If you are at a healthy weight, but you still have a “pooch” in your stomach, it may be due to separated abdominal muscles. This condition is called Diastasis Recti and it is very common in women who have been pregnant—studies show that up to 60% of women who have given birth have this abdominal muscle separation.1 Many women are told that abdominoplasty surgery (tummy tuck) is the only way to fix post-pregnancy Diastasis Recti, but a tummy tuck isn’t right for everyone. At Cassileth Plastic Surgery we offer minimally invasive procedures that can fix separated ab muscles without tummy tuck surgery and without creating any new scars.
Diastasis Recti occurs when the midline of the abdominal wall separates or stretches out due to abdominal pressure. The connective tissue that holds together the two sides of the rectus abdominis muscles, or “six-pack”, is called the linea alba. This area stretches normally in pregnant women to allow the baby to grow, and Diastasis Recti occurs when the muscles don’t come back together after pregnancy. For women who get back into their health and fitness routine after giving birth, the stomach may seem fairly flat in the morning only to gradually bulge out as the day goes on.
Women with Diastasis Recti may be able to regain some of their abdominal strength and prevent lower back pain by working with a physical therapist, but no amount of sit ups, abdominal exercises, pilates, or physical therapy can fully repair separated abdominal muscles. However, an extensive tummy tuck is not always needed to regain the flat stomach and small waist of your pre-pregnancy days.
Our team of plastic surgeons use their extensive experience in abdominal wall reconstruction, and advanced surgical techniques, to offer patients who are candidates the opportunity to repair their abdominal separation without adding any new scars.
For some postpartum women who give birth via cesarean section (C-section), Dr. Cassileth can perform an abdominal muscle repair through the existing C-section scar. Dr. Cassileth will carefully sew the medial sides of the diastasis recti abdominis together to repair the separation. The ideal candidate for this type of procedure is at a healthy weight with little-to-no loose or excess skin in the abdominal area.
This procedure involves abdominal muscle repair through the belly button. For patients who do not have a C-section scar, an umbilical approach may be an option. A very small incision will be made around the belly button, which will be virtually undetectable once healed. Ideal candidates are at a healthy weight but struggle with the look and feel of separated abdominal muscles. Similar to the C-section approach, patients should have little-to-no loose or excess skin in the abdominal area. Women with very small or very shallow belly buttons may not be candidates for this technique.
For patients who have loose skin and hold significant excess weight in their midsection, lipoabdominoplasty is a great procedure that provides dramatic improvement. A lipoabdominoplasty creates a lean silhouette while repairing Diastasis Recti. This procedure requires a typical abdominoplasty incision at or below the bikini line and also offers significant reshaping that can change the entire shape of the torso. A lipoabdominoplasty is similar to a tummy tuck, but extensive liposuction is performed to remove fat before the muscles are repaired and the skin is recontoured. If you struggle with excess skin and fat in the midsection and you would like to achieve dramatic results, lipoabdominoplasty may be right for you.
It is very important to ease into working out in a way that encourages the abdominal muscles to heal properly. Recovery after Diastasis Recti repair will require you to refrain from heavy lifting or strenuous exercise for four weeks after your procedure. Dr. Cassileth, Dr. Killeen, and Dr. Min will advise you on how and when to perform abdominal exercises, such as planks, in the month after your surgery.
Every doctor has their own preferences when it comes to surgical recommendations. A surgeon will take your concerns and goals into consideration, but they will also consider their own experience and skills. In addition to their extensive plastic and cosmetic surgery experience, our team of breast and body surgeons have a background in reconstructive abdominal surgery that gives them an in-depth understanding of the abdominal muscles and surrounding structures. They are also devoted to helping women look and feel their best with more minimally invasive procedures.
A medical professional can tell you for sure if you have this condition, but you can get an idea by doing this: Lie on your back and slowly try to do a situp—while supporting your head to look down at your belly, then put your other hand along the middle-top of your abdominal muscles. If you can feel a gap bigger than 1 to 2 finger widths between the two sides of your abs, this could indicate Diastasis Recti.
If you are fit and healthy, but you are bothered by a “mommy pooch” caused by Diastasis Recti, a minimally invasive surgical repair may be right for you. If you have excess skin, an abdominoplasty may be the best option and if you have excess skin and excess fat in the tummy area, you may want to consider a lipoabdominoplasty. The best way to reach your goals is to schedule a consultation appointment to learn more about your options and get a personalized treatment recommendation.
1 Sperstad JB, Tennfjord MK, Hilde G, Ellström-Engh M, Bø K. Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain. Br J Sports Med. 2016;50(17):1092-1096. doi:10.1136/bjsports-2016-096065
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