Abdominal diastasis is a common functional condition with an effective surgical solution.

Many women notice that after giving birth, their abdomen doesn't return to its previous state. Although this distension is often attributed to postpartum cosmetic changes, it can actually mask a medical condition called abdominal diastasis . This is a separation of the rectus abdominis muscles that, beyond its physical appearance, has important functional consequences.

"Abdominal diastasis is not just a cosmetic concern. It's a health problem that can seriously affect a patient's quality of life if not treated properly," says Dr. Santos Jiménez de los Galanes , head of the General and Digestive Surgery Team at Ruber International Hospital .

According to the specialist, abdominal diastasis occurs when the rectus abdominis muscles separate along the midline, known as the linea alba. This phenomenon can occur due to sustained intra-abdominal pressure, such as that which occurs during pregnancy, but also in men with abdominal obesity, people with chronic respiratory diseases, or individuals who exercise their abs incorrectly.

Although it's closely linked to postpartum, it's not a condition exclusive to women. Dr. Jiménez de los Galanes emphasizes that it's also observed in men and non-pregnant women.

"It's important to understand that this condition can occur in anyone exposed to risk factors such as obesity, chronic cough, or even improper weight lifting," he notes.

The symptoms associated with this condition should not be underestimated. Among the most common are lower back pain, core weakness, digestive problems, difficulty holding urine, pelvic floor disorders , and even sexual dysfunction .

"Abdominal wall weakness compromises core stability and digestive and urinary function . Many patients come in seeking a cosmetic solution and are surprised to learn that they can also improve functional symptoms they had assumed were normal," explains the surgeon.

Recent studies published in Obstetrics & Gynecology indicate that up to 45% of women still have diastasis recti three months after delivery .

Diagnosis is made through a combination of physical examination and imaging studies such as abdominal ultrasound or, in more complex cases, magnetic resonance imaging . In mild cases, conservative treatment can be effective. This includes specific exercise programs, pelvic floor physical therapy, therapeutic Pilates, and diaphragmatic breathing techniques.

"The initial approach should be conservative, as long as symptoms allow. There are programs that have demonstrated significant improvement in muscle separation, especially in women recently postpartum," says the Ruber International specialist.

When the separation is greater than 3 cm and symptoms persist despite conservative treatment, surgical treatment is indicated. In these cases, Dr. Santos Jiménez de los Galanes highlights the REPA (Endoscopic Preaponeurotic Repair) or MILA (Minimally Invasive Lipoabdominoplasty) techniques as the procedures of choice.

"These are minimally invasive techniques, with highly effective results and fewer scars than a traditional abdominoplasty. Not only do we restore muscle function, but we also achieve a significant aesthetic improvement," the doctor emphasizes.

To be eligible for this procedure, certain criteria must be met: at least six months since the last birth or cesarean section, diastasis of at least 3 cm despite muscle strengthening work, and the patient must have completed her pregnancy .

Characteristics of the procedure :

• Laparoscopic or robotic approach

• Three small incisions under the bikini line

• Suturing of the rectus abdominis muscles

• Placement of mesh if necessary

• Possibility of combining with liposuction or mini-abdominoplasty

According to a study published in the journal Plastic and Reconstructive Surgery, surgical closure of diastasis recti improves both abdominal function and aesthetics. In the United States, in 2022, more than 130,000 such procedures were performed, according to data from the American Society of Plastic Surgeons.

As the surgeon at Ruber International Hospital explains, the postoperative period is generally well tolerated. It is recommended to avoid strenuous exercise for the first 4-6 weeks, use an abdominal support belt, and follow a progressive, supervised rehabilitation plan.

"The key to a successful recovery lies in medical follow-up and good adherence to the postoperative plan. With proper precautions, the results are excellent," says Dr. Jiménez de los Galanes.

Prevention also plays a key role. Maintaining a healthy weight, strengthening your core with professional supervision, and avoiding unhealthy postural habits are key measures to prevent the onset or worsening of this condition.

Diastasis recti is a more common condition than one might think and can have a significant impact on the daily functioning of those who suffer from it. Thanks to advances in minimally invasive surgery such as the REPA/MILA technique, patients now have the opportunity to resolve not only an aesthetic problem, but also to regain abdominal health, improve mobility, and, in many cases, their self-esteem.

"Recognizing diastasis recti as a health problem, not just an aesthetic one, is the first step toward improving the lives of thousands of patients. Surgery is not a cosmetic solution; it's a therapeutic tool with scientific evidence and excellent results," concludes Dr. Santos Jiménez de los Galanes .