Diastasis Recti Surgery: Everything You Need to Know

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Diastasis recti is a condition where the muscles of the abdomen have come apart. The muscles can separate when someone is pregnant or for other reasons. If you have this condition, you may need to have an operation to fix it. Diastasis recti surgery can be done on its own or as part of a "tummy tuck" procedure.

This article will go over everything that you need to know about diastasis recti surgery. You will learn why it is done, what to expect when you have the surgery, and what the recovery will be like.

Diastasis recti

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What Is Diastasis Recti?

Diastasis recti is a condition where a gap forms down the center of the muscles of your abdomen. If you are pregnant, these muscles come apart in the later stages of pregnancy. The condition can also happen in newborns and older people.

If an adult has a separation between the abdominal muscles that's a width of two fingers or more, it is considered diastasis recti.

If you have the condition, it can increase your risk of getting a hernia, having trouble controlling your urine (incontinence), and experiencing low back pain.

Sometimes, diastasis recti will get better on its own. It might improve if you do exercises that work your abdominal muscles.

If it doesn't get better, you'll need to have surgery to fix the problem. A surgeon can close the space and reconnect the muscles. This can be done by itself or as part of an abdominoplasty. This is also called a "tummy tuck."

Many people feel better after they have surgery to fix diastasis recti. However, there are some things that you should know if you are considering it.

Recap

Diastasis recti is a condition when the muscles in your abdomen come apart. It can be fixed with surgery. You might have the condition fixed when you are having another surgery, like a tummy tuck.

Contraindications

If you are breastfeeding, most surgeons will want you to wait a couple of months after weaning your baby before having diastasis recti surgery.

If you're planning to become pregnant again, remember that pregnancy separates the muscles in your abdomen. You should wait until you are done having kids to have surgery to fix diastasis recti.

Most surgeons will want you to wait at least six to nine months after giving birth to have surgery to fix diastasis recti. You need to give your body time to recover from childbirth. You also need to give your hormone levels a chance to return to what they were before you were pregnant.

Potential Risks

There are potential risks of diastasis recti surgery. The amount of risk will depend on the kind of surgery you have.

For example, some surgeries are done with just a few small cuts. This is called laparoscopic surgery. The surgeon uses a camera to see inside your belly. Other surgeries, like a tummy tuck, are done with more cuts or bigger cuts. These cuts are also called incisions.

Every surgery comes with risks, including:

  • Infections
  • Numbness or lasting pain
  • Skin loss
  • Swelling that does not go away
  • A belly that looks uneven or lopsided (asymmetrical)

If you are thinking about having diastasis recti surgery, talk to a board-certified plastic surgeon. It's important that you talk to them about the risks of having surgery. They might be different for you than they would be for someone else.

They might also be able to show you "before and after" photos so you can see how they fixed diastasis recti for other people.

Recap

Every surgery has risks. Having surgery to fix diastasis recti can lead to infections, numbness, and swelling. Even if the surgery fixes your muscles, you might not like how it looks after it heals.

Purpose of Diastasis Recti Surgery

In most cases, surgery is the only way to repair diastasis recti. However, you should know that diastasis recti surgery may not be covered by insurance. It's considered an elective procedure, which means that it can be scheduled ahead of time. In other words, it's not an emergency.

Diastasis recti surgery can also be considered a cosmetic procedure. If you have diastasis recti, it changes how your belly looks.

While surgery can improve its appearance, that's not the only reason people have a procedure. Many patients have less back pain and no longer have incontinence after they have a tummy tuck.

People with diastasis recti can also get hernias. A hernia happens when part of an organ or tissue pokes through the muscle in your abdomen. It can be uncomfortable and may make it harder for you to do your daily activities.

Hernias happen when the muscles in your abdomen are weak or torn. That means having surgery to fix diastasis recti may also help if you have a hernia.

While insurance providers might not see it that way, having surgery to fix diastasis recti is often about more than "looks." It can also help people feel better physically.

There are ways to address how your abdomen looks that are not major surgery, like body contouring procedures like liposuction. These procedures take fat from the abdomen but they do not fix separated muscles or get rid of excess skin.

Doing exercises that strengthen your core muscles can also be helpful, both physically and in terms of looks. However, they will not fix diastasis recti.

Recap

Surgery to diastasis recti can help you feel better physically. It can also help you feel better about the way your abdomen looks. Sometimes, diastasis recti will get better on its own. It might also get a little better if you do exercises to make your core muscles strong. However, surgery is the only way to fix the muscles.

How to Prepare

Here's what you'll need to do to get ready for diastasis recti surgery.

Location

Most diastasis recti surgeries are outpatient surgeries. It's sometimes called "day surgery" because you do not have to stay overnight in a hospital.

Your surgery will be scheduled at a place that does outpatient surgeries. However, older adults, newborns, and people with certain medical conditions may need to be admitted to the hospital to have diastasis recti fixed. This is called inpatient surgery.

What to Wear

On the day of your surgery, wear loose, comfortable clothes. You want something that will be easy to change out of. Here are a few pointers:

  • Pick a top that opens easily in the front. Don't wear a shirt you'd have to pull over your head. A hoodie or a button-up shirt would also work.
  • For bottoms and shoes, drawstring pants and slip-on shoes are easy and comfortable.
  • Choose items that are easy to wash or that you don't mind getting dirty. After your surgery, there might be bleeding from where you were cut. Even though they will have bandages on them, your clothes could still get stained.

Food and Drink

You will have to follow some rules in the day or so before your surgery. One important instruction your surgeon will give you is to not eat or drink for a certain amount of time before your surgery. This is called fasting.

Usually, you will need to stop eating at least eight hours before you have to be at the hospital. You might be able to keep drinking clear liquids, like water, until about two hours before your surgery.

Medications

Your doctor may ask you to stop taking some of your medications before your surgery. This is because some medications can thin your blood and make it easier for you to bleed.

There are many different prescription medications that can thin your blood. However, many over-the-counter medicines, supplements, and herbal remedies can have the same effect. Aspirin is a common example of an OTC medicine you should not take before you have surgery.

When you are preparing for your surgery, tell your doctor about all the medications you take. This includes over-the-counter medicine, nutritional supplements, and herbal remedies.

What to Bring

On the day of your surgery, you will need to bring several important things with you. The first is a support person. You won't be able to drive after your surgery. You need a trusted person who can safely get you home.

You also need to bring some documents, including:

  • Personal identification (like a driver's license)
  • Health insurance information (if you have it)
  • Any paperwork that your surgeon's office asked you to fill out

There are also some things that you should leave at home. Don't bring valuable items or a lot of cash with you. Leave your favorite jewelry or watch at home. If you bring your phone or tablet with you, make sure to give it to your support person when you are getting ready for surgery.

Pre-Op Lifestyle Changes

Being as healthy as possible before your surgery will help you get through the procedure and your recovery. If you're having diastasis recti surgery, your surgeon might talk to you about why it's important to be at a weight that supports your health.

If you lose or gain a lot of weight after you have a procedure like a tummy tuck, it can make the skin of your abdomen stretch out.

Your healthcare provider will encourage you to eat a nutritious diet and get regular exercise before your surgery. However, you might want to avoid doing exercises that put pressure on your abdomen. For example, doing crunches may make diastasis recti worse.

There are also some exercise programs meant to help people with diastasis recti. You might be able to work with a physical therapist to strengthen your abdominal muscles before your surgery.

Recap

Preparing for diastasis recti surgery involves staying healthy in the weeks leading up to your surgery, fasting the night before your procedure, and arranging for someone to bring you home after the surgery is done.

What to Expect on the Day of Surgery

When the time comes to have your diastasis recti surgery, here's what you can expect.

Before the Surgery

Your surgeon will tell you what to do the night before and the morning of your surgery. For example, they may have you wash your body with antibacterial soap. This can help prevent infections.

Follow the instructions carefully. If you have questions, call your surgeon's office. It's best to share your concerns or ask questions in the days and weeks leading up to your surgery. On the day of, you won't have very long to talk to your surgeon.

Plan ahead to make sure that you will get to the place where you are having surgery on time. When you arrive, you will change into a hospital gown. You might be given a bag to put your clothes and personal items in. Your support person can look after it for you.

A surgical assistant or nurse will check in to see how you are doing. They will take your vital signs (for example, your temperature and your blood pressure). If you are not feeling well or have had a fever, make sure you let them know.

You will be under general anesthesia for your surgery. The medicine makes you unconscious—like being asleep, but much deeper. You will also get medicine that makes it so you can't move during the surgery. You won't feel any pain or remember the surgery when you wake up.

The doctor who is in charge of giving anesthesia (anesthesiologist) will come to talk to you. They will have you look at a document that tells you about your rights as a patient. This is called a waiver. Every patient has to read and sign it before they can have surgery.

Once the paperwork is squared away, the anesthesiologist will give you some medicine to help you relax. Then, you'll be ready to go to the operating room.

During the Surgery

Once you have been given anesthesia, your surgery can begin. Your surgeon will either do the procedure with a big cut (open) or a few smaller cuts and a camera (laparoscopic).

If your operation includes a tummy tuck (or mini tummy tuck), your surgeon will start by making a cut going side to side between your pubic bone and belly button.

In a mini tummy tuck, the surgeon only tightens the skin below your belly button.

Next, they will lift up the skin. The surgeon uses stitches to pull the abdominal muscles back together and put them in the right position. If you have a hernia, your surgeon will fix it.

Once they finish the repairs, your surgeon will trim the excess skin. They do this by pulling down the remaining skin to stitch it together. This is also called suturing.

Since the skin has been moved around, your surgeon will need to make you a new belly button. When they're done, they close the wound with adhesives, clips, tapes, or more stitches.

You may have liposuction to remove abdominal fat if you're having a tummy tuck. Your surgeon will explain the steps of this procedure to you before your surgery.

If you're having a laparoscopy, your surgeon makes a few small cuts in your abdomen. They put tools and a camera inside the cuts to look around and make repairs. This type of surgery is also called a "keyhole" surgery.

Laparoscopic surgery is not as major as open surgery. It's also called "minimally invasive" because you do not need to have as many cuts. However, you'll still need plenty of time to heal.

After the Surgery

You'll usually be able to go home a few hours after you get out of surgery. However, if you had any problems during the procedure or if you have certain health conditions, you may need to stay in the hospital overnight. This allows your medical team to keep an eye on you.

You will have bandages on your wounds. You will also have drains on your body to let the extra fluid come out as you start to heel. You will be shown how to keep the drains clean. It's very important that you follow the instructions carefully.

You will also be sent home with something you can wear around your middle that puts pressure on it. It's called a compression garment. It provides support and can help the swelling go down.

You will check in with your doctor next within a day or two. They may take the compression garment off to see how you are healing. From there, you will have to take the garment off and on yourself for about a week. You might need someone to help you if it's uncomfortable.

Recap

You will have your surgery at a hospital or another facility. If everything goes well, you won't have to stay overnight. After your surgery, your support person can drive you home.

You will have instructions for caring for your wounds and the drain in your belly. If possible, have someone help you around the house so you can rest.

Recovery

Most people can go back to work within two to four weeks of having diastasis recti surgery. That said, if you do a lot of heavy lifting at your job, you may need to wait a month. If you start lifting heavy objects too soon, it can affect your healing.

Healing

You will have some swelling after your surgery. You might notice some small changes in your weight, but it is not fat. Your body is actually holding on to water in the early stages of recovery.

Since diastasis recti surgery is on your muscles, they'll probably be sore for a while. Your abdomen may feel taut for a week or so, especially if you had the skin tightened. You might also have some trouble standing up straight. It might hurt when you cough or laugh.

As you are healing, you need to avoid straining your muscles. You also need to prevent the cuts in your belly from getting infected. Your doctor will give you instructions on how to do this and you need to follow them carefully.

You won't be able to get your abdomen wet until your surgeon gives you the OK. That means no bath, shower, or swimming. If you get the cuts wet before they are healed, it can cause an infection. It might also make them not heal right.

Coping With Recovery

Your provider will give you medication to help with any pain you are having. You will need to rest as much as possible. You might need to take naps or go to bed earlier than usual.

That said, you do want to keep moving around. In the first week of healing, walking around your house will get your blood flowing and help with healing. You won't be ready to jump back into a workout routine for a while, though.

It's important to stay busy so you're not tempted to push yourself too much before you're ready. It will also help if you have some loved ones close by who can help you with things like shopping for groceries and laundry. Since you won't be able to do the heavy lifting yourself, making sure someone is around to help will be important as you're recovering.

Possible Future Surgeries

The results from diastasis recti surgery will last forever. That means they are permanent. Once you have the surgery, your abdominal muscles should stay in the right place. The gap you had should not come back.

However, it's also possible that the surgery won't turn out how you hoped it would. Even if your surgeon was very experienced and you did not have complications during your surgery, you might not end up with the results you wanted.

If you've been healing for a few months and you are not happy with how your belly looks (for example, the skin is uneven), you might need to have another surgery. This is called a revision.

Lifestyle Adjustments

Diastasis recti will fix your abdominal muscles but you need to take some steps to make sure the changes stick. One of the most important things is keeping your weight stable. If you gain a lot of weight or get pregnant, the fixes your surgeon made might not hold.

A lifestyle that includes nutritious eating habits and regular exercise will help the results of your surgery last for a long time.

Once you're healed, you will have some scars on your abdomen. They will fade with time, but there are steps you can take to help them heal. For example, keep that skin protected from the sun. If you get a sunburn on a scar, it might not fade as well.

Recap

Your surgeon will let you know when you can start easing back into your normal activity. Once you have diastasis recti fixed, it should last forever. However, if you get pregnant or gain weight, the muscles could come apart again.

If you don't like how your belly looks after you've healed up, you might be able to have another surgery to make changes.

Summary

Diastasis recti surgery fixes muscles in your abdomen that have come apart. The separation can lead to other health problems like hernias. You might also feel self-conscious about how your abdomen looks.

A surgeon can fix your muscles. If you also want to have skin and fat removed or tightened up, you can have a "tummy tuck" or liposuction at the same time as your muscles are fixed. After your surgery, follow your doctor's instructions for taking care of your body while you are getting better.

If you have healed up but do not like how your belly looks, you can talk to your surgeon again. They might be able to do another procedure to fix it.

A Word From Verywell

People have diastasis recti surgery for a variety of reasons. It can support your body physically, fix hernias, and improve your self-image.

If you're thinking about having the surgery, choose an experienced surgeon that you trust. Every surgery comes with risks, but some more so than others. Your surgeon can talk to you about the risks and benefits of having diastasis recti surgery and decide which one is the best fit for you.

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