"When should a rectus diastasis be treated?"
A rectus diastasis only requires treatment if symptoms occur.”
Depending on the severity of the symptoms and the size of the diastasis, different treatment options are available. In the first year after childbirth, conservative measures are primarily emphasized. These can support the hormonally regulated regression of the condition. Physiotherapy and exercise can strengthen the core muscles and improve coordination and stability of the trunk.
If the rectus diastasis and symptoms such as back pain, trunk instability, or urinary incontinence persist even after a year, physiotherapy and other exercises may reach their limits. In this case, many studies show that surgery can be helpful. Surgery to restore trunk anatomy can significantly reduce symptoms and is often much more effective than physiotherapy and other training methods.
Physical therapy supports the regression of rectus diastasis during the first year after childbirth. Targeted exercises improve core muscles, stability, and coordination to alleviate symptoms.”
What are the surgical treatment options for rectus diastasis
There are many different surgical techniques for treating rectus diastasis. A rectus diastasis only requires treatment if symptoms occur.
However, large studies on this topic are lacking, so there are no clear recommendations in the guidelines yet. Experts agree that proven methods from hernia surgery should be used. Therefore, such procedures should ideally be performed by specialists in hernia surgery.
The goal of surgery for rectus diastasis is to bring the separated abdominal muscles back together through a suture in the centerline. To ensure long-term stability and prevent recurrence of the diastasis, the suture is often reinforced with a synthetic mesh, a biosynthetic mesh, or autologous tissue. This material is placed behind the abdominal muscles on top of the suture.
The choice of surgical technique depends on the condition of the abdominal skin. If there are no issues with the skin, the surgery can be minimally invasive, meaning with small incisions, similar to a ventral hernia repair.
Our standard procedure is the MILOS surgery (Mini Less Open Surgery). This involves correcting the rectus diastasis and reconstructing the abdominal wall through a 3-4 cm incision at the belly button. This procedure takes about an hour. The MILOS surgery has shown very good results in hernia surgery, which is why we have successfully applied this technique for rectus diastasis for many years. There are also newer, robot-assisted procedures (such as eTEP), but these offer no advantages and take much longer (2-3 hours).
Often, after pregnancy, the skin is significantly stretched or has stretch marks. In such cases, additional skin correction may be recommended, such as an abdominoplasty (tummy tuck). In this procedure, excess skin in the lower abdomen is removed, and the abdominal wall is tightened. Sometimes, patients have little to no fat under the skin but many skin folds. In these cases, soft tissue correction is also recommended to achieve a good cosmetic result after surgery.
The MILOS procedure gently removes rectus diastasis through a small incision at the navel and reconstructs the abdominal wall. If necessary, excess skin can also be removed and the abdomen tightened in the same operation, resulting in a functional and aesthetic outcome.
What is the Swiss Diamond Repair?
The “Swiss Diamond Repair” is an exclusive, high-quality treatment concept. There are many different surgical techniques for treating rectus diastasis.
The “Swiss Diamond Repair” is an exclusive, high-quality treatment concept that we have developed based on our years of experience in abdominal wall surgery, in close collaboration with our partner and plastic surgeon PD Dr. med. Rik Osinga (Basel). The name “Swiss Diamond Repair” stands not only for surgical excellence but also for the perfect combination of expertise and precision.
In this exceptional combined procedure, the abdominal wall is reconstructed to address the rectus diastasis, while simultaneously excess skin from the abdominal wall is removed (abdominoplasty). This close collaboration between abdominal wall surgeons and plastic surgeons makes it possible to achieve both functional and aesthetic results of the highest standard – a perfect solution that excels in both function and appearance.
Through the close cooperation of both surgical disciplines in the operating room, the “Swiss Diamond Repair” offers a unique opportunity: instead of the classic synthetic mesh, the patient’s own skin, which is removed during the abdominoplasty, can be used as a “biological
implant” to stabilize and support the abdominal wall suture. However, this is only possible if enough excess skin is available in the lower abdomen. This procedure is unique in Switzerland and is only used internationally in Scandinavian countries.
During the operation, the autologous skin graft is processed by PD Dr. Osinga and prepared for implantation into the rectus muscle compartment. Shortly thereafter, it is inserted into the abdominal wall by the ZweiChirurgen team, replacing a traditional synthetic mesh – an innovative technique that delivers exceptional results. With the “Swiss Diamond Repair,” you as a patient benefit from years of expertise in both abdominal wall surgery and plastic surgery. You will receive comprehensive, personalized care from both specialties – from the initial consultation to post-operative care. We work closely together to develop the best treatment strategy for you and to provide individualized support after the surgery.
With sufficient excess skin, it can be used as a “biological implant” to stabilize the abdominal wall instead of a synthetic mesh. In the first step, skin is removed and then implanted as an autologous skin graft—an innovative method for achieving a natural result.
What complications can occur?
The surgery is generally low-risk. However, despite all precautions, complications can occur.
Overall, this surgery is considered low-risk. The main risks associated with abdominal wall surgeries like the “Swiss Diamond Repair” include pain, postoperative bleeding with bruising, fluid buildup (seroma), issues with wound healing, wound infections, and skin necrosis. In rare cases, abdominal organs may also be injured. We will thoroughly explain the specific risks for you and the potential complications during the preoperative consultations.
The surgery is generally low-risk. Possible complications include pain, bruising, fluid accumulation, wound healing issues, or infections. Your personal risk will be discussed individually during the preliminary consultation.
