When the post-partum belly does not regain its tone after childbirth or a significant weight loss, It's not just a question of aesthetics. The separation of the abdominal muscles, the abdominal diastasis, the muscular strap, disrupts the posture, generates back pain and can complicate perineum re-education. Physiotherapy and physical exercise are not enough to correct this gap: surgery is the only option, abdominoplasty, This is the ideal way to bring the rectus abdominis muscles closer together.
Dr Jérémy Djian, plastic surgeon in Paris, takes care of diastasis with both a medical and a personal objective: to restore a functional abdominal wall, regain a balanced posture and regain a lasting quality of life.
Diastasis recti refers to an abnormal separation of the rectus abdominis muscles along the midline. According to a study by Garnett & Larson, it is often under-diagnosed.
The most frequent cause of abdominal diastasis is pregnancy. Under the effect of hormones and the baby's growth, la linea alba, this fibrous tissue that connects the abs, The abdominal wall stretches and loses its tone. In many cases, this abdominal wall does not return to its original position after childbirth, leaving a space where the organs are no longer properly supported.
However, motherhood is not the only factor. Significant weight gain followed by rapid weight loss can also cause the abdominal wall to relax.
For top sportsmen and women, men and women, paradoxically, a excessive intra-abdominal pressure poorly executed exercises and without strap protection, can lead to disjunction of the rectus abdominis.
To confirm your intuition, you can perform a simple clinical examination at home.
Lie on your back, knees bent and feet on the floor. Place one hand behind your head and lift your shoulders slightly as if to start a cracking motion. With the other hand, palpate the area just above and below the navel.
If you feel a gap more than two fingers wide, or see a dome-shaped protrusion in the center of your belly, you probably have abdominal diastasis.
This test measures the distance between the white line, but does not replace a full medical check-up. If you still have concerns about your pregnancy belly, it's advisable to consult a healthcare professional to validate the diagnosis with imaging such as an ultrasound. ultrasound.
Diastasis of the rectus abdominis is not just an aesthetic or skin problem. It is a true functional pathology which impacts the posture and the overall health. When the separate abdominal muscles no longer play their role tutoring role, The lower back has to compensate for this effort. This often leads to chronic back pain and daily discomfort during carrying loads or walking.
On the visceral level, the absence of muscular tension can lead to digestive disorders and a stubborn constipation.
In the most advanced cases, a relaxation of the pelvic floor may occur, resulting in a urinary stress incontinence.
We also sometimes see a umbilical hernia or a epigastric hernia associated, as the fragility of the midline allows some of the internal tissues to pass through.
Restoring strong abdominal muscles is therefore essential for pelvic health and core stability.
Not all muscle separations require immediate surgical intervention.
Prevention begins from the start of pregnancy by adopting a good postural hygiene.
Avoid getting out of bed abruptly from the front ; Always opt for side passage, so as not to overstretch the rectus abdominis muscles. Appropriate physical activity, such as prenatal yoga, helps maintain tone without creating harmful intra-abdominal pressure.
The managing weight gain is also a major risk factor. Over-stretching the skin and subcutaneous tissues increases the chances of white line dehiscence.
After childbirth, the wearing a support belt can be discussed with your physiotherapist to help tissues retract during the first few weeks postpartum, while at the same time avoiding heavy physical effort.
The abdominal rehabilitation is the first essential step before considering any surgery. It must begin with a perineal reeducation to secure the pelvic floor. Once this foundation has been laid, the hypopressive gymnastics allows you to work deep muscles, like the transverse, without pushing the organs downwards.
These exercises based on breathing and diaphragmatic aspiration, can reduce a slight gap and improve wall competence.
However, if the spacing exceeds 3 or 4 centimetres and the fibrous sheath is ruptured, physiotherapy has its limits. It will strengthen the muscle, but will not be able to physically close the anatomical breach.
This is where the advice of a plastic surgeon in Paris becomes relevant.
The crunch-type exercises or classic leg raises without control are to be avoided at all costs in cases of abdominal diastasis. These movements increase internal pressure and push muscles outwards, This can exacerbate the gap between the white line and lead to the appearance of a hernia.
Intense sports such as Crossfit or weightlifting should be performed with extreme caution. As long as the abdominal strap is not locked in place, each pushing movement risks further stretching the midline.
Choose soft activities as the swimming or the Pilates, always taking care to engage the perineum before any muscular effort.
When rehabilitation is no longer sufficient to correct the deformity, reconstructive surgery offers definitive results.
The diastasis treatment is to recreate a strong strap using a plicature technique. The surgeon performs a strong, durable suture along the entire height of the midline, from the pubis to the rib cage. Often referred to as internal corset, This procedure brings the muscles together and maintains them in their original anatomical position.
This muscle re-tensioning helps to remove the camel hump« and stabilize posture. The procedure is performed under general anaesthetic and usually lasts between 1 and 2 hours, depending on complexity of the case. It radically transforms the silhouette into restoring a slim waistline and a solid back support.
In most cases, muscle separation is accompanied by’excess skin and localized fat. Abdominoplasty in Paris is then the intervention of choice to treat all stomach components. In addition to muscle repair, the surgeon performs a resection of damaged skin, often located below the navel, to tighten the wall.
Depending on the degree of skin laxity, Dr. Djian may suggest a mini abdominoplasty. This variant is ideal for patients whose’excess skin is limited to the subumbilical region.
A tummy tuck liposuction is frequently combined to refine the flanks and eliminate fatty deposits resistant. This global approach makes it possible to treat the "abdominal apron while correcting deep muscle structure.
To find out more about this complete procedure, you can read about the intervention of’abdominoplasty in Paris. The result is a flat, firm stomach and perfectly smoothed skin.
For patients with moderate diastasis without excess skin New technologies have made it possible to reduce the need for incisions. The Rainwater, using the’helium plasma energy, can be used as a complement to liposuction to retract the skin from the inside. This innovative technique offers an interesting alternative for those who dread the classic tummy tuck scar.
However, it should be borne in mind that Rénuvion does not replace muscle suture for diastasis treatment.
If your problem is purely muscular, the traditional surgical technique remains the standard of excellence for a solid repair.
A consultation with Dr. Djian will determine whether you are a good candidate for these advanced techniques, or whether a conventional approach is preferable for your safety.
Successful surgery depends on careful preparation and a relationship of trust with your surgeon.
The timing of the intervention is crucial to guarantee safety and results. There are three typical profiles for determining the ideal timing.
Post-partum, The body undergoes a hormonal and tissue transition. Early surgery on unstable tissue is not recommended.. We recommend a consultation from 8 months after delivery and an operation after one year, once the tissue has stabilized and natural recovery is complete.
In the case of overweight, the rule is strict: no surgery is performed.. Visceral adiposity prevents effective muscular closure and increases risks. It is imperative to’achieve a stable healthy weight before considering diastasis repair.
For athletes, Although they are often physically ready, the challenge is planning. The intervention must fit into their schedule to respect recovery time without immediate performance constraints.
Finally, it is preferable to’wait until your maternity project is complete. Pregnancy may cause the repaired muscles to relax, compromising the lasting aesthetic result of the operation.
Before surgery, your condition plays a major role in wound healing.. A food rich in protein and vitamin C assistance collagen regeneration.
It is also it's imperative to stop smoking at least one month before and after surgery. Smoking reduces tissue oxygenation and considerably increases the risk of necrosis and infection.
The physical preparation should not be neglected. If your back allows it, continue gentle sheathing exercises to maintain peripheral muscle tone.
The more fit you are when you arrive at the operation, the faster your recovery will be. Don't forget to check your body mass index, because a BMI and abdominoplasty are a guarantee of safe operation.
The fear of pain is often an obstacle for patients. Today analgesia protocols modern allow you to live through the post-operative period with a great deal of serenity.
At home, a appropriate analgesic treatment will be prescribed.
The sensation often resembles very sore muscles after an intensive sports session.
Wearing a support sheath is also a major element of comfort, as it limits stress on the sutures and provides a feeling of security during movement. Most patients report that the discomfort is largely bearable compared to the benefit felt.
The scar from a tummy tuck is located very low, just above the pubis. It is designed to be concealed by most undergarments and swimwear. Over time, she fades to a thin white line. Dr. Djian pays particular attention to the quality of the suture to ensure that the brand is as unobtrusive as possible.
Scar care is essential during the first year. From massages with specific creams and the use of silicone plates can be recommended to optimize skin regeneration.
You also need to protect the area from the sun to avoid permanent pigmentation.
RESUMING SPORT AND DAILY LIFE: RECOVERY PLANNING
Hospitalization generally lasts 24 to 48 hours.. When you return home, plan a total rest period of two weeks. The Gentle walking is encouraged from the very next day of the operation to promote blood circulation, but the carrying heavy loads (including carrying your children) is strictly prohibited for at least 6 weeks to give the muscles time to heal properly.
The a gradual return to sporting activity. After one month, you can resume exercise on the exercise bike or brisk walking. Exercises directly involving the abdominal muscles should only be resumed after validation during your follow-up consultation at the clinic, generally around the 3rd month. Respecting this schedule is the best guarantee of avoiding damage to your internal corset.
The result of a diastasis cure is often described by patients as a a true renaissance. Beyond the aesthetic aspect of a flat stomach, it's the a sense of bodily unity which predominates. Clothes fall off better, posture is straightened and back pain often disappears after a few months of post-operative strengthening.
This physical transformation has a profound impact on self-confidence. Rediscovering your tummy after abdominoplasty means that you no longer have to hide or fear questions about a possible pregnancy, thus facilitating the reclaiming one's femininity.
The price of a diastasis cure depends on the technical nature of the procedure and any corrective procedures such as liposuction. For a aesthetic abdominoplasty, rates are as follows between 6,000 and 7,000 euros. If it is a corrective surgery, the average cost is 4500 euros.
For patients wishing to restore their overall silhouette, Mommy Makeover (combined tummy tuck and breast lift without implants) starts at 9,000 euros with Dr Djian.
Before and after photos of a mommy makeover with diastasis correction
These amounts include fees, the clinic fees and annual follow-up. You can find all the details on our page dedicated to the price of abdominoplasty.
The management of your abdominal surgery is sectorized according to the nature of the procedures performed:
Hernia: it is automatically covered by social security, as it constitutes a medical pathology.
Diastasis cure and abdominoplasty: these procedures are considered cosmetic and are entirely at the customer's expense (practice and clinic fees), unless an abdominal apron with real functional discomfort is noted.
To hope for partial reimbursement of the diastasis cure or abdominoplasty, the medical consultant must validate a request for prior agreement. This treatment is reserved for cases of proven functional discomfort, such as :
a "abdominal apron which covers all or part of the pubis:
repeated skin irritation or infection in the fold (intertrigo):
major discomfort in walking or daily mobility:
The Dr. Jérémy Djian, an expert in reconstructive surgery in Paris, will assess during your consultation whether your criteria qualify for a preliminary agreement. If the procedure is deemed purely cosmetic by the medical advisor, no reimbursement will be granted for diastasis and abdominoplasty.
Diastasis is an anatomical reality that can be effectively treated at Dr. Djian's Paris practice. Our approach is based on a precise diagnosis and a surgical solution tailored to your personal situation. Our aim is to help you regain a functional abdominal wall and a natural-looking tummy, while respecting the time required for proper healing. By intervening at the most opportune moment for your tissues, we ensure optimal recovery and a stable result, enabling you to regain the daily comfort and figure that suits you.
Sources :
Yes, abdominal diastasis can often be identified on clinical examination, In particular, the midline bulges when the patient is lying down. However, a ultrasound of the abdominal wall is recommended to accurately measure muscle spacing and assess the need for reconstructive surgery. This examination is often requested prior to abdominoplasty with diastasis cure.
Yes, diastasis can be aggravated by certain types of poorly adapted exercise, These include the classic abdominals and push-ups. Over time, the gap can widen, causing back pain, digestive problems or a feeling of a swollen belly. Surgery is the only effective solution to restore a functional abdominal wall and prevent aggravation.
A diastasis can cause troublesome symptoms, These may include a belly that remains bloated despite weight loss, lower back pain, digestive problems or a feeling of instability in the trunk. It can also be responsible for a “permanent pregnancy belly”. Reconstructive surgery makes it possible to restore the abdominal muscles and improve posture.
Caesarean section’is not the direct cause of muscle spacing. This phenomenon is linked to abdominal distension during pregnancy and to the quality of your connective tissue. However, the surgical procedure can weaken the wall or accentuate an existing gap, making natural recovery more complex.
During exercise, the diastasis creates an elongated vertical bulge (loaf or dome-shaped) along the entire centerline. Conversely, a hernia manifests itself as a localized, round and precise protuberance, like a small marble protruding at or above the navel. If the lump is reducible (returns under pressure) or painful, surgical advice is essential.
The specialist's examination, accompanied by an ultrasound scan, will help determine the diagnosis.
Dr Jérémy Djian is a plastic surgeon based at 5 square Thiers, near the Victor Hugo roundabout, in the 16th arrondissement of Paris.
He trained in Paris and remains attached to the hospital in the prestigious department of Pr Laurent Lantieri.
Hello, I had a sleeve operation in 2021 and having lost 54KG I find myself with skin that falls off (stomach, arms, slightly thighs), I would like to know if I could benefit from an abdominoplasty to remove my complex.
info: 25 years old, Female, 1m62, 58kg
Thank you for your reply,
sincerely
Hello, ma'am,
I think that you can benefit from an abdominoplasty covered by social security,
But you need to be examined,
Yours sincerely,
Dr Djian
After abdominoplasty and diastasis
How long afterwards can you feel
Tightness (discomfort) in the abdominal muscles?
Thank you
Hello, ma'am,
We recommend a 6-week rest period to allow for healing,
Yours sincerely,
Dr Djian