Diastasis is usually defined as a stretching of the rectus abdominis muscles. An article by Rúben Malcata Nogueira, a specialist in plastic, reconstructive and aesthetic surgery.
The abdominal wall is made up of the rectus abdominis, internal oblique, external oblique and transverse abdominis muscles. These muscles are paired – this means that if we imagine a vertical line dividing the abdomen, there is symmetry on the right and left.
The integrity of these structures is fundamental in many ways:
Firstly, in keeping the abdominal contents (aka intestines) inside the abdomen. In cases of abdominal weakness, there may be hernias or other pathologies with a significant functional and aesthetic impact.
Secondly, these muscles are crucial for maintaining good posture. The position of the lumbar spine is directly affected by the quality of the abdominal wall. Thirdly, and no less importantly, the integrity of the abdominal wall is important in preventing genitourinary pathology – usually urinary incontinence, faecal incontinence or other pelvic pathology.
Finally, the aesthetic component of the abdomen is invaluable, and the main complaint is often that of a “broken belly”.
Diastasis is usually defined as a stretching of the rectus abdominis muscles. In the vast majority of cases, this absence is related to pregnancy or major weight fluctuations. In the first case, it is a physiological and necessary phenomenon, with an important hormonal component, which allows the foetus to develop in the uterus (if the abdomen behaved like a rigid wall, there would be no possibility of distension to accommodate the growth of the foetus); in the second, it is a phenomenon that occurs due to increased intra-abdominal pressure and increases susceptibility to pathologies.
In most patients, the physiological diastasis of pregnancy resolves naturally after 12 months. However, in around 30-40 per cent of cases, the muscles do not return to their “original” position. In these cases, as well as in the case of patients with major weight fluctuations, we turn our attention from prevention to treatment in order to improve quality of life.
As with any other pathology, we can consider conservative or surgical treatment. When we think of conservative treatment, we’re talking about muscle strengthening, improving dietary quality and possible physiotherapy support. Although these measures are fundamental to adopting a healthy lifestyle, they are not usually the solution to this problem, but rather an adjunct to treatment.
The most effective treatment for correcting diastasis is an abdominoplasty. Through this surgical procedure, it is possible to strengthen the muscles and reposition the rectus abdominis muscles, helping to strengthen the integrity of the abdominal wall, as well as significantly improving aesthetics and narrowing the waistline. The navel is also repositioned, and the scar made for the access route is hidden in the underwear, allowing all the excess skin and fat that has accumulated to be removed.
Correcting diastasis is fundamental to preventing future problems.
Although, in most situations, the immediate gain is aesthetic (and the improvement in abdominal shape and aesthetics is invaluable), the functional gain obtained is an often forgotten hero – from improving the posture of the lumbar spine, to improving genitourinary symptoms or abdominal strengthening that prevents the appearance of hernias – Abdominoplasty performed by a competent Plastic Surgeon has the potential to vastly improve patients’ quality of life.