done by a general surgeon at the time of the tummy tuck he/she could probably do it laparoscopically without any incisions other than through the lower abdominal incision.

Seek several other opinions as there may be better options for you than a vertical scar.