Diastasis recti: physio first
The HSE says the gap between the tummy muscles is normal in pregnancy, can take up to six weeks after the birth to reduce and sometimes longer, and advises asking your GP for a physiotherapy referral if you're worried about it after eight weeks.
The HSE's self-check: lie on your back, knees bent and feet flat, lift your head and shoulders slightly, and feel above and below your belly button for a gap. If you can fit more than two fingers between the muscles, there are things that help: good posture, a binder or compression top in the first eight weeks, and the right exercises. After a caesarean, wait at least five weeks to check, and twelve before those exercises.
When surgery makes sense
When physiotherapy has been given a fair go and the gap or the loose skin is still there, your weight is stable, you've stopped breastfeeding, and you don't plan more pregnancies. A full tummy tuck stitches the muscles back together and removes the loose skin and stretch marks below the belly button.
Why wait for the last baby
A pregnancy stretches the repair and the skin again. Surgeons generally advise waiting until your family is complete.
A tummy tuck isn't for you yet if:
- your weight is still going down or up
- you plan more pregnancies: a pregnancy can undo the result
- you smoke and won't stop well before surgery (some surgeons won't operate on smokers at all)
- the problem is fat with firm skin, when liposuction may be enough
Recovery with small children
Expect about four to six weeks off work and exercise, and several weeks before you can drive. No lifting children for weeks. Line up help at home before you book.
Risks
The common and the less common:
- a long scar across the lower tummy (and around the belly button after a full tummy tuck), red at first and fading over 12 to 18 months
- numbness of the lower tummy skin for months, sometimes years
- a pocket of fluid above the scar (a seroma), which may need draining
- a collection of blood under the skin (a haematoma)
- wounds that are slow to heal, more likely if you smoke
- thick or obvious scars, or 'dog ears' of extra skin at the ends of the scar
- a blood clot in a leg vein, which can travel to the lungs
- infection, or a reaction to the anaesthetic
Your surgeon should tell you how likely each one is for you, and what they'd do about it.
Cost
A full tummy tuck with a muscle repair: €8,000 to €12,000 in Ireland. A mini: €5,600 to €7,900.
Every doctor practising in Ireland must be registered with the Medical Council, and only a doctor with specialist registration can practise independently as a specialist. For a tummy tuck, check that the surgeon is on the Specialist Division in Plastic, Reconstructive and Aesthetic Surgery, using the Medical Council's online register.
Questions people ask
How soon after a baby can I have a tummy tuck?
Not until you've finished having children, stopped breastfeeding and your weight has been stable for some months. Physio for the muscles comes first.
Will a tummy tuck remove stretch marks?
Those on the skin that's removed, below the belly button, go. Stretch marks above it stay.
Is diastasis repair covered by health insurance?
Usually not when it's done as part of a cosmetic tummy tuck. Ask your GP and your insurer if there's a medical problem, such as a hernia.