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Ron Hoxworth, M.D. Answers Questions On Plastic Surgery

Ron Hoxworth, M.D. Answers Questions On: Plastic Surgery

What is diastasis recti and when does this condition become problematic?

Diastasis recti, or recti diastasis, is a normal separation between the rectus muscles. We all have a separation between these muscles that we are born with. On average this range is between 1 and 3 cm. Some clinical situations can cause the separate to enlarge. This leads to a bulge, or in worst cases, a hernia. These abnormal bulges or true hernias can be fixed cosmetically.

This condition becomes more prevalent over time due to weight fluctuations and aging for some men and women. Additionally, it can worsen in women after multiple pregnancies or a twin pregnancy. Sometimes, we will see a larger diastasis in individuals after trauma or surgery.

In more extreme situations, some individuals will develop a true hernia of the rectus muscles. These larger defects can result from prior trauma or multiple pregnancies. They can be more symptomatic and painful. There are surgical options to repair these as well. Given that they are more unusual, they should be repaired by a specialist who is experienced in diagnosing and successfully treating these anatomic defects.

It's essential to meet with a doctor familiar with treating this type of condition who can properly diagnose and treat the diastatic defect. I have met patients affected by diastatic hernias who were told there is no hope. Fortunately, I have been able to help those patients by providing them with a beneficial outcome.

The plastic surgery team at UT Southwestern has the skill and experience to evaluate the individual, determine what is going on, make the appropriate diagnosis, and then treat appropriately. We offer individualized care for our patients, whatever their condition.

What is the advantage to having a multidisciplinary team for abdominal wall reconstruction?

The majority of the patients seen at our abdominal wall hernia center has extensive prior surgical and medical histories. We often see patients who have undergone bariatric, transplant, oncologic, urologic, traumatic, colorectal, gastrointestinal, pediatric, obstetric, or congenital defect surgery.

In order to ensure that these patients receive the best care possible, we incorporate members of the team who will be most helpful in determining the best surgical approach. Having one individual or team manage all of the complicated medical requirements does not seem prudent.

By having a multidisciplinary team with various levels of experience and expertise, we are able to utilize an individualized approach and standard of care for each patient. These complex reconstructions are never one size fits all. Our multidisciplinary program allows us to tailor that individualized approach.

Is it safe to perform ventral hernia repair (VHR) and abdominoplasty at the same time?

Yes. The literature regarding combined VHR and abdominoplasty, along with our personal experience here at UT Southwestern, indicates that these two procedures can be safely performed simultaneously in most patients, the exception being patients who have extensive medical comorbidities.