After four years of attempting to close my abdominal diastasis on my own through physical therapy and stretching and upping my vitamin intake and all sorts of random tactics (including ingesting beef collagen…), I finally decided to schedule a consultation with a plastic surgeon last October; in all those years I had seen minimal and short-lasting results in the width of the gap with self-care, and no change in the contour of my stomach (it still looked like I was pregnant with a three year old…).
Surgery’s not for everyone and I would never try to talk anyone into an elective surgery, but a consultation with a good plastic surgeon never hurts, and I’m glad I scheduled that initial visit to fully explore all of my options (it was at that consultation that I learned I had an umbilical hernia, so there’s that…).
The procedure is a doozy and the recovery is a beast, so if you’re considering a surgical repair for your diastasis (or are just curious about how a doctor goes about sewing your abdominals together), here are some of the details from my pre-op, post-op and actual procedure:
The day of surgery I arrived at the hospital around 7:00 a.m. for a surgery start time of 10. I checked into my room and got cozy, and after a little while my surgeon came in and did my body markings. She also went over what would happen during the procedure and all of the risks one last time (if she was trying to talk me out of the surgery, she almost did a really good job…).
I then met with the anesthesiologist who also discussed the procedure for general anesthesia, and followed it up with a long list of all the risks (again, had me thinking, do I really want to sign this paper?!)
At this point you’re really starting to wonder if you’re going to survive surgery, lol.
I got wheeled down to the OR a little before 10 and was promptly knocked out before I knew what had hit me.
I wasn’t really nervous for surgery, no more than a healthy dose of concern regarding potential risks, but things in the OR are a little hectic and crazy in the moments before you go under if you’ve never had surgery before. I had a wonderful surgeon with a really great bedside manner who put me at ease, but just know the moments pre-surgery can be a bit stressful.
I woke up in recovery around 2:30, meaning the surgery had lasted about four hours. Strangely it felt as though I hadn’t slept or been unconscious at all.
So what happened in those four hours?
The procedure for a diastasis repair is called an abdominoplasty and it’s exactly the same procedure that’s performed for a tummy tuck with a muscle plication (when the abdominal muscles are sewn together); this is why most insurance companies won’t cover the cost of your diastasis repair…sadly, they now like to claim there’s no medical necessity for repairing a large diastasis, and it’s hard to fight the case when the surgery is the same as a cosmetic procedure (diastasis repairs were covered by most insurers up until around 2010).
During the procedure, a sort of oblong-shaped incision is made in the lower abdominal region, starting from your pubic area to somewhere up near the middle of your abdomen; that entire area of excess skin will be removed. The skin is lifted up to about your rib cage to expose the abominal muscles, which are sewn together with sutures. After the procedure is complete, the skin is pulled down and sewn together near your pubic area. A new hole has to be created for your belly button as well, so you’ll also have scarring there.
I also had an umbilical hernia repair performed, and basically the tissue that’s bulging through is pushed back in and the weak area is reinforced with sutures (I didn’t have mesh put in).
I spent one night in the hospital following surgery and left the following evening fairly late. To be honest I think I could have benefited from spending one more night in the hospital, but I really wanted to get home and see my kids (my opinion about that changed as soon as I got home lol).
In that day following surgery, I was put on a liquid diet for 24 hours (not sure if that’s standard in the US…my surgeon was actually kind of pissed the next morning when she found out I hadn’t eaten anything yet). I was put on a pain pump of morphine and was able to self-regulate my own pain meds. I was really sleepy the rest of that day but had quite a bit of trouble sleeping that night and was given some sleeping pills. I had to wear compression boots on my legs that periodically tightened and loosened to keep my circulation going, and I remember them getting crazy itchy and I kept ripping them off. You’ll have drains in your lower abdomen to drain excess fluid and blood from your surgery site. They should come out within a week or so.
You’ll be wearing a belly binder to compress your abdomen. The next morning my surgeon came in and changed my bandages and cleaned the incision area (not pleasant) and was pleased with how things were looking. I spent most of the afternoon in bed until they removed the catheter. Once that was out I was super antsy to get out of bed and walk around. Using a walker I did a few laps around the hospital but it was pretty slow going. They told me I couldn’t leave the hospital until I went took a poo, and I’m pretty sure I didn’t but they let me leave around 8pm. Trust me, you’ll probably be constipated.
The day following surgery, you will be sore. Really sore. You will be amazed how much you took your abs for granted. When my surgeon took my belly binder off to check my surgery site, I remember trying to answer one of her questions and no sound came out; I literally didn’t have enough strength in my core to speak without the binder on. Coughing will hurt. Turning will hurt. Trying to sit up, stand up, sit down will hurt. You won’t be able to lay flat on your back for at least a couple of weeks.
The reason I wish I’d just stayed longer in the hospital is, if you have small kids, you will get zero rest at home. You’re still in so much pain, you’re uncomfortable, and you’ll have kids climbing all over you. You’ll get annoyed by how trashed your house is, you’ll get annoyed with your spouse for not fluffing your pillow right or not getting you water as cold as you asked for. You’re justifiably ridiculous because of the vulnerable state you’re in, but you’ll end up taking it out on everyone else at home, and I think if I’d had one more quiet, peaceful day to really recover before I went back into the mad house, it would have been better for everyone.
After I got home, once I was off the pain pump and started feeling for the first time what was going on inside my abdomen, I got really curious about just what went on in there. I ended up doing a YouTube search for a diastasis repair and ended up watching one almost start to finish…like an hour and a half’s worth of footage. Afterward, I remember thinking “no wonder I’m so sore…that junk is so violent!” I’ll let you do your own search since I know not everyone can handle the graphic nature of surgery, but Dr. John Diaz is an abdominoplasty specialist and has a lot of great videos on YouTube if you’re interested.