What is Rectus Diastasis Repair?

Rectus diastasis repair is a surgical procedure to correct the separation of the rectus abdominis muscles, a condition known as diastasis recti, commonly caused by pregnancy, significant weight fluctuations, or aging. This separation creates a gap (often >2 cm) in the midline of the abdomen, leading to a bulging appearance, core weakness, lower back pain, urinary stress incontinence, or digestive issues. At Nairobi Sculpt Aesthetic Centre, Dr. Mukami Gathariki, a board-certified plastic and reconstructive surgeon, specializes in restoring core strength and abdominal contour through advanced techniques like plication or endoscopic repair. Often combined with a tummy tuck or liposuction, the procedure enhances both functional stability and aesthetic harmony, tailored to each patient’s anatomy and goals.

Performed in an accredited outpatient facility under general anesthesia, rectus diastasis repair offers lasting results with a focus on patient comfort, safety, and minimal scarring, addressing both physical and psychological impacts of the condition.

Benefits of Rectus Diastasis Repair

• Restored Core Strength: Realigns separated muscles to enhance abdominal stability and support daily activities.
• Flatter, Toned Abdomen: Eliminates the bulging or “pooch” appearance for a smoother, contoured midsection.
• Improved Posture and Pain Relief: Reduces lower back strain and alleviates associated discomfort by strengthening the core.
• Enhanced Functionality: Improves physical performance, from exercise to lifting, by restoring muscle integrity.
• Relief from Incontinence: May reduce stress urinary incontinence by stabilizing the pelvic floor and core.
• Better Clothing Fit: Achieves a slimmer waistline, making clothes fit more comfortably and flatteringly.
• Boosted Confidence: Enhances body image, particularly for post-pregnancy patients or those with weight-loss-related changes.

Who is a Candidate for Rectus Diastasis Repair?

Ideal candidates for rectus diastasis repair include individuals who:

• Are in good general health with no uncontrolled conditions (e.g., diabetes, heart disease) that impair healing.
• Have a confirmed diastasis recti diagnosis (gap >2 cm), verified by physical exam or imaging (e.g., ultrasound).
• Experience functional issues like core weakness, lower back pain, pelvic floor dysfunction, or digestive discomfort due to muscle separation.
• Seek aesthetic improvement for a bulging abdomen unresponsive to exercise or non-surgical treatments.
• Are at a stable weight, as fluctuations can compromise results or cause recurrence.
• Are not pregnant or planning future pregnancies, as pregnancy can re-separate repaired muscles.
• Are non-smokers or willing to quit 2–4 weeks before and after surgery to optimize healing.
• Have realistic expectations, understanding that results enhance natural contours and function.
• Do not have significant abdominal hernias requiring separate repair, unless combined with diastasis repair.

During a consultation, Dr. Mukami uses physical assessment or imaging to measure the separation’s width and depth, reviews medical history, and discusses aesthetic and functional goals to ensure suitability, potentially recommending complementary procedures.

Rectus Diastasis Repair Techniques

Dr. Mukami customizes the procedure based on the severity of the separation and patient needs:

• Plication Repair: The separated rectus muscles are sutured together using permanent or absorbable sutures (e.g., PDS), restoring midline strength, often during a tummy tuck.
• Endoscopic Repair: A minimally invasive technique using small incisions (1–2 cm) and a camera, ideal for mild cases (<4 cm gap) with minimal skin excess.
• Open Repair with Mesh Reinforcement: For severe cases (>6 cm gap), a synthetic or biologic mesh reinforces the repair to prevent recurrence, used in complex cases.
• Combination with Tummy Tuck: Combines muscle repair with removal of excess skin and fat for a flatter, sculpted abdomen, suitable for post-pregnancy or weight-loss patients.
• Combination with Liposuction: Enhances contours by removing localized fat deposits in the abdomen, flanks, or hips alongside muscle repair.
• Revision Repair: Corrects recurrent diastasis or unsatisfactory prior repairs, addressing complications like suture failure or asymmetry.

Dr. Mukami selects techniques based on the gap’s size, skin laxity, and patient goals, ensuring functional restoration with minimal invasiveness and scarring.

The Rectus Diastasis Repair Procedure

The procedure is performed under general anesthesia, taking 1–3 hours depending on complexity:

1. Preoperative Consultation: Dr. Mukami assesses the separation’s extent using physical exam or ultrasound, designs the surgical plan, and advises avoiding blood thinners (e.g., aspirin), smoking, and alcohol for 2 weeks prior.
2. Anesthesia: General anesthesia ensures a pain-free experience, administered by a board-certified anesthesiologist.
3. Incisions: A low transverse incision (10–15 cm, similar to a C-section scar) is made for open repair or tummy tuck combination; endoscopic repair uses 2–3 small incisions (1–2 cm) near the navel or pubic line.
4. Muscle Repair: The rectus muscles are sutured together along the midline using permanent (e.g., Prolene) or absorbable sutures, restoring core integrity. Mesh may be placed in severe cases.
5. Additional Adjustments: Excess skin or fat is removed if combined with a tummy tuck; liposuction contours surrounding areas for enhanced aesthetics.
6. Closure: Incisions are closed with layered absorbable sutures to minimize tension, and drains may be placed to prevent fluid buildup. A sterile dressing and compression garment are applied.
7. Post-Procedure: Patients are monitored in recovery for 1–2 hours and typically discharged the same day with detailed aftercare instructions.

Dr. Mukami’s meticulous technique minimizes trauma, using fine sutures and sterile protocols to ensure optimal healing and aesthetic outcomes.

Risks and Considerations

Rectus diastasis repair is generally safe, but potential complications include:

• Swelling and Bruising: Common for 1–2 weeks, managed with compression garments and elevation.
• Seroma: Fluid buildup under the skin, treatable with drainage if persistent.
• Infection: Rare with proper sterile technique, managed with antibiotics if it occurs.
• Recurrence: Uncommon (<5%) with proper technique, but possible with future pregnancies or excessive strain.
• Scarring: Scars are low and discreet but may hypertrophy or form keloids, treatable with steroid injections or scar revision.
• Numbness: Temporary sensory changes around the incision, resolving within 3–6 months.
• Hematoma: Rare blood collection, treatable with surgical drainage if significant.
• Delayed Healing: Possible in smokers or patients with poor nutrition, mitigated with preoperative optimization.

Dr. Mukami reduces risks through thorough preoperative planning, precise surgical execution, and comprehensive postoperative care.

Recovery and Aftercare

Recovery varies by technique and combination procedures, with the following timeline:

• First 48 Hours: Mild to moderate discomfort, managed with prescribed analgesics. A compression garment is worn to reduce swelling. Light walking is encouraged to prevent blood clots.
• Days 3–7: Swelling peaks and begins to subside. Patients resume light activities; drains (if used) are monitored. Avoid bending or twisting motions.
• Weeks 2–4: Drains are typically removed (7–14 days), and non-absorbable sutures (if used) are removed. Return to light work is possible; avoid core exercises or lifting >5 kg.
• Weeks 6–8: Swelling significantly resolves, and initial results are visible. Light exercise (e.g., walking, yoga) may resume with clearance; avoid crunches or heavy lifting.
• Months 3–6: Full results emerge as muscles strengthen and scars mature. Resume all activities, including core workouts, with Dr. Mukami’s approval.
• Months 12–18: Scars fade to fine lines, and long-term core stability is achieved with proper lifestyle maintenance.

Dr. Mukami’s aftercare instructions include:

• Wearing a compression garment continuously for 4–6 weeks, then as needed for comfort, to support healing and reduce swelling.
• Keeping incisions clean and dry, using antibiotic ointment to prevent infection.
• Avoiding heavy lifting, strenuous exercise, or core-straining activities (e.g., sit-ups) for 6–8 weeks.
• Maintaining a balanced diet rich in protein and hydration to support tissue repair.
• Avoiding smoking and alcohol for 2–4 weeks to enhance circulation and healing.
• Attending follow-up visits (e.g., 1 week, 2 weeks, 1 month, 3 months) to monitor recovery and address concerns.
• Protecting scars from sun exposure for 6 months with SPF 30+ sunscreen to minimize hyperpigmentation.

Combining Rectus Diastasis Repair with Other Procedures

Rectus diastasis repair is often paired with complementary procedures for enhanced outcomes:

• Tummy Tuck (Abdominoplasty): Removes excess skin and fat while tightening muscles, ideal for post-pregnancy or weight-loss patients.
• Liposuction: Contours the abdomen, flanks, hips, or thighs for a sculpted silhouette, complementing muscle repair.
• Mommy Makeover: Combines rectus diastasis repair with breast augmentation, breast lift, or body contouring to address post-pregnancy changes holistically.
• Hernia Repair: Simultaneously corrects umbilical or ventral hernias, which often coexist with diastasis recti, for comprehensive abdominal restoration.
• Breast Reconstruction: Enhances chest aesthetics for patients seeking full-body rejuvenation, often post-mastectomy.
• Brachioplasty (Arm Lift): Tightens upper arm skin for patients with significant weight loss, paired with abdominal repair for body contouring.

Dr. Mukami develops a tailored treatment plan during your consultation, ensuring safe combinations that align with your recovery capacity and aesthetic goals.

Frequently Asked Questions

• Can rectus diastasis repair be done without a tummy tuck? Yes, endoscopic or standalone plication repair is suitable for mild cases with minimal skin laxity, using smaller incisions.
• Will scars be visible? Scars are placed low (e.g., bikini line) and fade to fine lines within 12–18 months with proper care; endoscopic scars are nearly invisible.
• Can diastasis recti recur after surgery? Recurrence is rare (<5%) with expert technique, but future pregnancies, obesity, or heavy lifting can increase risk.
• How soon can I exercise after surgery? Light exercise (e.g., walking) resumes at 4–6 weeks; core exercises (e.g., planks) at 3–6 months with clearance.
• Can non-surgical treatments fix diastasis recti? Physical therapy or core exercises may improve mild cases (<2 cm), but surgery is required for significant separations or functional issues.
• Will insurance cover rectus diastasis repair? Coverage varies; functional issues (e.g., back pain, incontinence) may qualify. Contact Nairobi Sculpt Aesthetic Centre at +254 720 626 037 for assistance with insurance inquiries.
• How much does rectus diastasis repair cost? Costs depend on technique and combined procedures. Schedule a consultation for a personalized quote.