Rectus Diastasis

What is rectus diastasis?

Prior to pregnancy or weight gain, the rectus muscles are very intimately approximated and meet in the midline of the abdominal wall at a linear point called the “linea alba”. If your rectus muscles are separated by more than 1 to 2 cm (or, a fingerbreadth), you likely have rectus diastasis or a ventral/umbilical hernia.

What is the difference between rectus diastasis and a hernia?

Rectus diastasis is when the rectus muscles separate from the midline, leaving a wide “linea alba” or gap between the muscles. While there is a gap, there is no complete defect, or hole, in the abdominal wall.

An umbilical or ventral hernia is when there is a full thickness defect, or hole, in the abdominal wall, which allows intra-abdominal contents to herniate outwards through the defect.

It may be very difficult for a patient to determine whether they have a hernia or a rectus diastasis. Dr. Madni specializes in both conditions and can give you your diagnosis as well as a recommended management plan.

How is rectus diastasis diagnosed?

Dr. Madni will examine your abdominal wall to determine whether you have a concurrent umbilical/ventral hernia as well as rectus diastasis. The recommendation for conservative versus surgical intervention will depend on how wide your diastasis is and how symptomatic you are.

How is rectus diastasis treated?

Exercise is the first step, and very often, that is enough! What exercise? Those that strengthen the oblique muscles and focus on pulling the core inward. For example, side planks, pelvic tilts or toe taps.  However, if you are unhappy with the appearance of your diastasis, or if your symptoms have failed to improve with conservative management, surgery may be an option. Dr. Madni is well versed in robotic rectus diastasis repair and she is able to reconstruct your abdominal wall with three tiny, 8 mm incisions. Forget those big plastic surgery incisions- robotic surgery incisions are so small that they will be hard to notice once you are healed!

What can I expect after rectus diastasis repair?

Patients often feel improvement in lower back pain and can also see improvement in urinary incontinence once their diastasis is repaired. The surgery can also be done for cosmetic purposes – and the outcomes look great!

Is robotic rectus diastasis repair the same as a tummy tuck/abdominoplasty?

No. Robotic rectus diastasis repair utilizes three tiny, 8 mm incisions to re-approximate your rectus muscles about the midline, thus reducing the “gap’ or “bulge”. Importantly, there is no removal of fat or tightening of skin with a rectus diastasis repair.

An abdominoplasty is done by a plastic surgeon and involves a very long incision along the Pfannenstiel line. While muscle repair can be added to every abdominoplasty, these plastic surgery procedures also remove abdominal wall fat and excess skin.

Any reason not to pursue rectus diastasis surgery?

There are risks with any and every surgery and thus no surgery should be taken lightly. Though risks of surgery are minimal, they include: pain, bleeding, infection, hernia and need for further procedures. This surgery involves general anesthesia, where you will have a breathing tube throughout the procedure. Though the incisions on the abdominal wall are small, patients can expect to have a moderate amount of pain and/or discomfort  for several weeks following surgery. Most patients take narcotic pain medication and muscle relaxers for 1-2 weeks following surgery. Your activity will also be restricted for eight weeks following surgery, where you will be advised not to do any core strengthening or heavy lifting.

Why should you choose Dr. Madni to perform this procedure?

Dr. Madni has extensive experience with the robot and is one of the highest volume robotic surgeons in the DFW area. She performs a large number of complex abdominal wall reconstructive surgeries and rectus diastasis repairs. With high volume, comes surgical experience and excelling outcomes.