Diastasis Recti Repair and Abdominoplasty FAQ's

What is Diastasis Recti?

Diastasis recti is abdominal separation that happens on both sides of the rectus abdominis muscle. 

This condition can occur in pregnant individuals due to the size of the growing uterus, the size of the baby, or even just due to pregnancy itself. It happens more frequently in individuals who are on their second, third, etc. pregnancy but can certainly happen on the first as well. It can also happen in men and infants.

There appears to be no higher risk of morbidity for individuals who have diastasis recti and there is no treatment technically necessary. The muscle being separated however, while not fatal, can make it difficult to lift objects and sometimes cause lower back pain and can sometimes lead to exercise routines not being as effective. 

There are physical therapists and athletic trainers who work specifically on helping individuals with diastasis recti. They hope to restore the muscle with proper and deliberate exercises and therapies.

What is an Abdominoplasty?

Some individuals will choose to operate on the muscle to repair it and bring it back together. This is called diastasis recti repair and is often included in many board certified plastic surgeons procedure called abdomnioplasty, commonly referred to as a “tummy tuck”. 

“Tummy tuck” surgery will remove excess fat and skin from the abdominal area and then repair the abdominal muscle. While the muscle repair is often included in the surgery, you can have an abdominoplasty done without needing a muscle repair. Though chances are, if you are having an abdominoplasty done, you may benefit from have the muscle resorted. 

Tummy tucks are done on individuals who are generally healthy and within typically normal body weight, do not smoke, and who have diastasis recti and an abdomen that is protruding with loose skin and that is sagging. According to the American Society of Plastic Surgeons, approximately 85% of the people who undergo this surgery identify as women.

Eating healthy, exercises, getting enough sleep are all wonderful things to do after pregnancy to try to feel great and get back in shape. However, the fact is, sometimes it is not enough to address the skin that that sags and protrudes, especially after profound weight loss.

What is the "Tummy Tuck" Procedure?

The abdominoplasty is not a cure-all. It does not address mental health problems or self-esteem. It also is not permanent in nature. Meaning, women can actually get pregnant again after having one done and you can gain weight again even without a pregnancy. 

Having an abdominoplasty done is a major procedure. The surgery itself can take 3 hours and is done while the patient is "out". An incision will be made from hip to hip, and usually a little bit above the bikini line. This incision will scar. Typically the naval will have to be moved as well, and this may scar as well. Upon the end of the procedure, two drains are usually placed in to collect excess fluid and the drains will be emptied one or two times a day by the patient until 5 days post-op when they are removed. 

What is the "Tummy Tuck" Recovery?

The recovery from a tummy tuck is, simply put, no joke. Once patients arrive home from the hospital or outpatient surgery center, they will definitely need assistance, especially if the muscle repair was done. Assistance with pain medication distribution, drainage tubes, and simple things like getting comfortable and eating will be needed for 4 days most likely. This is one of those surgeries that many people regret doing until they are fully healed, as it is painful and long. Most surgeons will recommend 1-2 weeks off of work and a 6-8 week physical recovery. Those who have the muscle repair done will have to wait 10 weeks to do any exercises that directly involve the core.

Things like massage, receiving flowers in the mail, cards, and text messages can help patients feel a little happier during the recovery.

Studies have shown that this surgery is known to improve the quality if life for those who undergo it. Patients ought to keep that in mind during the recovery period and remember there is a (very bright) light at the end of the tunnel.  

What is Postoperative Depression?

Like with all surgeries, there are risks and one of those for an abdominoplasty is a risk of postoperative depression. Postoperative depression (or post-surgical depression as it is sometimes called) can occur due to loneliness, decreased mobility, pain levels, change in routine, cessation of normal activities, etc. Since the recovery of the tummy tuck procedure especially with the muscle repair is so great in length, it is important to be aware of mood swings and view the healing process with as much reality as possible.

Societal Views

For some reason, there is a lot of social stigma surrounding this procedure and also misinformation. Calling it the easy way out is completely unreasonable, as it is a major surgery with a significant healing time and financial investment involved. Individuals who choose to go through with this procedure have to be healthy, and they are generally deciding to do this surgery after years of working out. According the American Society of Plastic Surgeons, the average age of women getting this procedure done is 42 years old. It typically isn't their first step, and even if it is, that is okay, too, as long as their surgeon is comfortable.

Conclusion

Included in the physical changes that take place in some women while pregnant and postpartum is the diastasis recti separation. One of the ways to remedy this is with working with a trainer or therapist skilled in healing it. Another way is through surgery, and with the surgery can come an abdominoplasty. If you think you may have this separation or are considering skin and excess fat removal from the abdominal area, give a board certified plastic surgeon in your area a call to schedule a consultation. They will be able to answer any questions you have about the procedure and healing time and tell you if they think you are a good candidate. 

References

"Liposuction and Tummy Tuck Improve Quality of Life, Reports Plastic and Reconstructive Surgery." American Society of Plastic

           Surgeons. Lippincott Williams & Wilkins, 29 Mar. 2012. Web. 10 Feb. 2016.

           <http://www.plasticsurgery.org/news/2012/liposuction-and-tummy-tuck-improve-quality-of-life.html>.

"Postoperative Depression." Tuck That Tummy. Web. 10 Feb. 2016. <http://www.tuckthattummy.com/postop_depression.htm>.

Rectus Abdominis. Healthline. Web. 10 Feb. 2016. <http://www.healthline.com/human-body-maps/rectus-abdominis-muscle>.

"What Is a Diastasis Recti." Tupler Technique. Tupler, Inc. Web. 10 Feb. 2016. <https://www.diastasisrehab.com/what-is-diastasis-recti>.