In some cases where patients have a minimal pouch in the lower belly, the standard has been the “Mini tummy tuck.” An incision similar to that used for a “C Section” is used to tighten the muscles below the belly button. At the same time a small amount of skin is taken out above the mons pubis. The procedure works well, but does not address the muscles above the belly button.
Muscle separation with bulge , but no loose skin on the abdomen
My first rectus diastasis repairs , was a man who requested a correction of a bulge above his belly button. He had a muscle separation above the belly button which is more common in men. He was recently divorced, did not want scars, and requested Liposuction to get rid of the bulge. I explained to him that Liposuction would not solve his problem. During the examination, I showed him the area of the separation of his rectus diastasis muscles. I explained that only the muscle needed to be tightened, but he did not need any loose skin taken out.
My first rectus diastasis repair performed with full informed consent and trust of the patient
I asked the patient if he be interested in a procedure to tighten the muscles that was not described anywhere in the literature (this was early 90’s!) but that I could perform a surgery using techniques I was comfortable with? He agreed, signed the informed consent, and I did the procedure by making an incision around the belly button for access to the deeper tissues.
The procedure went so well I immediately felt bad for all those patients on whom I had done a traditional incision to treat this problem. So if I could do this going above the belly button, why not do it for muscle separations below the belly button?
Rectus diastasis repair became another technique in my tool box
Well, once you know you can do something well, you start recommending it to more and more patients. I recommend it now to anybody who has a separation of the muscles without skin folds or excess skin. If somebody is working out a lot yet when they relax the abdomen it still pouches out, they probably have separation of the muscles (Rectus Diastasis). I like the procedure a lot because it appeals to the Plastic Surgeons dream goals – Get a lot accomplished without any visible trace of your work.
(originally published November 3, 2005)
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