Diastasis Recti Surgery: Everything You Need to Know

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Diastasis recti surgery corrects separation of the abdominal muscles, which can occur due to pregnancy but is also seen in other individuals. It may be an open or laparoscopic procedure and may include a tummy tuck. It is usually a same-day surgery, but requires two to four weeks of recovery.

Diastasis recti

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What Is Diastasis Recti Surgery?

Diastasis recti is a physical condition that describes a gap down the center of the abdominals. Abdominal separation widens the torso and commonly occurs during the late stages of pregnancy. It is also seen in newborns, as well as in older people without regard for gender.

In adults, a separation between the abdominal muscles with a width of two fingers or more is considered diastasis recti. Diastasis recti may increase the risk of hernia, incontinence, and low back pain. Many patients experience multiple benefits after surgery to correct diastasis recti.

Diastasis recti may heal on its own or improve with the help of targeted exercises. However, when the issue persists, you may choose to have it corrected surgically. Surgeons can close the space and reconnect the muscles as a standalone procedure or as part of an abdominoplasty (tummy tuck).

Here's what you should know if you're considering surgery for diastasis recti.

Contraindications

If you are breastfeeding, most surgeons advise waiting a couple of months after weaning your baby before diastasis recti surgery. If you're planning to become pregnant again, it's best to wait until you're finished having kids to have the procedure.

Most surgeons advise waiting at least six to nine months after giving birth before having surgery to repair the diastasis recti. Your body needs sufficient time to recover from childbirth and for your hormone levels to return to baseline.

Potential Risks

The potential risks of diastasis recti surgery are greater based on how much work you're having done. For instance, a laparoscopic repair is less invasive than a full tummy tuck. Many of the risks are common to other types of surgery, including:

  • An infection at the incision site that can spread throughout the body
  • Numbness or persistent pain
  • Skin loss
  • Swelling that doesn't subside with time
  • Uneven or asymmetrical result

Consult with a board-certified plastic surgeon to reduce your risk of complications. An experienced surgeon should share before and after photos of real patients to give you realistic expectations before surgery.

Purpose of a Diastasis Recti Procedure

Diastasis recti surgery is rarely covered by insurance since it is primarily considered an elective procedure. However, many patients report less back pain and incontinence following a tummy tuck, indicating functional benefits that extend beyond cosmetic changes.

Hernias are common with diastasis recti, so correcting the abdominal separation fixes the issue and makes it easier to live an active lifestyle.

Less invasive treatment options include body contouring procedures and targeted exercise to strengthen the core. Body contouring procedures, like liposuction, can be an alternative to a full tummy tuck.

Although body contouring can reduce excess fat on the abdomen, it will not fix separated muscles or eliminate excess skin. Many surgeons report that surgery is the only way to repair diastasis recti.

To qualify, surgical candidates should have preoperative physical to ensure good health for healing and recovery. Being a nonsmoker and having control over chronic conditions (like diabetes) will put you in the best position for a successful procedure.

How to Prepare

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

Location

Your surgeon will schedule diastasis recti surgery in an outpatient certified surgical facility. For elderly patients, newborns, or those with more complex medical issues, an inpatient hospital procedure may be required.

What to Wear

Wear loose, comfortable clothes that you can change easily. You'll want to choose a top that opens easily in the front rather than having to pull something over your head.

Opt for a hoodie or a button-up shirt, slip-on shoes, and comfortable drawstring pants. Choose items that are easy to wash and you don't mind staining, as the drains after surgery can leave you with marks on clothing.

Food and Drink

For patients having surgery under general anesthesia, following your healthcare provider's orders on pre-surgery fasting is crucial. As a basic rule, adults should avoid eating at least eight hours before their scheduled arrival time for surgery. You may be permitted to consume clear liquids up to two hours before heading into your appointment.

Medications

Your healthcare provider will advise you to discontinue certain medications before surgery, particularly those that increase bleeding risk, such as aspirin. You'll want to avoid over-the-counter drugs or supplements to prevent potential issues.

Let your healthcare provider know about all of your medications before surgery to reduce the risk of dangerous complications.

What to Bring

Someone will need to drive you home after the surgery. Along with your support person, bring personal identification, insurance information, and any last-minute paperwork with you on the day of your surgery. It won't be long before you're heading back home, so avoid taking any valuables or cash with you to the operation.

Pre-Op Lifestyle Changes

Getting close to your ideal weight through healthy eating and physical activity will help you prepare for diastasis recti surgery, especially if you also plan on having a tummy tuck. By avoiding weight fluctuations after surgery, you can prevent your skin from stretching out again after the procedure.

In some cases, common exercises, like crunches, can increase abdominal pressure and make the existing diastasis worse. However, several exercise programs explicitly target diastasis recti. You can also search for a physical therapist in your area who specializes in diastasis recti treatment.

What to Expect on the Day of Surgery

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

Before the Surgery

Your surgeon will provide specific instructions to follow on the night before and the morning of your surgery. These may include washing your body with antibacterial soap to reduce the risk of infection. Follow the directions carefully and plan to get to the surgery center on time.

Once you arrive for your surgical appointment, you'll be given a hospital gown to change into and a surgical assistant or nurse will check your vital signs. If you have unusual symptoms on the day of your surgery, such as a fever, be sure to share this information with your provider.

When possible, it's better to ask questions on the days and weeks leading up to your surgery so you'll feel confident when it comes time for the procedure. There will be just a few minutes to speak with the surgeon on the day of your operation before it begins.

Most surgeons choose to place patients under general anesthesia for diastasis recti surgery. You'll be visited by an anesthesiologist who will review the plan with you and have you sign a liability waiver before your operation. Once this is complete, the anesthesiologist will put you under, and surgery will begin.

During the Surgery

Your surgeon will either perform diastasis recti surgery as an open procedure or laparoscopically. When your operation includes a tummy tuck (or mini tummy tuck), it will begin with a horizontal incision between the pubic bone and belly button.

After lifting the skin, the surgeon uses stitches to pull the abdominal muscles back together and secure their new position. If you have a hernia, your surgeon will also repair this during the procedure.

After the repair work is complete, your surgeon will trim the excess skin and pull down the remaining skin to suture it. Your surgeon will create a new belly button and close the wound using adhesives, clips, tapes, and, or more stitches. In a mini tummy tuck, the surgeon tightens only the skin below the belly button.

Some patients will also have liposuction to remove abdominal fat as part of the tummy tuck procedure. Your surgeon should review the exact sequence and techniques planned for your operation before the day of your surgery.

For those having diastasis recti surgery through laparoscopy, three to four small "keyhole" incisions will be placed to perform the surgery. Laparoscopic procedures are less-invasive, although the underlying muscles will still require plenty of time to heal.

Surgical instruments are inserted through the holes, along with a laparoscope, (a narrow rod with a light and a tiny camera attached). A monitor projects the surgery for the surgeon to reference as they go.

After the Surgery

Although it's an invasive operation, you'll be able to go home within a few hours of surgery. Higher-risk patients may be required to have an overnight stay in the hospital to monitor for complications. Be sure to make arrangements in advance for a ride home and someone to help care for you after your procedure.

Along with bandages on your wounds, your healthcare provider will send you home with drains to allow the release of excess fluid during the early stages of healing. Follow your healthcare provider's aftercare instructions to keep the drains clean. Your surgeon will provide a compression garment for support and to help minimize swelling.

Since you'll be heading back to see your healthcare provider shortly after the procedure (often the next day), they'll probably be the first person to remove the compression garment and check on your recovery. You may need assistance at home to change in and out of the compression garment for the first week or so going forward.

Recovery

Most people can return to work within two to four weeks of diastasis recti surgery. Hold off on jobs that require heavy lifting for the first month after your procedure. If you have young children at home, be sure to have extra help available. Lifting too soon after your procedure can damage your results.

Healing

Expect some swelling after surgery, along with minor weight fluctuations as your body holds onto fluid while healing. Don't rush to judge your results until you've had enough time to get beyond the initial stages of recovery.

Diastasis recti surgery directly involves your muscles, so muscle soreness is normal. Your abdomen may feel tight for a week or so after the procedure, especially if you've also had the skin tightened. Many patients report temporary difficulty standing up straight and pain when coughing or laughing.

Your top priority for early healing should be to avoid straining your muscles and to prevent infection at the incision sites. Keep bandages clean and dry per your healthcare provider's instructions.

Bathing and swimming are off-limits until your surgeon says otherwise. If you undergo a tummy tuck as part of your diastasis recti surgery, you'll have a significant scar that needs enough time to heal before you can submerge in water. Failing to be patient with the time it takes to heal can set you back, compromise your results, or put you at risk for a life-threatening infection.

Coping With Recovery

Take pain medication as prescribed by your healthcare provider to avoid unnecessary discomfort as your body begins to heal. Rest is essential for recovery, so plan to be in bed early and give yourself time to relax at home.

During the first week after surgery, walking around the house will keep your blood flowing and encourage healing. You'll need to avoid strenuous exercise, so now is an excellent time to sort through old photos and paperwork, chat with friends and family over the phone, and catch up on your favorite television shows.

Set aside light projects to keep busy and avoid the temptation to push yourself physically before your body is ready. Let a few trusted contacts know about your surgery so they can help you out with things around the house, like grocery shopping and laundry.

Possible Future Surgeries

Even the best surgeons sometimes end up with suboptimal results. If, after several months of healing, you're unhappy with the outcome of diastasis recti or tummy tuck surgery, your healthcare provider may be able to recommend a revision.

Generally, the results from diastasis recti surgery are permanent. Once you have the procedure, your abdominals should remain properly positioned, and the gap should not return.

Lifestyle Adjustments

Maintaining a stable weight after surgery will help you to maintain the results of diastasis recti surgery. Significant weight gain or subsequent pregnancies can take away from the progress your surgeon made during the operation.

Living a healthy lifestyle that includes balanced and nutritious eating habits and regular physical activity will let you enjoy the long-term benefits of your surgery. If you had a tummy tuck, avoid getting sunburned on your scar to help it fade.

A Word From Verywell

Beyond improving your self-image, diastasis recti surgery can support your core strength and fix issues like urinary incontinence and hernias. However, diastasis recti surgery is an invasive procedure with serious potential risks. Consult with a board-certified plastic surgeon and take your time to consider whether surgery is the right option for you.

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10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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