Diastasis Recti
Diastasis recti develops when the connective tissue between the two sides of the rectus abdominis stretches and widens, allowing the muscles to move further apart. It can create a persistent central bulge or visible doming through the abdomen, even after pregnancy weight has reduced and overall fitness has improved.
What our patients say
This content has been medically reviewed by Mr Roshan Vijayan (GMC Number 7020524) MBBS, BSc (Imperial College London), MRCS (Eng), FRCS (Plast), Executive MBA.
A tummy tuck (abdominoplasty) can repair the separation while removing loose abdominal skin and reshaping the surrounding tissues. Mr Roshan Vijayan assesses the skin and abdominal wall together to determine the extent of repair required.
What Is Diastasis Recti?
Diastasis recti is a widening of the connective tissue running down the centre of the abdomen, which causes the two rectus abdominis muscles to sit further apart than normal. The separation reduces tension across the abdominal wall and can leave a persistent central bulge, ridge, or doming, particularly when sitting up, coughing, or engaging the core.
Diastasis recti develops when the connective tissue between the rectus muscles stretches and allows them to move further apart.
What Are the Symptoms of Diastasis Recti?
Diastasis recti does not produce identical symptoms in every person. Some are primarily concerned by a persistent change in abdominal shape, while others notice reduced support or difficulty controlling pressure through the core.
Signs and symptoms can include:
- A ridge or dome along the centre of the abdomen
- Bulging that becomes clearer when sitting up, coughing or straining
- A persistent rounded abdominal contour after pregnancy
- Reduced tension through the central abdominal wall
- Difficulty engaging the core during movement or exercise
- A feeling of weakness or instability through the midsection
- Discomfort during activities that increase abdominal pressure
- Loose abdominal skin alongside the muscle separation
What Causes Diastasis Recti?
Pregnancy is the principal cause of diastasis recti because the abdominal wall must expand to accommodate the growing uterus. Hormonal changes also soften the connective tissues, allowing the centre of the abdominal wall to stretch further as pregnancy progresses.
Factors associated with abdominal muscle separation include:
- Pregnancy, particularly during the later stages
- Multiple pregnancies
- Twin or multiple pregnancy
- A larger baby or greater abdominal expansion
- A previous diastasis that did not fully resolve
- Repeated increases in abdominal pressure
- Significant changes in weight
- Reduced tissue elasticity
- Natural differences in connective-tissue strength
- Previous abdominal procedures or abdominal-wall weakness
Muscle repair and excess skin removal can be incorporated into the same abdominoplasty when both concerns are present.
How Does Mr Vijayan Assess Diastasis Recti?
Mr Vijayan examines the abdomen while the muscles are relaxed and contracted. This establishes the width and depth of the separation, the strength of the tissue across the midline and whether the diastasis affects the upper abdomen, lower abdomen or both.
The assessment also considers loose skin, fat distribution, the position of the belly button and scars from previous procedures. Future pregnancy plans are discussed because another pregnancy can stretch a repaired abdominal wall and affect the result.
How Is Diastasis Recti Treated?
Diastasis recti is treated surgically through abdominoplasty with abdominal muscle repair. Under general anaesthesia, a low incision is made across the abdomen, and the skin is lifted to expose the abdominal wall. Internal sutures are then used to tighten the stretched tissue between the rectus muscles, bringing the muscles into a more supported position and restoring tension through the centre of the abdomen.
Once the muscle repair is complete, the excess abdominal skin is removed, and the remaining tissue is repositioned. The belly button is brought through the tightened skin in an appropriate position before the incisions are closed. A compression garment supports the abdomen during recovery, while strenuous exercise and heavy lifting are avoided for approximately four to six weeks.
Why Choose Mr Roshan Vijayan for Diastasis Recti Surgery?
Repairing diastasis recti requires an assessment of the abdominal wall beneath the visible bulge. Muscle separation, skin laxity, remaining fat, and previous scars must be considered together before planning the extent of treatment.
Mr Vijayan’s approach includes:
Consultant-led examination of the full abdominal wall
Careful distinction between muscle separation, loose skin and localised fat
Abdominoplasty planned around the location and extent of the diastasis
Abdominal muscle repair incorporated into the procedure
Assessment of the abdomen, waist and flanks as connected areas
Clear discussion of incision placement, recovery and future pregnancy
A second consultation before surgery to review the proposed treatment
Personally conducted postoperative reviews
Realistic guidance about abdominal support, contour and the results surgery can achieve
Diastasis Recti FAQs
How can I check for diastasis recti at home?
A central gap or ridge may become visible when you lie down and gently lift your head or shoulders. A clinical assessment is required to measure the width and depth of the separation and establish how much of the abdominal wall is affected.
Can diastasis recti heal naturally after pregnancy?
Mild separation can reduce as the abdominal tissues recover following pregnancy. A wide or established diastasis may persist when the connective tissue at the centre of the abdomen remains stretched.
Can exercise close diastasis recti completely?
Exercise can improve core control and the way pressure is managed through the abdomen. It cannot reliably close every significant separation and will not remove loose abdominal skin.
When should diastasis recti be assessed by a surgeon?
Diastasis recti should be assessed by a surgeon when significant separation remains alongside persistent doming, reduced abdominal support or loose skin. Assessment is also appropriate when physiotherapy has improved strength but has not corrected the structural change in the abdominal wall.
Can diastasis recti be repaired years after pregnancy?
Diastasis recti can be repaired years after pregnancy when the separation remains, and the patient is suitable for surgery. The timing of treatment depends on general health, weight stability and whether any further pregnancies are planned.
How does a tummy tuck repair diastasis recti?
A tummy tuck exposes the abdominal wall so the widened tissue between the rectus muscles can be tightened with internal sutures. The procedure also removes loose skin and reshapes the abdomen during the same procedure.
Does every tummy tuck include diastasis recti repair?
Muscle repair is included when an examination confirms diastasis recti or abdominal-wall weakness. A tummy tuck can also remove excess skin when the abdominal muscles do not require repair.
Should diastasis recti surgery wait until after pregnancy?
Diastasis recti surgery should generally be delayed until no further pregnancies are planned. Another pregnancy can stretch the repaired abdominal wall and alter the abdominal contour again.
How long is recovery after diastasis recti surgery?
Initial recovery generally takes several weeks, with strenuous exercise and heavy lifting restricted for approximately four to six weeks. The exact timeline depends on the extent of the repair, the amount of skin removed and how the individual heals.
Can diastasis recti return after surgical repair?
Surgical repair can provide long-lasting support when body weight remains stable, and no further pregnancy occurs. Pregnancy, substantial weight changes and repeated increases in abdominal pressure can stretch the tissues again.
Book Your Diastasis Recti Consultation
Diastasis recti can leave a persistent abdominal bulge and reduce support through the midsection, particularly when it occurs alongside loose skin after pregnancy. Abdominoplasty allows the separated muscles and excess skin to be addressed within the same procedure.
Mr Vijayan will examine the abdominal wall, assess the extent of the separation and explain the proposed muscle repair, scar pattern and recovery. If diastasis recti continues to affect abdominal shape or support, please contact us for further information or to arrange a consultation.
Request a Consultation