Ron Hoxworth, M.D. Answers Questions On: Diastasis Recti and Abdominal Wall Surgery

Diastasis recti, or recti diastasis, is a normal separation between the rectus muscles. We are all born with a separation between these muscles. On average, this separation ranges from 1 to 3 cm. Some clinical situations can cause the separation to enlarge. This leads to a bulge, or in worst cases, a hernia. These abnormal bulges or true hernias can often be repaired with surgery.

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

In more extreme situations, some people 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.

Treatment typically starts with the least invasive effective care, such as rehabilitation. Surgery can help when weakness, pain, or a related hernia persists. 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 with hernias related to diastasis recti who were told there was no hope. Fortunately, I have been able to help those patients by providing them with a beneficial outcome.

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

The majority of the patients seen at our abdominal wall hernia center have 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. These needs are often too complex for one specialist to manage alone.

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

Yes. The literature about 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 is those with complex health conditions.