The Belly Bulge that Won’t Budge: Diastasis Recti

Mom holding here daughter with her legs: Can't do this with Diastasis Recti

You have a couple of kids, you’ve gotten a bit older, and despite diet and exercise, that belly pooch won’t seem to go away. Sound familiar? Sometimes it is just a cosmetic issue (which can be bad enough), but other times that belly bulge is a sign of damage to underlying muscles. More specifically, it can be a sign of a condition called diastasis recti.

To understand this condition, it will help to break down its name: Diastasis is the Greek word for “separation” and recti refers to large abdominal muscles called the rectus abdominis. These muscles run from the rib cage down the center of the abdomen to the pubic bone. There are two of these muscles on the left side and on the right side. They are responsible for the “six pack” abs you see in magazines. The two sides of the muscles meet in the middle of your abdomen and are held together with a strip of connective tissue called the linea alba.

Diastasis recti is a condition where the linea alba has widened and become weak. As a result, the two sides of the rectus abdominis muscles have moved farther apart and the weight of the internal organs causes the tummy to “pooch” out. This is not a hernia, as the tissue is still intact, but it can essentially function like one in extreme cases.

Diastasis recti sometimes occurs in newborn babies who typically grow out of it. It can also happen in people who develop a large beer gut or overwork their abdominal muscles, but it is most common in women following pregnancy. During the second and third trimester the growing uterus puts increased pressure on the linea alba, stretching it out.

For many women, the condition goes away after pregnancy, but for some the diastasis recti remains. The problem is more likely to occur as a woman ages and has more children, especially if the pregnancies are close together.

Though you might not like the way it looks, diastasis recti is not an inherently dangerous or painful condition. However, the more severe it is, the more the rectus abdominis muscle can be compromised. This muscle plays a large role in protecting the internal organs, supporting posture, and facilitating movement. When it is not working properly, it can cause problems like,

  • low back pain,
  • constipation,
  • difficulty breathing,
  • and difficulty lifting, sitting, or standing.

So, what can you do about it?

When the condition is mild, it is quite common for women to just chalk it up to pregnancy or age and move on with their lives. However, when it causes symptoms or its appearance is overly bothersome, the first line of treatment is usually physical therapy. The American Physical Therapy Association has a comprehensive guide that explains the problem and their treatment approach in detail.

When this doesn’t work or the problem is too severe to be corrected with exercise, surgery may be the best solution. Here, a surgeon folds over the loosened connective tissue (linea alba) and sutures the two sides of the rectus abdominis muscles back together, into a more normal position. The reason you are reading about this on a plastic surgery website is because this procedure is often done as part of a tummy tuck or a mommy makeover.

According to the American Society of Plastic Surgeons, the number of tummy tucks in the United States has more than doubled since 2000. Though fixing a diastasis recti can be a component, the tummy tuck may or may not also include liposuction and skin removal. Below is a photo of a woman with a diastasis recti before and after a tummy tuck procedure with Dr. Slack.

Before and after of a mommy makeover.

It is not uncommon for women to need more than just a muscle repair to regain a more youthful appearance to their belly. That decision is best made following a physical exam by a qualified plastic surgeon.

Only an in-person consultation with a board-certified plastic surgeon can truly confirm which procedure would best achieve your goals – and for this, there are key variables we assess to formulate an individualized surgical plan — American Society of Plastic Surgeons

If you are concerned about the appearance of your abdomen or have questions about diastasis recti, contact our office and schedule a consultation with Dr. Slack today.