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Rectus diastasis and muscle repair in tummy tuck surgery

Posted on
December 11, 2022
by
Miss Sujatha Tadiparthi, Consultant Plastic and Reconstructive Surgeon

If you have a bulging tummy after childbirth, you are likely to have ‘rectus diastasis’ (aka ‘rectus divarication’ or ‘divarication recti’). During an abdominoplasty (tummy tuck), any excess skin that you may have over the lower part of your tummy can be removed and the abdominal muscles are repaired to give a more attractive, hour-glass shaped, flat tummy and so that you can return to your pre-pregnancy body.

rectus diastasis repair tummy tuck before and after
before and after rectus diastasis repair during tummy tuck surgery

What is rectus diastasis or rectus divarication?

Plastic surgery can be life-changing, but the potential risks of cosmetic surgery should be carefully considered. Therefore, during the consultation, Miss Tadiparthi will spend time listening to your concerns, advise on the most suitable plastic surgical options individual to your needs and ensure that you have realistic expectations of what can be achieved with surgery.

diagram of diastasis recti

Who can get rectus diastasis?

  • After having children, the tummy is stretched by the growing baby. This leads to the rectus muscles being pushed forwards and stretched. It is more common after multiple pregnancies but can be seen even after a single pregnancy.
  • Rectus divarication can also happen with general ageing. As we get older, especially if we are not active or doing any exercise, the muscles can also lose their tone and become stretched by our growing waistlines.
  • Divarication recti is occasionally seen after having abdominal surgery as the rectus muscles separate from each other after surgery.

What problems does rectus diastasis cause?

Separation of the rectus ‘six pack’ muscles (recti) can cause problems with your daily function and it can also be visually unattractive.

There is reduced abdominal support due to the stretched muscles. As a result, there may be either a visible vertical bulge in the centre of your tummy (due to the gap between the two vertical muscles) or the whole of your tummy may look bulging and prominent, almost like a pregnant tummy. Some ladies are often mistaken for being pregnant and this can be very upsetting. They feel self -conscious and wear loose clothing to hide their bulging tummy – restricting what clothes they wear. On holiday, they do not have the confidence to wear a bikini.

Functionally, the rectus muscle separation can cause core muscle weakness – this can lead to problems with getting out of bed, getting up from a sitting to standing position or climbing stairs. It may be difficult for you to do yoga or pilates and other exercises that require core strength e.g. sit ups, push ups, plank positions.

How is muscle repair done during a tummy tuck? i.e. how is rectus diastasis repaired during abdominoplasty surgery?

Repair of the rectus divarication (i.e. the separation) is aimed at bringing the muscles close together and reducing the vertical central gap between them. The repair provides better support to the abdomen thereby reducing the bulging. During a tummy tuck surgery (full abdominoplasty), a large horizontal ellipse of skin and fat from the level of the belly button to the pubic area is removed. The skin and fat above the umbilicus is raised up so that the underlying muscle separation can be seen. The muscles themselves are very fragile and can tear easily. However, the lining of the muscle over it, called the ‘Rectus Fascia’ is thick and strong.

Permanent stitches are put in the fascia to bring the rectus muscles together and close the gap (the 'divarication’) between them and give more support to the abdomen. One row of permanent stitches above the umbilicus and another below the umbilicus are placed.

The skin above the belly button that has been raised from the underlying muscle layer is pulled down to cover the large elliptical area below the belly button that has been removed. Throughout the procedure, the belly button is kept intact on its stalk and it is repositioned in its natural position when closing the wounds.

What are the benefits of muscle repair (rectus plication) in tummy tuck surgery?

The rectus plication (muscle repair) not only reduces the gap between the rectus muscles and gives more support to the abdomen. As the muscles are brought back together and tightened with the repair, it also gives a more ‘hourglass’ contoured shape to the waist line and a flat tummy.

To learn about muscle repair as part of tummy tuck surgery, get in touch….

Book an online or face to face consultation with our multi-award-winning London based plastic surgeon, Miss Sujatha Tadiparthi. She can discuss your concerns with you, assess the underlying muscle damage and offer the most suitable surgical options to give you the best result.

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