Surgical diastasis recti repair shares the risks of any major abdominal operation, including bleeding, infection, blood clots and anaesthetic complications. Because it is performed as part of a tummy tuck, it also carries the risks of that procedure, such as seroma, wound healing problems, numbness and scarring. Tightening the muscles adds some specific considerations, including increased pressure within the abdomen, more post-operative discomfort and a small chance of the separation recurring.
Understanding the operation
Diastasis recti is a widening of the gap between the two rectus abdominis muscles, most often after pregnancy. The surgical repair, known as plication, stitches the front sheath of the muscles together to narrow the gap and firm the abdominal wall. With Mr Nassab it is performed as part of an abdominoplasty, which also removes loose skin, from £12,500. It is a significant operation, and understanding the risks is an important part of deciding whether it is right for you.
General surgical risks
- Venous thromboembolism: blood clots in the legs or lungs are one of the most important risks after abdominal surgery. Tightening the abdominal wall can slightly increase this risk, so prevention includes compression stockings, calf compression devices in theatre, early walking and, where appropriate, blood-thinning injections.
- Bleeding and haematoma: a collection of blood that may need a return to theatre.
- Infection: of the wound or, rarely, deeper tissues, usually treated with antibiotics.
- Anaesthetic risks: assessed beforehand and managed by a consultant anaesthetist.
Risks linked to muscle repair and tummy tuck surgery
- Seroma: fluid collecting under the skin flap, which may need draining in clinic.
- Wound healing problems: small areas of breakdown, often at the centre of the scar where tension is greatest; more likely in smokers and people with diabetes or a higher BMI.
- Numbness: reduced sensation of the lower abdominal skin is common and may be long-lasting.
- Recurrence: the separation can stretch again, particularly with future pregnancy, significant weight gain or early heavy strain.
- Discomfort from stitches: occasionally a permanent internal stitch can be felt or become irritated.
- Raised abdominal pressure: tightening can make breathing feel restricted at first; very tight repairs can rarely affect breathing or circulation, which is why the degree of repair is judged carefully.
- Scarring and belly button changes: a low horizontal scar and a scar around the navel, which can stretch or thicken.
- Contour irregularities: including ‘dog ears’ at the scar ends that may need minor revision.
How the risks are reduced
Assessment begins at consultation. Mr Nassab examines the abdomen standing and lying, checks the width of the gap and looks for any hernia, and may request an ultrasound scan. A hernia may require input from a general surgeon. You will be asked to stop smoking and all nicotine for at least six weeks before and after surgery, and to reach a stable, healthy weight. Your individual blood clot risk is formally assessed. In theatre, the repair is tailored to your anatomy, and drains may be used to reduce fluid build-up. Afterwards, a binder, early walking, sensible activity limits and scheduled reviews all contribute to safe healing.
What is normal, and what is not
It is normal to feel very tight, walk bent forward for the first week or two, have bruising and swelling low on the abdomen, and feel numb above the scar. Swelling can worsen towards the end of the day. What is not normal is severe pain that is increasing rather than improving, rapid swelling, a hot and red wound, or difficulty breathing.
When to seek help
Contact the surgical team urgently if the abdomen swells rapidly or becomes very tense and painful. Call the team the same day for fever, spreading redness or discharge from the wound. Sudden one-sided calf pain or leg swelling needs a same-day GP appointment or a call to NHS 111. Chest pain or breathlessness is an emergency: call 999. The recovery guide sets out the typical healing timeline.
Surgery versus physiotherapy
Surgery is not the first step for everyone. Many people see improvement in core function with targeted physiotherapy, and this is usually recommended before surgery is considered. Surgical repair is an option when a significant gap and loose skin persist despite rehabilitation, and when your family is complete.
Frequently Asked Questions
Is diastasis recti repair a major operation?
Yes. It is performed as part of a tummy tuck under general anaesthetic, with one or two nights in hospital and several weeks of restricted activity.
Can diastasis come back after surgery?
It can, particularly after a future pregnancy or significant weight gain. Following lifting restrictions during healing also helps protect the repair.
Does repair treat a hernia too?
Small umbilical hernias can sometimes be addressed at the same time, but larger hernias may need assessment by a general surgeon.
Are blood clots more likely after muscle repair?
Abdominal surgery carries a recognised risk of clots, and muscle tightening can add to it. Individual risk is assessed and preventive measures are always used.
Is it safe to have another baby after repair?
Pregnancy is possible but may stretch the repair and skin again. It is generally best to wait until your family is complete.
