How Long Does It Take to Recover from a Rectus Diastasis Repair?

Rectus diastasis is a common condition in which the large abdominal muscles separate. While common among pregnant and postpartum people, it can occur in middle-aged or older individuals with higher body weight. 

When connective tissue in the abdomen separates, it can cause several problems for the individual affected, including:

  • A vertical protrusion of abdominal tissue in the abdomen that may not align with some individuals’ aesthetic goals
  • Back pain due to instability of the spine
  • Urinary incontinence and/or constipation
  • Increased risk of umbilical hernias
  • Pain while engaging in sexual intercourse

Abdominal separation can occur due to weight gain or muscle strain caused by weightlifting. It is also common among pregnant women—up to 60% of pregnant people experience diastasis recti due to pregnancy. Most cases of abdominal muscle separation require plastic surgery from a board-certified plastic surgeon. Exercise and physical therapy do not correct rectus diastasis.

A rectus diastasis repair can not only help patients achieve their desired silhouette—but it can also reduce or eliminate discomfort and embarrassment due to abdominal separation. However, like any surgical procedure, including elective plastic surgery, diastasis recti repair requires post-operative healing and recovery time to prevent complications and achieve the desired results. 

What to expect after a rectus diastasis repair

If post-surgical guidelines are followed, most people fully recover from a diastasis recti repair within 10-12 weeks. Proper healing requires adequate rest, minimizing exercise, and maintaining a healthy lifestyle.

Some people elect to have their diastasis recti repaired during a tummy tuck (or abdominoplasty) procedure. Both procedures involve a similar incision and help support the abdominal muscles. The main difference between a rectus diastasis repair and abdominoplasty is that excess tissue is removed during a tummy tuck.

24 hours after surgery

To repair diastasis recti, a plastic surgeon must put the patient under anesthesia and make a transverse incision between their belly button and pubic bone. In the hours after surgery, most people will feel slightly groggy from the anesthesia, and they may experience some muscle soreness in the abdominal area. This muscle soreness may last several days up to two weeks, but the plastic surgeon may prescribe medications to help with pain control.

Most plastic surgeons will require the patient to be monitored by a registered nurse (RN) for 24 hours after the procedure. If the patient is local, monitoring can be performed by a family member and occur at home or a nearby hotel after 24 hours.

If fluid accumulates near the incision site during the procedure, the plastic surgeon may place one or two wound drains in the incision to eliminate excess fluid from the wound. Wound drains must be kept clean and dry until they are removed, but they should not cause discomfort. These drains may need to stay in place until the swelling is reduced.

At discharge, the patient will be provided with a custom compression garment to help reduce swelling and speed up the healing process. This compression garment should be worn at all times under loose, comfortable clothing.

1–7 days after surgery

In the days following the procedure, patients should avoid getting the incision area wet to help prevent infection. The abdominal muscles may feel tight for the first few days or weeks. It is normal to have discomfort when standing up straight or flexing abdominal muscles while coughing or laughing.

It can be helpful to have a caretaker in the home for the first few days after surgery to avoid putting excess strain on the abdominal muscles. Since most activities involve the abdomen, including standing, twisting, bending, and lifting, in-home support can help prevent re-injury or complications after surgery.

Most people take 7-10 days off of work after surgery to help minimize abdominal stress. During this time, no strenuous exercise should be performed, especially activity that uses core strength, like weightlifting. Light walking is encouraged to help reduce swelling and reduce the risk of developing a blood clot.

1–4 weeks after surgery

Most patients will begin to feel more comfortable during this interval. Typically, the compression garment can be discontinued during this time, although wearing loose-fitting clothing is recommended for up to two weeks. Surgical drains are usually removed one week post-surgery, and the incision site should begin to heal. 

If the incision appears red, swollen, or inflamed, it is important to share that information with the plastic surgeon who performed the surgery.

During this time, physical activity should still be kept to a minimum. Although many patients return to work within the period and discontinue in-home care, strenuous activity is still dangerous and can cause muscle damage if resumed too quickly. It can take patients six weeks or more to safely return to physical exercise like running or lifting weights.

Possible complications

As with any surgery, some people experience side effects from diastasis recti repair, including:

  • Muscle reinjury or separation
  • Infection at the surgical site
  • Hematoma (blood in the wound)
  • Seroma (fluid in the wound)
  • Scarring at the incision site

Post-incision scarring is common following a diastasis recti repair; however, the incision is in the lower abdomen and can easily be hidden behind a swimsuit or underwear. Scarring can be minimized by following the proper wound care protocol.

Tips for recovery

To improve your diastasis recti repair recovery outcome, follow these guidelines:

  • Quit smoking. Most plastic surgeons will not perform cosmetic surgery on smokers.
  • Wait to have surgery until at least twelve months after childbirth, as your body needs time to heal from pregnancy and postpartum before undergoing surgery.
  • Eat a balanced diet and exercise regularly to avoid excessive weight gain, which can impair recovery and cause your abdominal muscles to separate again. Ideally, you should wait to have surgery until you are no longer expecting to have children—this way, your repair is not compromised by weight gain during pregnancy.
  • Avoid strenuous exercise until you are fully healed from surgery to prevent your incision from reopening or your abdominal muscles from separating. Light exercise, such as walking, is recommended to prevent blood clots.

Choosing your surgeon

Choosing a board-certified plastic surgeon trained by a reputable institution can help give you the confidence that you will achieve your desired results from surgery. An experienced surgeon should provide recommendations and a treatment plan before scheduling surgery. They should also be able to provide reviews from other patients and before and after photos of their work if requested. 

Start by scheduling an initial consultation to learn about the surgical process and follow-up care. If the surgeon has the appropriate credentials, provides thorough pre- and post-surgical care, and is aligned with your aesthetic goals, they may be the right choice to perform your rectus diastasis repair.

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