What is Diastasis Recti?
Diastasis recti is a condition in which the abdominal muscles are separated, leaving a gap between the left and right muscles. This condition leads to a loose, protruding abdomen that cannot be resolved by diet or exercise. This extremely common condition is caused by weakened connective tissue and affects over 60% of women who have given birth.
Before & After Results
How do I know if I have diastasis recti?
Diastasis recti is rarely discussed, even though it happens in varying degrees to most women during pregnancy. Typically, diastasis recti or abdominal separation is diagnosed during the second or third trimester of pregnancy. That said, with all the hormones, joys, and challenges that a new mother is faced with, it’s important to understand these physiological changes that are occurring. It can sometimes take weeks, months, or even years before the full extent of your diastasis recti may be clear. Some ways to figure out if you may be suffering from this condition include:
- A rounded, or distended abdomen resembling pregnancy;
- “Tenting” or “doming” when doing basic maneuvers such as: sitting up, coughing, or even laughing.
- Overall core weakness/instability despite targeted diet and exercise programs;
- Low back pain, pelvic floor instability, and mild urinary incontinence.
When the abdominal wall is weakened, your whole core is affected. Your core is utilized in nearly every aspect of physical movement from sitting to standing, running and working out, and everything in between. In addition, your core plays a critical role in helping to stabilize and protect your spine and pelvic floor. The less function of the abdominal muscles, the more your overall core is affected, leading to symptoms such as: chronic low back pain, digestive discomfort, and pelvic floor instability. These symptoms can be debilitating, affecting your overall quality of life.
How Does Pregnancy Cause Diastasis Recti?
Among the many amazing changes your body undergoes both physically and hormonally during pregnancy, there are two primary culprits of your changing body that can result in diastasis recti: a hormone called relaxin, and increased internal pressure on your abdomen from a growing fetus. Your body is impacted by these elements in the following ways:
- Relaxin is secreted in order to help loosen your muscles, ligaments, and joints to accommodate your growing baby.
- As your baby continues to grow, the internal pressure creates additional pressure on the linea alba, sometimes resulting in damage to the muscle strands and connective tissue.
- Post-birth, this overstretching can lead to a more permanent separation between your right and left abdominal muscles resulting in diastasis recti.
Diastasis recti and lower back pain
Your abdominal wall and your lower back are a connected unit that works together to stabilize your spine. When one part of this unit is malfunctioning, other painful or unpleasant physical symptoms begin to surface as your body tries to compensate. With the weakened abdominal muscles that occur with diastasis recti, the muscles in your back start to:
- Overcompensate due to lack of support and function;
- Become fatigued and overworked, leading to muscle spasms and chronic pain;
- Become unresponsive to core strengthening exercises due to the inhibiting pain and lack of function.
Dr. Rahban understands the struggles of living with these symptoms and its impact on the quality of your everyday life. He wants to make sure that this is not a problem you live with in the long term!
Treating diastasis recti non-surgically
Dr. Rahban sometimes receives patients in his Beverly Hills office inquiring about non-surgical ways to treat diastasis recti. Although there may be certain types of exercises to help overall function, and reduce the physical side-effects of diastasis recti; there is no proven way to ensure that the damage to the fascia (a sheet of connective tissue beneath the skin that separates and stabilizes muscles) in your abdomen will be fully healed without surgical intervention. Surgically repairing the damaged tissue addresses the root of the condition to ensure sustainable, and long-lasting results.
As you are working on core strengthening exercises, it is crucial to have knowledge of exercises that can worsen the separation. Exercises such as sit-ups, crunches, planks, running, and certain yoga poses can all increase abdominal pressure worsening the diastasis.
How to Get Help
Although diastasis recti is a very common condition, it is not talked about frequently enough, causing unnecessary shame for the many women who suffer from it. Rest assured there are options for your circumstance and we are more than happy to help you! Whether this is your first time hearing about diastasis recti, or you are researching corrective interventions, it’s important to have foundational knowledge about this condition, so you can be educated about what is happening within your body, and the correct procedure is performed.
When you are ready to take the next step to get the help you need, here is a checklist of what to do:
- First, contact diastasis recti surgeon and expert, Dr. Rahban in his Beverly Hills office to schedule an in-person, or virtual consultation;
- If you have had previous images taken, or photos, you are welcome to email them and/or bring them to your consultation with Dr. Rahban;
- Dr. Rahban welcomes questions, so have questions and/or concerns prepared regarding your circumstance, and procedure to correct your diastasis recti.
Dr. Rahban is an expert in the correction of diastasis recti. He will work together with you to establish a personalized treatment plan to correct the separation of your abdominal muscles, determine your surgical plan, as well as provide you with a personalized post-operative plan.
Can Diastasis Recti Surgery be included in a Mommy Makeover?
If Mommy Makeover means that your strength and stability in your core can be restored post-childbirth, then yes, diastasis recti surgery can be included into your Mommy Makeover.
Unlike a tummy tuck, which is purely cosmetic, and according to a study from the Journal of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS), the results of diastasis recti surgery are expressly meant to help repair the separation of the abdominal muscles that often occur after pregnancy, and so is referred to as a “functional” surgery. That the outcome has cosmetic as well as physical results is just an added benefit for your postpartum body.
What does a diastasis recti surgery entail?
Diastasis recti surgery overlaps with a tummy tuck in that both surgeries address muscle laxity and separation of the muscles in the abdominal wall.
During diastasis recti surgery, Dr. Rahban will:
- Make a low incision below the bikini line allowing him access to the separated muscles;
- Folded the fascia lengthwise (called “plication”) by sewing the weakened, and thinned connective tissue to the midline;
- Provide necessary reinforcement using your own natural tissue, to bring the abdominal muscles back to their correct anatomical position, and close the gap;
- Correct existing hernias;
- Recreate the belly button to a more youthful, and aesthetic disposition;
- Use a multi-layer closure technique to create a thin, easily concealed, and aesthetically appealing scar.
Surgically repairing the abdominal wall, will bring the fascia back to the midline restoring the strength and structure of the abdomen. Once the abdominal wall is corrected, your core muscles will be supported and properly functioning, relieving the painful and uncomfortable symptoms associated with diastasis recti.
Please keep in mind that the surgery requires anesthetics, and you will have a period of recovery. To ensure proper healing, and experience the long-term benefits of this effective surgery in treating diastasis recti, it is important to take the necessary time to heal. This will ensure the symptoms are gone for good!
Diastasis Recti and Hernias
A potential side effect of untreated diastasis recti is the development of a hernia. A hernia differs from diastasis recti in that it is an actual hole in the connective tissue of the abdominal wall. An umbilical hernia tends to be the more common type of hernia among post-partum women, and generally has the appearance of an “outie.”
Although it is very common for a hernia to exist alongside diastasis recti, it is to be taken seriously as it can lead to emergency surgical intervention. Hernias are serious in that they can lead to obstruction of the bowels, which is a life-threatening situation requiring immediate emergency surgery.
Symptoms of a strangulated hernia include:
- Severe abdominal pain and tenderness;
- Nausea and vomiting;
- A bulging lump in the abdomen;
- Discoloration of the hernia site.
If you are experiencing these symptoms, please seek help immediately.
Diastasis recti and hernias are both caused by the raised internal abdominal pressure creating a weakness in the abdominal wall. When the fascia has been stretched and thinned, it creates the perfect environment for the formation of a hernia. It also signifies the importance of correcting both conditions simultaneously to reinforce both repairs and prevent reoccurrence.
Correcting diastasis recti and hernias at the same time
If you are suffering from both diastasis recti and a hernia, it’s ideal to correct both conditions during the same surgery. As research shows, attempting to repair a hernia without correcting the underlying issue (diastasis) can lead to a higher rate of re-occurrence because of the already compromised tissue. Additionally, there is an increased chance of needing to use mesh to reinforce the fascia, which poses its own set of risks.
The benefits of correcting both conditions simultaneously are:
- Lower chances of reoccurrence;
- Eliminating the use of mesh;
- Prevention of additional surgeries;
- Stronger reinforcement creating greater support to both conditions; and
- Long-term sustainability of the repair.
This surgery requires precise, meticulous, and attention to detail to execute properly. It's crucial to seek out a highly-skilled, Board Certified Plastic and Reconstructive surgeon like Dr. Rahban to perform your diastasis recti and hernia repair. Dr. Rahban is a diastasis recti expert with extensive knowledge of the condition, how to successfully repair it, and resolve the many symptoms that are inhibiting you from living your best life. Something your body yearns, and deserves!
Dr. Rahban's Meshless Approach to Diastasis Recti Surgery
Dr. Rady Rahban has mastered the technique of successfully correcting diastasis recti and hernias simultaneously without the use of surgical mesh. Instead, his strong technical ability has allowed him to utilize your own natural body tissue to reinforce the abdominal wall. Dr. Rahban advocates against the use of mesh due to the potential risks involved to your future health. These risks include:
- Tears in the abdominal tissue,
- Bowel Obstruction,
- Chronic Pain,
- Perforation or other irreparable damage,
- Healing delays,
- Additional surgeries, which puts you at risk for further complications and added recovery time.
Dr. Rahbans strong ethical standards are the driving forces behind his ability to successfully execute diastasis recti and hernia repair in the safest way possible. His attention to detail, keen eye, artistic and technical abilities have led to long term, sustainable results.
Preparing for your diastasis recti surgery
The most important decision you will make in preparation for your diastasis recti surgery is to choose the right surgeon. Picking the right surgeon is crucial, as it will dictate your recovery and final results. Once you have chosen your surgeon, there are several ways you can prepare:
- For optimal results, be as close to your ideal weight goal as possible.
- Work on diastasis recti safe exercises to help strengthen your core as best you can.
- Upon scheduling your surgery, arrange for assistance to aid in recovery including childcare and care for yourself (especially the first few weeks).
- If inclined, prepare freezer-healthy meals for easy access.
- A comfortable resting area with plenty of pillows, and a side table where medications are easily accessible.
- Have a clear understanding of your financial obligation, as unfortunately, diastasis recti repair is generally not covered by most insurance plans.
This surgery is seen to be very effective in repairing, and alleviating the many symptoms that are inhibiting your daily life both functionally as well as aesthetically. The healthier you are, the easier the recovery will be!
Pain management Post-Surgery
In addition to ensuring your safety and working to get you outstanding results, Dr. Rahban prioritizes your comfort both during, and after surgery. While undergoing diastasis recti surgery, you will be carefully monitored for the entire duration of surgery by a Board Certified Anesthesiologist alongside Dr. Rahban. Upon completion of surgery, you will be gently awakened and monitored as you transition into recovery mode.
Most patients find that the most uncomfortable part of recovery is during the first week. The pain is easily managed with medications, and adherence to the specific post-op instructions provided. It’s important to follow Dr. Rahban's specific post-op instructions as they are strategically created for the best interest of the patient to achieve optimal recovery and results.
When it is safe for you to move, you will be encouraged to walk slowly and carefully to ensure you don’t do too much too soon, which can increase pain and swelling. Generally, after the first week post-op, most patients find that their pain has significantly lessened and their comfort level steadily increases.
Life after your diastasis recti surgery
As with all surgeries, there is a window of important healing that should be nurtured. It is important to rest and allow your body to heal after undergoing surgery to repair your diastasis recti. In addition to pain management post-surgery, you should expect the following during your recovery period:
- Limited movement for approximately two weeks;
- Time off from work for at least 2 weeks to give your body a chance to rest and heal;
- Many are cleared to resume work two weeks after surgery, but are to avoid strenuous activity and heavy lifting.
- Support with daily tasks such as childcare, cooking, cleaning, and especially lifting which should be avoided for the first six weeks.
- By four to six weeks post-op, you can begin to slowly resume all normal activities and are usually given the green light to return to your usual exercise program.
Preparing for your consultation with Dr. Rahban
It is important to know what to expect during your consultation with renowned diastasis recti expert, and Board Certified Plastic and Reconstructive surgeon Dr. Rady Rahban. When you come into Dr. Rahban’s Beverly Hills offices, you can expect the following:
- An in-depth exam of your abdominal region;
- A long, informative conversation regarding your particular circumstance(s);
- Clarity about your diagnosis, treatment options, and realistic expectations;
- An explanation regarding Dr. Rahban’s meshless technique for correcting diastasis recti and hernias, and how the meshless technique minimizes potential complications to ensure favorable outcomes.
Contact us today to schedule a consultation with Dr. Rady Rahban, one of the best diastasis recti surgeons Los Angeles has to offer.