Case #5004
Rectus Diastasis Repair
A woman in her 40s was bothered by a lower abdominal bulge after two pregnancies that did not improve with exercise. Dr. Azadgoli repaired her separated rectus abdominis muscles through her existing C-section scar.
A woman in her 40s was bothered by a noticeable bulge of the lower abdomen after two pregnancies. It did not improve regardless of how much she exercised. Dr. Azadgoli repaired her separated rectus abdominis muscles (rectus diastasis repair) through her previous C-section scar, so no new incision was added. The lateral views show the change in the lower abdomen.
Why this approach
The decisions that shaped this surgical plan.
- Pregnancy-related anatomy informs the plan: rectus separation, skin laxity, and breast tissue volume change all factor in.
Pre-op preparation
What to do before surgery. Specific to this case.
- Stop NSAIDs, aspirin, and high-dose fish oil two weeks before surgery; the surgical team provides a full medication list at the pre-op visit.
- No nicotine for 6 weeks before through 6 weeks after surgery. The vascular impact directly affects skin healing.
- Plan the first week so nothing needs to be lifted or reached. Most patients also pre-cook simple meals or arrange delivery.
- Confirm a driver for surgery day and a companion who can stay through the first night.
- Hormone status confirmed stable; if nursing, scheduling waits until cessation. Sleep, nutrition, and iron levels reviewed pre-op.
Recovery timeline
Milestones specific to this case. Individual recovery varies.
- Day 1–7
Short walks every couple of hours, no lifting over 5 lb, and full nights of rest. The worst of the swelling peaks around day 3.
- Week 2
Activity ramps up cautiously: longer walks, no lifting yet. Most patients return to desk work this week.
- Week 4
Light cardio and most desk-work activities cleared. Lifting limit increases to 15 lb. Scar massage typically starts now.
- Week 6
The "back to normal" week for most patients. Final compression schedule transitions to optional.
- Month 3
Shape is 80–90 percent of final. Scars are still pink and will continue to lighten through month 12.
Continued care
Recommended aftercare, skincare, and MedSpa services for Rectus Diastasis Repair.
- Abdominal binder continuously for 6 weeks
- Walk bent slightly forward for the first week to protect the muscle repair
- No lifting over 10 pounds for 6 weeks
- Core exercise resumes at 8 weeks
- Coordination
Recovery medications calibrated to nursing status; hormone panel rechecked if symptoms warrant.
Post-pregnancy hormonal shifts influence healing and skin behavior.
