One of the most popular and gratifying cosmetic procedures I perform is the Mommy Makeover (a combination procedure usually consisting of a tummy tuck, liposuction, and a breast enhancement procedure such as breast augmentation). At my Naples-Fort Myers, Florida practice, I’ve noted that moms are often surprised in their consultations to learn that there are multiple causes for their “flabby” midsections, so I thought this might be a great topic to address in my blog.
Excess skin and fat play a role, of course, but in many cases, women develop diastasis recti — a separation of the abdominal muscles — during pregnancy.
What is diastasis recti?
Also called abdominal separation, diastasis recti is defined as a gap between the two sides of the rectus abdominis muscle (the muscle that covers the front surface of the abdomen). As we all know, the abdomen expands quite a bit during pregnancy to accommodate a growing baby. As the uterus pushes against the abdominal wall, the fascia (i.e., connective tissue) between the left and right halves of the rectus abdominis muscle can begin to spread apart. Some separation is normal, but when it persists after the baby is born, we know it as diastasis recti. And if it is present after one child, a subsequent pregnancy can exacerbate the condition.
Diastasis recti is something that all the crunches in the world cannot fix, and beyond the cosmetic implications of a bulging belly, it can also lead to lower back pain and a pelvic tilt that alters your posture.
How do I know whether I have it?
There is a simple test you can perform to know for sure.
- First, lie on your back with bent knees, keeping the soles of the feet on the floor. (The distance between the buttocks and your feet is not really relevant, so long as the soles of your feet remain on the floor.)
- Place one hand behind your head and the other on your abdomen. Specifically, your fingers should be parallel with your waistline and perpendicular to your belly button.
- Press your fingertips into your abdomen.
- With relaxed abdominal muscles, tilt your head forward.
- Move your fingertips along the midline. You are searching for the left and right halves of the rectus abdominis muscle.
- Perform the same test above, at, and below the belly button.
If you notice a gap that’s wider than 2 fingertips, contract the abdominal muscles. If the gap remains, you most likely have diastasis recti.
You can see an example of this issue in the patient before-and-after images pictured below.
How does a Mommy Makeover repair it?
During your consultation, I will be able to tell you with certainty whether diastasis recti is contributing to a protruding midsection. If it is, I will correct it during the tummy tuck portion of a Mommy Makeover.
In a tummy tuck, I make an incision from hip to hip, curving downward below the bikini line. Aside from allowing me to remove any excess skin, this incision also gives me a way to tighten the muscles of the abdominal wall by suturing the fascia and muscle back together. These sutures are made from a long-lasting absorbable material that is gradually dissolved by your body when your own tissue has gotten strong enough to hold the repair together by itself.
Overall, a tummy tuck corrects for a lax, bulging abdomen, whether the cause is diastasis recti, excess skin, stubborn fat, or a combination of all these factors. Many women, when they have these symptoms as the result of one or more pregnancies, also want to improve the appearance of their breasts. We can perform breast enhancement at the same time as part of the Mommy Makeover procedure. Our photo gallery highlights the transformative results that make Mommy Makeover procedures so popular.