What is Diastasis Recti? 

What Causes Diastasis Recti?

What You Should Know About Diastasis Recti Surgery

Diastasis recti surgery repairs abdominal muscle separation by surgically reconnecting the rectus abdominis muscles.

Unlike physical therapy or abdominal exercises, surgery provides direct, structural repair when non-surgical methods aren’t enough.

This surgery isn’t purely cosmetic, it significantly improves core strength, reduces discomfort, and addresses physical limitations.

The procedure involves suturing the muscles back together. This enhances your posture and in turn, relieves the back pain you were previously experiencing. 

When Is Surgery the Best Option?

When persistent muscle separation keeps interfering with daily life, diastasis recti surgery often emerges as the most effective option.

Despite dedicated attempts through physical therapy, specialized exercises, or supportive garments, many people still experience ongoing symptoms like chronic lower back pain, significant abdominal bulging, and reduced core stability.

Doctors typically recommend surgical intervention, particularly for cases involving multiple pregnancies, major weight fluctuations, or genetic factors, especially when these conditions consistently limit your physical capabilities or negatively impact quality of life.

The Diastasis Recti Surgery Procedure

Diastasis recti surgery involves surgically reconnecting the separated abdominal muscles by carefully suturing them together along the midline. Key aspects of the procedure include:

• Surgical Techniques: Options include minimally invasive laparoscopic surgery involving small incisions and specialized instruments for reduced scarring, traditional abdominoplasty (tummy tuck) that allows for the removal of excess skin along with muscle repair, or robotic-assisted methods providing precision and potentially quicker recovery.

• Anesthesia: The procedure typically requires general anesthesia, ensuring patient comfort throughout the surgery and minimizing any discomfort.

• Duration: Surgery generally lasts between one to three hours, depending on factors such as the severity of muscle separation and whether additional procedures like skin tightening or liposuction are performed.

• Hospital Stay: While many patients undergo surgery as an outpatient procedure, individuals with more extensive repairs or additional procedures often require an overnight hospital stay to manage initial pain and monitor recovery closely.

Surgery vs. Non-Surgical Treatments

Choosing between diastasis recti surgery and non-surgical treatments involves weighing several important factors. While non-invasive options like physical therapy, specialized core exercises, and supportive garments can be effective for minor cases, they often fall short for severe muscle separations.

Diastasis recti surgery provides a direct, permanent repair by physically reconnecting the separated muscles, significantly improving core strength, posture, and reducing abdominal bulging. Patients typically notice substantial relief from chronic discomfort and limitations that non-surgical methods can’t fully address.

Although surgery carries recovery time and inherent risks, for many individuals experiencing persistent issues, it remains the most reliable, lasting solution.

Treatment for Diastasis Recti

Now let’s discuss treatment. A rectus diastasis does NOT require a tummy tuck to be repaired. I frequently repair the rectus diastasis through old C-section scars as well as through belly button incisions.

I have heard of other plastic surgeons fixing them through the C-section incision (therefore, ensuring the patient doesn’t have additional scarring), but as far as I know, I’m the only one who has done the “umbilicus” incision. Both the C-section and the belly button incision are ideal since the scar stays small and the recovery is much easier than a full abdominoplasty.

Not everyone has a C-section scar, of course, which is why the belly button incision can work better for some people.

I’ve been asked, why doesn’t everyone repair a rectus diastasis this way? I think that plastic surgeons were all taught to do these big abdominoplasty incisions, and it’s so easy to see the diastasis through a big incision than through a much smaller hole.

As my patients asked me to go smaller and smaller over the years, I realized that it is not just “do-able” to do the surgery through the smaller incisions; it’s actually preferable in some cases.

If you don’t need a skin excision, then you’re better off without it. It simply adds scar, risk, and recovery time that you don’t need. And surgically, it’s easier than you would think as the belly button is right in the middle of the abdomen, and the distance to the repair is short.

How Do You Fix  Diastasis Recti Without A Tummy Tuck?

Diastasis recti surgery is done by first making the incision and using the access to “create a plane” between your fat and muscles. That way, the top of the muscles, and the fascia that covers it, can be easily visualized.

The plane goes all the way up to the very bottom of the sternum, called the xiphoid process, and all the way down to the pubis bone, at the very bottom of the abdomen.

After the whole area can be visualized, the muscles are marked. The “medial edge” of the muscles, which is supposed to be the midline, will be split, and the maximum point of the split is usually just under the belly button, right in the middle.

Using a special, long-looped suture, the repair is done in one long, strong running repair.

Starting at the top, getting wider at the middle, and then tapering back to a point, the full diastasis is brought back to the midline. The central area receives a “double repair” for some patients to ensure a solid surgical repair compensates for the natural higher tension.

Then, the patient is seated upright to make sure we “see” all the extra skin and the appearance of the abdomen. As you may have figured out, abdomens always look better lying down, and we need to see it at its worst!

With the patient upright, additional tightening is done as necessary, and skin can be undermined laterally to allow the skin to shift to the full abdomen and lie smoothly. 

What About Recovery?

A drain is then placed that stays in for three to four days, and the skin is then closed with small sutures. The patient wears a compression garment to keep the abdomen tight and supported. After one month, heavy-lifting and exercise can be resumed.

So Who is a Good Candidate for Diastasis Recti Repair? 

These small incisions are great, but they don’t remove any skin, they only fix the muscle. This helps me determine who is a good candidate. 

A good candidate is someone who has stretched-out muscles but not a lot of stretched-out skin. That means that when you get up in the morning, and your stomach is flat, and you suck in all that extra size, that your skin does not hang or double over. The perfect patient looks great in the morning and then looks more and more “pregnant” or stretched-out throughout the day.

Remember, if you have a lot of loose skin or a very wide diastasis, and then surgically I “cinch” your waist back together, all that skin has to fit a much smaller version of you!

If your skin is hanging or loose, you may need some tuck (skin removal) on top of the diastasis repair, requiring a larger abdominal incision. A full abdominoplasty is for excessive skin, and a mini-abdominoplasty is when the extra skin is only present on the lower part of the abdomen, below the belly button.

Get Treatment for Your Separated Abs

The most important takeaway is to remember that you do have the option to fix only the muscle.

You don’t need to remove skin or make extensive incisions unless you choose to do so. Never let anyone say that you have to have a tummy tuck when you don’t really need it! Contact us to schedule a consultation and learn more about which treatment may be right for you.

FAQs

Is diastasis recti surgery covered by insurance?

In most cases, diastasis recti surgery is considered a cosmetic procedure and is not covered by insurance. However, if the condition causes functional issues like hernias or chronic back pain, some insurance plans may offer partial coverage. It’s best to check with your provider.

How long does it take to fully recover from diastasis recti surgery?

Initial recovery takes about 4 to 6 weeks. During this time, you’ll wear a compression garment and avoid heavy lifting. Most patients return to light activity within a month, with full core strength returning around 3 to 6 months post-op.

Will my stomach look flat right after surgery?

Swelling is common immediately after surgery, so your final results won’t be visible right away. However, once healing is complete, most patients notice a much flatter, firmer abdomen with improved core stability.

Can men get diastasis recti surgery, too?

Yes. Though commonly associated with postpartum women, diastasis recti surgery is also effective for men who develop abdominal separation due to obesity, weightlifting injuries, or frequent pressure on the core.

What are the risks of diastasis recti surgery?

Like any surgical procedure, risks include infection, bleeding, fluid buildup, scarring, or anesthesia complications. Choosing a board-certified surgeon and following aftercare instructions significantly reduce these risks.