Diastasis: Why You Can Still Look Pregnant Years After Giving Birth and the Solution to Fix It

Posted September 25, 2024 in Mommy Makeover, No Drain Tummy Tuck, Revision Tummy Tuck, True Form Body Contouring®, True Form Tummy Tuck®, Tummy Tuck, Uncategorized

By Dr. Chris Patronella

Introduction

In the patients’ preoperative photos featured in this video, the abdominal appearance is very round and protuberant. No exercise in the world is going to fix this. But it can be surgically-corrected in a tummy tuck procedure. In the patients’ postoperative photos you can see how effective the tummy tuck has been in flattening out the abdomen by repairing the space between the rectus muscles.

Video: Dr. Patronella Shows You the Details of His No-Drain True Form Tummy Tuck

Following pregnancy, many women experience something called diastasis recti. The schematic in this video represents exactly what is happening during this process. The growing fetus expands the abdominal wall, as we all know. Normally, the vertically-oriented rectus muscles sit right together in the midline. Varying degrees of diastasis can occur. Obviously, the bigger the child, the greater the risk it will expand, and with twins, even more so. But some women will experience severe diastasis even with a single childbirth. It just depends on the elasticity and the strength of the connective tissue for any individual person, and much of that is controlled by genetics.

The first case shown is a very mild diastasis. The gap between the rectus muscles is relatively narrow. Nevertheless that can show and give the abdominal wall more protuberance forward. And that can be disconcerting to a woman. As mentioned before, this, unfortunately, is not something that can be improved with exercise. The space between the muscles is composed of a tissue called fascia. Fascia is inelastic. It is rigid and does not respond to strengthening in any way.

The third image is an example of a much more severe case of diastasis where the gap is quite wide. And this can be very disconcerting for women who experience this because they often will look pregnant—they will look five, six, or even eight months pregnant. They’ll get asked, “How far along are you?” And they’re not pregnant. They have a very severe separation between the rectus muscles. The fascia gets thin and stretched out. And the only correction for it is a surgical one.

The patient shown in the first set of case photos looks like a three or four-month pregnancy. It can be repaired. When diastasis is present, abdominal exercises—crunches, sit-ups and such—become less effective because the muscles do not engage the same way as they do when the muscles are back together. So core strength is weakened—dramatically weakened. Some women will feel that low back pain is caused by weakness of the abdominal wall. And I’ve seen many, many patients who’ve felt like their back pain improved with diastasis repair.

One of the most severe cases of diastasis I’ve seen is in this patient I took care of who looks six to seven months pregnant, and she’s not. She has an umbilical hernia, which, more times than not, is present when a patient has a severe diastasis like this. I repair this when performing a True Form Tummy Tuck procedure, and a major, dramatic improvement can be achieved, as evident in her postoperative photos. Of course, prior to surgery, she did have loose skin as well, but the primary issue in this patient was a very weak abdominal wall and separation between the rectus muscles. It’s a rewarding experience to repair this because it can create a very dramatic change.

Contact us to schedule your in-office consultation or preliminary video meeting with Dr. Patronella.