2 C-sections, 30s, Diastasis Recti and Loose Skin - London, GB

I hope some of the below will be helpful to anyone contemplating surgery. I noted there weren’t many posts from the UK, although the number is growing, so thought this is would be helpful if you have the no-drain technique and undergo the procedure in the UK.

Apologies that I am not brave enough to post photos, but I am in my mid thirties and have two toddler-aged children, both by c-section. I have significant diastasis recti (stomach muscle separation) and loose skin. Due to the laxity in my stomach muscles, after eating even a small meal, my stomach can balloon to make me look like I am 5 months pregnant. I was actually not only asked if I was pregnant, but whether I was expecting a boy or a girl one time, as my stomach distension is so marked.

The procedure I had involved significant stomach repair, no drains were used and I had dissolvable stiches both internally and along the scar line.


Choosing a surgeon:

I visited 3 mainstream providers and got a feel for the surgeons. One of them, in fact charged to meet the surgeon and I only get a consultant and I did not pursue this one further. Aurora and the other place I visited offered an initial free consultation with a surgeon. It is important to get a feel for the surgeon, nurses and aftercare every place you visit and I think there is some merit in going to a few places in order to be able to compare. I chose Aurora as they really took time to explain the procedure and recovery period to me, gave me a lot of information, are readily available to answer questions and respond quickly too. I felt the staff were professional, down-to-earth and knowledgeable. Aggie Oakley in particular even answered queries during the Easter holidays. The surgeon Adrian Richards is very well-respected in his industry, rated as one of the best in the country, has written books, been an NHS plastic surgeon first and is a member of the associations you would expect and has had very good reviews. I felt like I was in very capable hands.

Whoever you choose, I would:

- check their review online, Google, Google Google – Realself provides ratings and also Google the name of the surgeon with key words like ‘suspension’, ‘litigation’ etc to see if there is any negative press.
- I was told by my GP, who was by no means an expert in this area, that a safe bet is to check that the surgeon has worked as an NHS surgeon first or also works on the NHS. That way, you know they have at least gone through a recognised quality control.
- Check they are BAAPS (British Association of Aesthetic Plastic Surgeons) and GMC (General Medical Council) registered;


Questions useful to ask:

- Cost
- What is their specialism, this or something else?
- infection rate post surgery
- complication rate post surgery
- how long is the ‘warranty period’ if, once swelling subsides, the surgery is not as you wish
- where will operation and follow up appointments take place (often these end up in hospitals outside of London)
- if you need follow up checks or have concerns some time down the line, how much would this cost?
- Ask to see before and after pictures if you have not seen them online
- Ask where scar will be on your frame
- Ask if stitches are dissolvable or not and if drains are used.


Feelings leading up to procedure:

I researched and researched, read many reviews on Realself. Thank you to all those brave ladies who contributed as it has been very helpful to me. As I was suffering back pain from my completely lax muscles, could not do core exercise, had bad posture and, although I’d grown accustomed to it, hated my tummy, it was a no-brainer to go ahead. Aside form the aesthetic benefit, I am keen to start running and engage in more all around exercise (incl core) exercise eventually. I hope not to worry about worsening back pain or sudden bloating in the future too.

I did think about the cost of course and felt guilty that it could have been put towards my children instead, but I rationalised that I needed to be happy and be able to lead a fully active life in order to be a good mother too.

Taking time off work:

This varies from person to person and the nature of their surgery. I feel like 3 weeks is a minimum period needed and I would say, longer if you have an active job. I have a desk-based job. I took 3 weeks off work and am working one further week from home before dealing with commuting to work.

After 3 weeks, I turned a corner in that I am not as hunched as I was, but I still had soreness, especially after I try to walk a short distance, even just 400m and I gradually hunch over as I feel my tightened muscles pull me forward. The hospital wrote me a 4 week ‘Fit for Work’ (i.e. sick) note, but I was able to work the 4th week from home, as walking longish distances and lifting are my main issues. I am still more tired than normal and a long way from being fully recovered.


Sunday 6th April (night before surgery):

I weighed myself just to see if I would lose any weight with the skin loss or how much weight I would gain due to swelling and inactivity (more to the point).

I had a good carby dinner, chocolate and hot cross buns with margarine. I was told by the hospital to have a good carby dinner the night before the operation as I had to fast from 2.30am onwards and drink no water from 6.30am (the operation was at 1pm). I certainly took this advice on board and then some and feasted on the carbs all day like there was no tomorrow!

I stay up late so I can eat something just before midnight. I wrap little gifts for the kids to open for the two days when I am away at hospital. I can’t believe it’s happening, but just want it to be over now!



Monday 7th April (operation day):


It was a rainy day, I hug goodbye to the kids and off we drive through the idyllic Buckinghamshire countryside to the hospital. Our youngest had slept badly last night and ended up in our bed, so we were both exhausted today, which was not ideal. I was also really thirsty as had no water since 6.30am and so was conscious not to talk too much as that would make my mouth drier. We were greeted and shown to my room and my husband and I tried some newspaper crosswords and watched DVDs on the laptop to while away the time.

I had a nice room with freeview TV and ensuite and the menu looked good for the days I was here: braised duck leg and red cabbage, poached salmon with herb and lemon crust to name a few highlights! The nurse came in and took vitals and gave me gown to change into and applied an anaesthetic cream to my hand for the anaesthetic canular, the anaesthetist introduced himself, then the surgeon came and took the before photos with a nurse and marked me up.

I got ready and I watched DVDs with my husband to kill time until at 1pm, I was collected to go to the theatre. I said goodbye and walked down to theatre. My husband finally got a chance to go outside and get some lunch!

Outside the operating theatre, I was greeted by the surgeon, anaesthetist and another attendant who asked me questions about allergies and my date of birth. There was some small talk with the surgeon and anaesthetist to put me at ease. I felt a little pain from cannula and some coldness and felt like I closed my eyes for a second, re-opened them to check I was still in pre-theatre room, but saw my husband instead, It was 5pm and I was back in my room. How bizarre.

I had legs raised up on pillow, stomach looked swollen and puckered around scar. My legs were moving up and down gently by the hospital bed and were raised up. They said the operation had gone well. The surgeon had spoken to my husband whilst I was asleep and said my muscles were very far apart. Looking at my stomach it was weird thinking that the excess skin section had now been removed and was probably being incinerated somewhere – who knows! I was leaking at both ends of the sutures, but it was not too bad. I didn’t have any drains attached as I had expected. I was drowsy and probably drifted back to sleep for a bit after.

The most painful thing today was actually the antibiotic injected through the cannula twice, once this evening and again the next morning.

I watched one more DVD episode with my husband, texted and called a few people and spoke to my kids before their bedtime. I had lots of food when both tea with biscuits and dinner came around. I was keen to take my medication on time after making the mistake and not doing so after my first c-section. My husband gave me my toothbrush in bed and then left to go home just before 9pm.

I was quite hot and sweaty. I had lots of blankets over me. My skin itched a lot all over. I remember this reaction to the anaesthetic last time I had a c-section.

I slept off and on throughout night. I had antibiotic via the cannula in the morning and my breakfast. My husband arrived just before the visiting hours window at BMI Shelbourne (10am to 10pm), just in time to eat the toast and marmalade I’d saved.


Tuesday 8th April:

Today, I had the catheter removed, extremely painful for me, but got there in end. This is quite unusual to feel so much pain having a catheter removed apparently. The first time getting out of bed, I felt dizzy and had oxygen as thought I might be sick, I was OK though.

My first wee, maybe 2 hours later was a bit painful, but it was all fine after that. After 3 wees (they check you produce a certain volume of urine and are adequately hydrated), I had cannula removed too. By 8.30pm, following my Starbucks soyaccino, I had bowel movement too thankfully. I had a flannel wash before bed with help from my husband.

My movement is already improving. I had time to type lots at laptop, even check work emails, hunched over as you would expect and still very sore.

I had low blood pressure in the evening and sweating again. I drank lots of water to combat this.


Wednesday 9th April:

I slept well. I got up this morning to sound of my alarm (6am – doh!). I had to get out of bed to turn it off, which was a bit painful. Once up, I brushed my teeth and hair at least, had breakfast, watched daytime TV – you realise how repetitive it is when you watch it longer than 5 minutes and how much they can try to eek out the non-stories.

When my husband arrived, I had just polished off breakfast. He helped me flannel wash and get dressed, I signed my forms and got ready to leave. I was given my medication of codeine, paracetamol and an anti-inflammatory. I only had a short course of anti-inflammatories (for a week, not more) and was advised to get off the codeine as soon as I could manage. My husband had bought had brought my toddler daughter’s toilet step stool to help me get into the car (as is quite a high 4 by 4) and it was fine being driven back – a 1.5 hour drive home. We listened to more cyclical news on radio and then some Heart FM as we breezed back in the lovely sunny weather. I had a cushion to protect me from the seatbelt, which worked well.

The kids were happy to see me. My youngest, 18 months, almost instinctively was more gentle with me was very gentle. My 3 year old was curious to know what she could and could not do around me and I had to stop her tickling my feet as laughing was painful! I stayed downstairs for the day and was able to go upstairs to bed relatively easily by the end of the day.

My husband used a combination of working from home and holiday to help me at home. Family pitched in to look after the kids

Thursday 10th April:

I weigh myself and realise I have gained 4 kilos. I can see most of it is swelling though! Bowel movements are not completely back to normal due to codeine, but having coffee each day helps.



Friday 11th April:


I am still very swollen. I went for walk outside, only got to end of our tiny road and had to turn back, quite sore. I did not have any pain relief for whole day. I was supposed to take 2 x paracetamol every 4 hours and 1 x codeine every 6 hours, but did not have any of either until 5.30pm after my attempted walk; then took codeine plus 2 x paracetamol together.

I am still flannel washing as I cannot shower until 9 days post. I used dry shampoo for first time ever, but it just made my hair look dusty. It may have removed some grease, but my hair still did not feel clean. I will have to kneel over the bath tomorrow to wash it.


Sunday 12th April:

Seem to have lost 3 kilos from 2 days ago, which shows you the extent of how much swelling has gone down already. I feel more mobile. I did not have any painkillers last night and have not had any yet today either, just the anti-inflammatory. I forgot to take anti-inflammatory tonight in fact. I desperately want to wash my hair. The dry shampoo leaves a weird residue that has left a dusty patch on sofa and my hair does not feel clean.

I manage a 300m round trip to the shops. I automatically try to keep myself more erect as I walk outside, so this really tugs on my skin and need to have a sit down as soon as I am back. It hurts.

I am now walking up and downstairs with ease. I needn’t have worried about how my kids would be around me. My 3 year old tickled my feet, which was the most harm she did. My son was so gentle around me, coming for cuddles and gently resting his head against me as he sensed my gingerly movements. He even rested his head on my chest and had a little snuggle. I kept my arm behind him to protect my tummy and was fine. The worst pain I had was forgetting about my tummy for a second and sitting back down in a chair quickly instead of lowering myself gently and the strain on my abs ached for quite a while afterwards. I am gradually getting quite straight, but frustratingly, I am not quite there yet and you do feel the ache of the skin being stretched (a sort of tugging feeling) every time you are upright for too long. To be honest, I feel the tugging of the skin being stretched more than any muscle being stretched or tightened

My husband washed my hair with me kneeling over the bath this afternoon. Much as I enjoyed the ‘waterboarding’ experience style hairwashing my husband provided, I was relieved to find that I could cope with stretching arms above my head now, thankfully.

It has been tough on my husband dealing with both kids and dealing with them when they wake in the night.



Sunday 13th April:


homina quasi erecta

I got up this morning hoping that I could finally stand up straight. Well, I could to begin with and then gradually degenerated to the slightly hunched shoulder chimp-like posture I had yesterday.


I have been off painkillers for a while, but remember being told when a midwife visited me 1 week post my first c-section to remove my stitches, that she would prescribe me more codeine as I was not moving very well. I am still moving very gingerly at 6 days post. I can walk up and downstairs with ease, can slowly pick up things from the ground, but, after a short while on my feet, I can really feel a tugging at my skin. Strangely, I do not feel a muscular tugging, but like the skin is tugging. I am not sure if it is the same for anyone else. My left hip scar end point is sore and now and then I feel sharp twinges there and around my belly button.

I sneezed for the first time today and it did hurt, burned for about a minute after!

I took two paracetamols to prepare me for the midday walk.

I walked 1km to and from a café for a large cappuccino. I was keen to walk in as upright a position as possible, but couldn’t really and naturally hunched and felt the need to put an arm across my belly the further I walked. I wonder if anyone thought anything of my odd hunched position. I am still in joggers as it is more comfortable and most other clothing digs in.



Monday 14th April:


I am still not upright as I would like. My belly button still hurts. I can see yellow under plaster, but dare not remove the dressing.

I walk maybe just under 2km today slowly.

I sneeze again and it burns for about a minute after again. I live in fear of sneezes and try to avoid them at all costs.



Tuesday 15th April:

I am back at my pre-operation weight and still swollen. I try to pull up straight and seem to tug around belly button the most. My belly button hurts the most still.

There is no noticeable improvement in being able to hold myself upright. I fell like I could possibly sleep on my side instead of on my back with legs up on pillows, but have not tried yet.


Wednesday 16th April (9 day follow up appointment):

I had the sutures checked and dressing changed, back at The Paddocks clinic in Princes Risborough. My mum came to collect me and take me there. Lovely sunny day and the drive into the country seemed a welcome escape.

It made me feel queasy having belly button cleaned and the anticipation of the bikini wax over my deep scar was not fun, but nurse was very gentle and we got the dressing off with a few deep breaths. I was pleased to find that dissolvable stitches had been used and I didn’t need those pulled out too. My scar looked deep, there was still ruching, a bit of lumpiness to my left hip, a deep gash in middle and a bit of exposed flesh on right. I was relived my belly button seemed to be surviving in its new location. My mum asked after all the bits that did not look right and the nurse assured her that these would all heal. Iodine was added on top of them and the dressing reapplied. When you look from a lying down position, you don’t get the best view, but everyone assured me that the scar was healing very well.

I was told to get back on paracetamol every 4 hours, so I could move better and not to walk any further than end of the garden until 3-4 weeks; stockings for 1 more week and compression garment for 1 more week and then can move to Spanx. My walking of 1km and 2km the next day was way too much and could be why I deteriorated after.

I slept in car on way home and during day. My husband made me a good salad. I need to eat fresh, healthy food if I am not exercising at least! All this sitting around has given me cabin fever and I’ve been reaching for the snacks a bit. Looking forward to getting back on track!



Thursday 17th April:

Homina erecta…finally! (Although it’s still only parts of the day I am full straight)


I had my first shower. I was slightly nervous of getting my dressings wet, but thoroughly enjoyed having a proper shower and washing my hair myself.

When I patted myself dry, the iodine from under the dressings leaked over the white towels.

I seem to have white bumps all over my face, not sure why. It could be heat rash or maybe I’m allergic to something. I’ve been taking my paracetemol regularly now.




Sunday 20th April:

My husband did a sterling job of changing my dressing. However, I took it literally when nurse said to put dressing over belly button too. I was sure it needed gauze too, but didn’t put this underneath. My husband put 2 very adhesive strips over my belly button. I felt it tugging at me and a while later thought I had to remove it. I got a damp cloth to ease it off and noticed a bit of scab around my belly button skin coming off. The whole thing made me feel quite queasy. I was very scared, to the point I actually started crying. This startled my husband from his yawning and email checking, but only I could really lift the plaster off as queasy as it made me feel and we washed it and applied a square of gauze and plasters just around it. I emailed the Aurora clinic and Aggie told me that I should actually just leave it open to air dry anyway.

The kids are with my parents for the weekend to give my husband a break.


Monday 21st April:


I’m OK, still a little hunched.

Aurora (Aggie) wrote again during holidays to respond to my queries:

- surgical stockings on for 6 weeks;
- walking only trying short distances if feel ready in week 3
- garment on at night for first 3 months and need to wear Spanx during day at least (can do this from Weds) as long as wear something for 23 hrs a day.
- Wash belly button daily





Wednesday 23rd April:

I walk 400m. I feel like my stomach muscles are tugging me forward into a hunched position even when walk short distances. I have been forgetting paracetamol and should take it again. I also had a sip of red wine (you are allowed alcohol 2 weeks post)..

I feel like getting much more mobile. I can sit on my daughter’s bed and read her a story better now, lean over and kiss her.


Thurs 24th April:

My first longish walk after being ticked off for my walks in week 1. I walked an 800m round trip. It was fine, I didn’t hunch too much, but walked very slowly. I am much more mobile, feel more flexible and able to stand longer generally – even managed to do some baking today.


Friday 25th April:

I changed my dressings, after cleaning with cool, boiled water (they need to be changed every 3 to 4 days). I did the same 800m walk. I was fine, I think I was faster than yesterday, but my left hip was quite sore. I’d taken paracetamol at about 8am and how needed to repeat it just after 12 when back home. My hip has been hurting the rest of the day in fact.

Result 1 year and 3 months later:

I have been careful to maintain weight and result looks good, the scar line has faded, although is still visible. My belly button is neither an innie or an outtie and I am not sure it is quite central either, which is kind of odd, so overall, I still do not feel comfortable showing my belly as it looks like all tummy tuck bellies, somehow not quite right. One thing I should also warn about is that although when you stand upright you have no loose tummy skin, when you bend over, you will still have some there. That said, the result is so much better than it was before, I feel comfortable in a high waisted bikini at least and do not regret decision.