Can An Abdominoplasty Resolve Diastases Recti?

Diastasis recti occurs when the connective tissue of the rectus abdominis muscles separates, creating a gap wider than two centimetres. It often occurs after childbirth, although men can also experience it. Diastases recti can be repaired during an Abdominoplasty (Tummy Tuck) procedure. A very small portion may be covered under Medicare item number 30175, provided you meet strict criteria.

Your rectus abdominus muscle is often referred to as the ‘6-pack muscle’. It sits superficially on the abdominal wall, running from your pubic bone to your rib cage. It has a right and left part, separated by a narrow band of tough connective tissue called the linea alba.

What Causes Diastasis Recti?

Diastasis recti is caused by excessive inner-abdominal pressure. During pregnancy, your expanding uterus stretches your abdominal muscles and weakens the connective tissue. Improper heavy lifting can also cause the condition in both men and women.

There are several other names for diastases recti, including rectus diastases and rectus divarication, as well as colloquial names such as ab separation and split tummy muscles.

Signs you may have diastasis recti

The most common sign of diastasis recti is a bulge in your stomach. This may become exacerbated when you tighten your abdominal muscles. Other symptoms include:

• bloating
• poor posture
• lower back pain
• constipation

You can assess yourself for diastases recti at home by doing the following:

• Lie on your back, bend your knees and keep your feet flat on the floor.
• Lift your head and shoulders slightly off the floor, supporting your head with one hand, and look down at your belly.
• Move your other hand above and below your belly button and all along the midline of your abdominal muscles. See if you can fit your fingers in the gaps between your muscles.
• If you feel a gap and can place one or two fingers in there, you may have moderate diastasis recti.

If you’ve recently been pregnant, this gap may start to narrow as your muscles recover strength. Any gap greater than two centimetres should be assessed by a doctor or physiotherapist. They can use a calliper or ultrasound-guided imaging to obtain a more accurate measurement.

IMPORTANT: If you have extreme back, abdominal or pelvic pain, you must see a doctor straight away.

When To Consider Surgery

Often, diastases recti will heal or be manageable. Exercise typically helps the condition.

However, if you also have functional issues due to excess skin and tissue or aesthetic concerns due to excess tissue and stretch marks, an Abdominoplasty may be a consideration.

(Technically speaking, diastases recti can be surgically addressed on its own; however, many postpartum women with diastasis recti also have excess skin and tissue that they may wish to have addressed through an Abdominoplasty.)

How Does an Abdominoplasty Repair Diastasis Recti?

An Abdominoplasty addresses changes in the abdominal wall. This typically includes removing excess skin and tissue and, when required, repairing the diastases recti.

During an Abdominoplasty (Tummy Tuck), a horizontal incision is made low on the abdomen from hip to hip. Another incision is made around the navel to elevate the abdominal skin and to tighten the abdominal muscles.

The muscles are then placated and sutured together, tightly closing the gap between the right and left rectus abdominis. Excess lower abdominal tissue is then removed, and the navel is repositioned.

Can Diastases Recti Return After Surgery?

Diastases recti can return after surgery, although incidences are low, with a recurrence rate of approximately 10 to 15 per cent. This can happen if there have been significant weight fluctuations, subsequent pregnancies or premature strenuous exercise.

Is There Medicare Coverage for Diastases Recti?

Medicare may cover an Abdominoplasty for diastasis recti under specific, strict criteria, primarily using the item number 30175. Following an assessment with Dr Dona, and if imaging and supporting documentation align with these criteria, you may be eligible for a Medicare rebate for your procedure.

The abdominal separation must be a result of pregnancy and be at least three centimetres wide (measured by diagnostic imaging). The patient must also have had moderate to severe pain, back pain or urinary symptoms following the muscle separation, and there must be proven failure of nonsurgical treatments, including physiotherapy. Additionally, at least 12 months must have passed since the pregnancy.

You can read more information about Medicare Benefits Schedule – Item 30175 here.

Steps for determining eligibility for a Medicare rebate

The steps to determine your eligibility for a Medicare rebate for a Tummy Tuck are as follows:

• Schedule a visit with your GP to discuss your abdominal symptoms and related health concerns.
• Obtain a referral from your GP outlining your medical condition.
• Book an Initial Consultation with Dr Dona, our respected and highly experienced plastic surgeon.
• During your consultation, Dr Dona will assess your condition and determine whether you meet the Medicare criteria.
• You may be eligible for a partial rebate if an applicable Medicare item number is identified. More importantly, meeting Medicare criteria is a prerequisite for accessing Private Health Insurance benefits.
• Private Health Insurance typically covers reconstructive procedures deemed medically necessary. To utilise your coverage, you may need to have the highest level of hospital cover and maintain it for at least 12 months.
• Your Private Health Insurance provider may cover your hospital fees, excluding any applicable excess payment as specified in your policy.
• After your consultation, you will receive a detailed quote outlining Dr Dona’s fees, anaesthetic fees and hospital costs. If relevant, the quote will also include any applicable Medicare item numbers and a clear explanation of how your Private Health Insurance may contribute to your surgery.

Outcomes of Diastasis Recti Surgery

Recovering from an Abdominoplasty with muscle repair will typically take approximately six weeks. Once you have healed, you’ll likely notice the following:

• Flat stomach – the repaired abdominal muscles will significantly reduce the bulging appearance.
• Relief from symptoms – such as lower back pain, incontinence and digestive issues.
• Improved function – once repaired, your core abdominal stabilisers will be stronger, helping to improve posture and providing more support to your spine. This support will improve function during exercise and day-to-day activities.

Risks & Potential Complications

All surgery carries risks. The risks generally associated with surgery include bleeding, infection, anaesthetic issues, allergic reactions, blood clots, wound problems and in rare cases, death.

There are also risks associated with an Abdominoplasty. These include:

• Naval deformity or malpositions
• Significant scarring
• Skin irregularities – such as bumps or uneven skin tone
• Asymmetry
• Poor circulation
• Temporary and permanent changes in skin sensation
• Fatty tissue damage – or necrosis
• Prolonged swelling or pain
• Seromas – where fluid builds up under the wound
• Further surgery requirements – fine-tuning the results

If you’re concerned that you have a diastasis recti that is causing problems in daily life and are interested in learning more about Tummy Tuck (Abdominoplasty) surgery, please get in touch with our clinic today.