In January of 2020, I had Diastasis Recti Surgery. My surgeon repaired both a hernia and my diastasis recti gap.
Diastasis Surgery Photos – Before and After (MORE Before/ After Photos at the END OF THIS POST)
HGTV has brainwashed me into thinking that before and after shots are everything, so I’ll start with the good stuff. But please believe me when I say Diastasis Recti surgery is about SO much more than appearances. (go to Diastasis Recti Pictures)
18 month post-op on a trip to Greece
How is Diastasis Recti (DR) Diagnosed?
Diastasis Recti had been affecting my life for ten years since I was pregnant with my first baby. While my belly expanded, I felt as if my abdomen was being slowly and painfully ripped apart. Being my first pregnancy, I assumed anything that happened was typical. After my son was born and even after I lost the baby weight, my stomach bubbled out between my abdominal muscles (pictured above). Test for Diastasis Recti
I discover Diastasis Recti
I eventually stumbled upon the term diastasis recti. The exercises I did to close the gap were marginally successful at best. I researched surgical options but soon found that diastasis recti surgery should not be performed until after you’re done having kids. For that reason, surgery research went on the back burner for a few years. I did DR exercises to strengthen my core and manage my symptoms as much as possible (this is the program I used that helped). In the meantime, I battled lower back pain and an awkward bulge, despite the fact that I had lost all the baby weight, ate well and exercised regularly. Many DR moms struggle with self-worth and depression due to sometimes daily comments from strangers who assume they are still very pregnant, months and years after their baby is born.
My Diastasis Recti Widens With Each Pregnancy
During my next two pregnancies (both my 2nd and 3rd child were 9-pounders), I again experienced pain between my abdominal muscles. During my last (and final) pregnancy, the pain moved slowly but surely up towards my sternum, like a zipper painfully coming undone. I even tried KT tape to try to hold my body together as much as possible to avoid the searing pain. Eventually, I felt like my connective tissues between my abdominal muscles had been ripped apart. They were, in fact, just painfully stretched. Regardless, the tearing pains stopped but were replaced by lower back pain as my body struggled to hold itself together. People always made comments about how adorable my very round and very prominent belly was. I looked like I was trying to smuggle a watermelon. Smuggling watermelons is PAINFUL.
Ob-Gyn diagnosed Diastasis Recti, recommended surgery and physical therapy
After I had my third (and last) son, the diastasis recti gap was more obvious than ever. My ob-gyn diagnosed me with diastasis recti, said I would ultimately require surgery to close the gap, but recommended seeing a physical therapist in the meantime. I did physical therapy for a while, but my physical therapist recommended surgery as well, so I started diligently researching (and saving for) diastasis recti surgery.
When is Diastasis Recti considered severe?
Diastasis Recti is considered severe if a painful abdominal hernia has developed. Some doctors consider Diastasis Recti severe based on the size of the gap (e.g. four or five fingertips or more). Other doctors consider the side effects of DR, such as lower back pain, constipation, and difficulty exercising.
Is Diastasis Recti Surgery Covered By Insurance?
Diastasis recti surgery is sometimes covered by some insurance companies but is often not covered.
Diastasis Recti repair, despite the similarity to (and often coinciding with) a hernia, is essentially the same procedure as a tummy tuck. For this reason, it is often NOT covered by insurance. Some people are able to get the surgery covered by insurance if performed by a general surgeon and limited to the muscle repair without skin removal; however, every insurance company is different.
I’ve seen diastasis recti patients who fought insurance companies to have their surgery covered. They were prepared with . . .
(1) Detailed documentation of their years of physical therapy and
(2) Doctors’ recommendations for surgery
. . . but still lost their case and had to pay out of pocket.
Partial Coverage for Hernia
Diastasis patients often have a hernia and insurance companies will often cover that portion of the surgery. Hernia repair is usually only a fraction of the overall cost. To get tips on how to pay for this important surgery despite its lack of insurance coverage, see my tips on the bottom of this article.
Does physical therapy fix diastasis recti?
In my case, my physical therapist (who would arguably be financially motivated to urge physical therapy over surgery) said my diastasis (a 6-finger gap) was beyond what could be helped by physical therapy alone. Doing proper DR exercises did help manage my symptoms and improve my appearance while I waited for surgery, though.
From my experience (and from communicating with other DR moms in this Facebook group + This DR Facebook Group), physical therapy might help improve functionality. Exercise, physical therapy, and diet improved my appearance and functionality somewhat, but the gap remained, limiting my core strength. When I laid on my back, my intestines bulged and I could (uncomfortably) feel and see my food working its way through–not normal! My physical therapist recommended surgery to close the gap and restore full functionality.
How to prepare for Diastasis Recti Surgery
STEP 1: Start saving for surgery
How much does diastasis recti surgery cost?
Diastasis Recti Repair Surgery can easily cost between $6,000 and $25,000+, according to a poll given to my DR Mom friends. A few patients were able to get the surgery covered by insurance, but the majority paid out of pocket.
The cost of surgery depends on:
- Where you live
- What type of procedures you’ll need (mini vs full tummy tuck, hernia repair, skin removal, etc.),
- Your surgeon’s fees (Often includes the cost of a surgical center, but hospital stays are often separate)
- Prescription costs (pain and other medications needed for surgery)
- Any physical exams and/or lab tests you need to prepare for surgery (I had to see both a GP and cardiologist to be cleared for surgery)
- Travel costs, if you opt for an out-of-town surgeon
- Surgery recovery center and/or hospital stay (some surgeons perform the surgery as out-patient surgery, some require at least a one night stay). Complications could result in a longer (very expensive) hospital stay.
- The cost of recovery time (child care, time off from work, etc.)
Wait until you’re done having children
Because the surgery is expensive, doctors will recommend you wait until you’re done having children to surgery repair DR. I loved using the MUTU System while I had two more children and saved up for surgery.
How to pay for diastasis recti surgery if not covered by insurance
If you’ve decided to have your DR surgically repaired, but are unable to get your diastasis repair surgery covered by insurance, here are some tips for saving:
- Realize YOU’RE WORTH IT. A big hurdle in saving was wondering if I was worth it. Most couples have a saver and a spender–I’m the saver. Maybe your partner is the saver and consequently balking at the cost. One mental shift happened when I realized I was willing to spend that amount on a car–something that would definitely not last a lifetime. I realized that having a functional body that I’d have for the rest of my life was worth so much more.
- START EARLY. Preparing and saving for surgery can often take years. The sooner you start saving, the better.
- CREATE A SEPARATE ACCOUNT, so you’re not tempted to spend your surgery savings on other expenses.
- Set up an AUTO DEPOSIT so you can slowly build up your funds without thinking about it. Don’t wait for leftover money–that rarely happens.
- Consider taking on another part-time job for EXTRA INCOME to make additional deposits to your surgery fund.
- ASK ABOUT DISCOUNTS, such as paying with CASH rather than a credit card.
- LOOK FOR PARTIAL COVERAGE, REIMBURSEMENTS from your insurance, such as getting the hernia portion of the surgery covered, or at least getting reimbursed by your HSA (Health Savings Account).
STEP 2: Select surgeons, Schedule a consultation
What kind of surgeon repairs Diastasis Recti?
Diastasis Recti can be repaired by a general surgeon or a plastic surgeon. Once I accepted that my surgery was unlikely to be covered by insurance, I focused my search exclusively on plastic surgeons. I did this because:
- General surgeons are, by definition, general. I wanted my surgery performed by someone who had successfully performed a LOT of diastasis surgery repairs.
- Most diastasis recti surgeries involve a large hip-to-hip incision. Although pretty much only my husband sees my bare midriff, after a decade of looking somewhat deformed, I knew I would mentally benefit by having a result that was as aesthetically-pleasing as possible.
How to find a good Diastasis Recti surgeon
I found surgeons to consult with by checking Yelp. Plastic surgeons can also be found on RealSelf.com. Ultimately, the surgeon I chose was one recommended to by another DR mom in my Facebook DR Surgery Support Group.
STEP 3: Consult with / Interview surgeon
I showed up to my surgery consultation with a long list of questions. These questions helped me understand the procedure better and helped me get to know the candidates I was interviewing. This is a major medical procedure and I wanted a surgeon who could not only competently perform the surgery but could also communicate well regarding concerns during preparation and recovery.
Questions to ask Potential Diastasis Recti Surgeons:
- How do you perform the surgery? Tell me more about your technique.
- How/where do you make an incision(s): (Most patients prefer incisions near the bikini line.)
- How do you create a new belly button? (Tip: when selecting a surgeon with a good looking aesthetic result, look at the belly buttons in before/after photos).
- Do you use permanent or dissolvable sutures for repair?
- Do you do your own suturing?
- What kind of sutures do you use? Do you do running stitches? (Running sutures are not ideal, as they are not as strong)
- How long will the surgery be?
- Do you use mesh? Note: Do your own research, but some patients have had major autoimmune reactions to mesh. My surgeon was able to repair my diastasis without mesh by creating several layers of sutures.
- Do you use drains? Drains aren’t fun, but I recommend them.
- How do you minimize the appearance of scars?
- How many layers of closure do you use?
- Where would you perform the surgery?
- What is the recovery time?
- How long will the surgery be?
My Choice of Surgeon: Dr. Rady Rahban
I ended up choosing Dr. Rady Rahban in Beverly Hills, CA to perform my surgery. Not only was Dr. Rahban able to answer my questions satisfactorily, his extensive experience with diastasis recti repair specifically made me confident he would be able to handle any challenges and complications.
STEP 4: Start recruiting help
You will need a lot of help to recover from diastasis recti surgery. You will need:
- Someone who can take care of you for two intense weeks where you may need help doing the most simple things, like getting out of bed. You won’t be able to lift anything for at least six weeks.
- Someone to take care of your kids while you recover. My husband was balancing working and taking care of me, so we needed extra help to care for our kids. I couldn’t lift anything, plus I needed naps while my tired body healed.
- I also lined up extra help to get kids to/from school and set up playdates with friends to give my mom a break (who took care of my three kids for a month — she is a saint).
Getting help from friends and family
Even before I scheduled my surgery, I started reaching out to my family and friends to see what kind of help I would have to aid in my recovery time. I asked my mom if she’d fly out to help watch my kids two years in advance because I knew it was a very big thing to ask. I started recruiting help from other family members and friends to help with my kids. The surgeon I trusted the most lived a short flight and about a 6-hour car ride away, so I needed help to hold the fort down for weeks.
p.s. If any of my tribe is reading this, THANK YOU again for all your help (especially my mom and my husband). I could not have done this without your help.
STEP 5: Pay deposit, Schedule Surgery
Many surgeons book their patient’s Diastasis Recti surgeries months in advance. Most surgeons require you to set up pre-surgery physicals with your general practitioner and blood labs to ensure you are healthy enough for surgery. I have a low resting heart-rate, so I had to set up an extra appointment with a cardiologist.
STEP 6: The actual Diastasis Recti Surgery
In the morning, my husband and I went to the surgical center. I had final prep photos and exams, a nurse gave me an iv, then I went into the surgery room. I woke up from surgery, transferred to a surgical center, then spent two nights in a recovery center.
“Home,” in my case, was actually an Airbnb my husband I were staying in. As my surgery was out of town, we stayed there for two weeks so I could be around for my two follow-up appointments (1 and 2 weeks post-op). As hard as it was being away from my kids for that long (once again — my mom is a hero for watching my kids), I was so glad I was able to rest and recover as needed. My kids were happy and taken care of (my youngest was 3 years old). We Facetime-d every day, but my kids were having so much fun with Grandma, they didn’t seem concerned that mom and dad were away.
STEP 7: Rest and Recover
How long does it take to recover from Diastasis Recti surgery?
The first week of recovery was the worst, the second was better, and so on. The pain was manageable after a few days. To prevent strain on the muscle repair, the surgeon recommended I not lift anything for six weeks or more. For the first couple of weeks, you may need help with basic things, such as getting out of bed.
Weeks 1-6: I wore a binder, as compression aids circulation and therefore healing. The pain was manageable after the first couple of days.
Week 1: I had a drain on each side of my lower abdomen to prevent fluid from building up inside my abdomen. Fluids went into those drains, which my husband or I emptied regularly to prevent infection. The surgeon removed my drains (such a weird feeling) at my 1-week appointment.
Items I recommend for Diastasis Recti Recovery:
Long camisoles to wear under the binder.
Wearing long camisoles under my binder helped cut down on the friction between my skin and binder, which helped with comfort and recovery. Double-check with your surgeon to make sure they are okay with this.
I bought two of these 3-pack camisoles (they also come in black and tan):
Natural Calm to promote healthy bowel movements
This is a product recommended by several people in my Diastasis Recti surgery group. Pain medications can result in slowed bowel movements. In addition to any prescription medications recommended by your doctor, a lot of women found this to be helpful to stay regular. Separate from surgery recovery, I take Natural Calm weekly to prevent magnesium deficiency.
Squatty Potty to promote healthy bowel movements
To be honest, I recommend Squatty Potties to anyone and everyone. But I think it was especially important for surgery recovery. Constipation is often an issue with pain medication. I didn’t bring my squatty potty to the Airbnb I stayed in and I regretted it. I ended up turning a trash can upside down to try to recreate it — obviously not ideal.
Week 2: My surgeon’s assistant removed my stitches. My surgeon gave me incision care instructions to improve both healing and the appearance of scars, including using Micropore Paper Tape and scar cream.
Weeks 3-6: I continued wearing my binder, caring for my incisions, and taking it easy. I was careful to listen to my body and rest as needed. The doctor and recovery nurses encouraged me to move around to prevent blood clots, but not exercise to prevent strain on my muscle repair and to allow my body to heal.
6-weeks: At my checkup, the surgeon cleared me to slowly begin exercising again.
After 6 weeks: My body slowly but surely continues to improve. After the first week or two, I was already so happy I chose to have surgery. My core felt stronger than it had in years, not to mention the fact that my internal organs were no longer bulging out.
Why my Diastasis Surgery was Worth the Cost
Since surgically repairing my diastasis, I have never questioned whether my surgery was worth the cost. I do feel like I paid extra for an experienced surgeon (Dr. Rady Rahban) who helped my body achieve a great result, functionally and aesthetically. I heard of several patients whose original surgery was so problematic, they ended up having the surgery and long recovery a second time. Avoiding a revision was a top priority for me, so I was willing to pay more upfront for a surgeon I felt confident about.
I feel better both:
- Physically: The surgeon repaired my hernia and muscle so my core is stronger than it’s been since having kids.
- Mentally: I’m no longer self-conscious about having a canyon between my abdominal muscles and my internal organs bulging out of that canyon.
My interview with Dr. Rady Rahban about saving up for Diastasis Recti Surgery
Here is the link to my interview with Dr. Rady Rahban about how to save for Diastasis Recti Surgery.
I asked members of Diastasis Recti Facebook Group for their before/after photos, so enjoy!
Best Diastasis Recti Exercise Program
While you wait for surgery (or possibly to replace surgery for mild cases), I recommend the exercise program I did. I think it helped me have such good results with strong abdominal muscles.I used the MUTU System to strengthen my core while waiting and saving up for surgery.