This 46 year old woman had prior childbirths and developed an umbilical hernia. She had this repaired by a general surgeon. She still had pain and a small bulge near her belly button. She was noted to have a significant diastasis recti- a weakness of the fascia ( normally tough covering encasing abdominal muscles) and abnormal separation of the rectus abdominus muscles. No amount of exercise seemed to help and her peri-umbilical hernia caused pain when she tried to do abdominal work.
She also had loose skin of her lower abdomen and wanted all of this corrected.
At surgery- she was found to have a very small hernia through her diastasis with intrabdominal fat stuck ( incarcerated) within it. This was carefully repaired and the reduced and then she had a two layer closure of her diastasis. Typically this is done by a "plication" technique where the fascia ( is tightened to help make a flatter abdomen. Although she did have loose skin below her umbilicus- she did not have enough to allow the umbilical opening ( the skin around the belly button is cut to separate it from the abdominal wall) to be completely removed. When this occurs- the opening is closed vertically just above the pubic incision and leaves a scar. The patient understood this and the scar doesn't bother her as much as all the stretch marks and loose skin that she used to have.
Now she has a flat abdomen and is very happy with tummy.