Friday, April 19, 2024

Diastasis Recti Surgery Covered By Insurance

Who Needs This Surgery

What are the different techniques for repairing the diastasis recti by Dr. Iraniha

Diastasis recti surgery is similar to a tummy tuck since it involves surgically bringing the separated muscles back together. A tummy tuck also usually involves removing excess fat and skin in the area. Most women who decide to have diastasis recti surgery after having children have a tummy tuck procedure, not just a repair of the diastasis recti.

Not all women with diastasis recti will need surgery. Some women will have less severe diastasis recti, while others will have significant cases that cant be corrected through any other means. According to the Mayo Clinic, surgery might be considered for women whose abdominal muscle weakness is interfering with their daily activities. Other than that, if women are bothered by the bulge, surgery might simply be for cosmetic reasons.

Even doctors cant always agree on what necessitates surgery for women who have diastasis recti. For example, The American Society of Aesthetic Plastic Surgery offers differing opinions on what a woman with diastasis recti should do. One doctor recommended simple diet and exercise, while another suggested reconstructive surgery. However, most doctors agree that you cant always fully fix diastasis recti without surgery.

Is An Umbilical Hernia Repair With A Tummy Tuck Handled By Insurance

As with any medical procedure, the question of cost is usually high on the list of concerns. Does insurance cover this? Well, the good news is when it comes to an Umbilical Hernia Repair, insurance will usually deem this a medically necessary procedure. If performed in conjunction with a Tummy Tuck, that portion will have to be paid for out of pocket, since it is considered an aesthetic or cosmetic procedure.

While a Tummy Tuck aims to remove excess skin and reattach the abdominal muscles to the abdominal wall, a hernia repair often involves the first half of a Tummy Tuck procedure where the muscles are pulled together, which it is commonly performed with a Tummy Tuck.

Sometimes you may need to find a general surgeon as well as a plastic surgeon to perform both procedures at once. It is also very important that you submit exactly what is being done to your insurance company to be sure of what they will and will not cover beforehand.

Sometimes your surgeon may not advise you to receive both procedures at the same time. There is a greater risk for impaired blood supply to the umbilical stalk or the hernia may not be in the best place to also perform an abdominoplasty.

Call our office today and schedule a consultation to speak directly with Dr. Hovsepian today.

Answer: Diastasis Recti And Hernia Repair Insurance Coverage

Many Plastic Surgeons will repair a small hernia at the same time as an abdominoplasty with rectus diastasis repair. Small umbilical hernias are very common, particularly after pregnancy. Sometimes, insurance plans will cover the portion of the procedure deemed appropriate for the hernia repair. I would check with your carrier before your procedures.

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Why Is Diastasis Recti Repair Not Covered By Insurance

If I ripped any other muscle in my body, it would be covered by insurance. Why is this not?It’s not simply cosmetic. I have an extremely large gap, which is causing my intestines to press against what’s left of my muscle membrane. I have GERD, lower back pain and digestive problems as a result. I understand cutting off excess skin is cosmetic, but this is tender and sometimes painful.If I had ripped my arm or leg muscles apart in an accident – that would be covered. And neither of those areas house important organs.

Abdominal Core Health Quality Collaborative

Does Insurance Cover Tummy Tuck For Diastasis Recti

Not only is Dr Glover an active member of the Americas Hernia Society, he is also an active participant in studying hernia outcomes with the ACHQC.

It is often said that no surgeon truly knows his own hernia recurrence rate. How do you know what you are doing is working if youre not keeping track?

The Americas Hernia Society aims to fix just that with the Abdominal Core Health Quality Collaborative or ACHQC. The quality collaborative is a database created by hernia surgeons that enables them to keep track of their performance, patient outcomes and complications. It also allows us to come together to pool our data to add significance and meaning to the numbers.

It is not research and nothing we do is experimental. It is merely a tool to make good surgeons better.

Participating in the ACHQC is completely optional with no obligation. There is no requirement to participate in order to have your hernia repaired.

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Why Choose Dr Chatson

A board-certified plastic surgeon with offices in Andover, MA and Nashua, NH, Dr. Chatson has decades of experience helping men and women throughout New England achieve their cosmetic goals. Trusted, and qualified, Dr. Chatson is on staff at Orchard Surgical Center, Holy Family Hospital, Southern New Hampshire Medical Center, and Saint Joseph Hospital, where all tummy tuck procedures are assisted by highly trained staff who, along with Dr. Chatson, work to protect your health and safety.

Respected by his peers and committed to his craft, Dr. Chatson is a past president of the New England Society of Plastic and Reconstructive Surgeons and remains an active member in this and other national trade associations and societies. Personable and caring, Dr. Chatson works individually with each patient, staying connected and available from that first consultation all the way through complete recovery.

If you are considering tummy tuck surgery in New England, please call our Andover office at or our Nashua office at to schedule a consultation with Dr. Chatson today.

With Each Pregnancy My Diastasis Recti Widen

I had soreness between my abdominal muscles again with my next two pregnancies . The pain rose slowly but steadily up towards my sternum throughout my last pregnancy, like a zipper cruelly coming undone.

To try to keep my body together as much as possible and minimize the excruciating pain, I used KT tape. I eventually felt like my abdominal muscles connective tissues had been pulled apart. They were just stretched to the point of pain. Regardless, the tearing pains subsided, but I was left with lower back discomfort as my body battled to stay together. People were frequently complimenting me on how cute my round, protruding belly was. I appeared to be attempting to smuggle a watermelon. Watermelon smuggling is HARD.

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Items I Recommend For Diastasis Recti Recovery:

Wearing long camisoles under my binder helped cut down on the friction between my skin and binder, which helped with comfort and recovery. Double-check with your surgeon to make sure they are okay with this.

I bought two of these 3-pack camisoles :

This is a product recommended by several people in my Diastasis Recti surgery group. Pain medications can result in slowed bowel movements. In addition to any prescription medications recommended by your doctor, a lot of women found this to be helpful to stay regular. Separate from surgery recovery, I take Natural Calm weekly to prevent magnesium deficiency.

To be honest, I recommend Squatty Potties to anyone and everyone. But I think it was especially important for surgery recovery. Constipation is often an issue with pain medication. I didnt bring my squatty potty to the Airbnb I stayed in and I regretted it. I ended up turning a trash can upside down to try to recreate it obviously not ideal.

Week 2: My surgeons assistant removed my stitches. My surgeon gave me incision care instructions to improve both healing and the appearance of scars, including using Micropore Paper Tape and scar cream.

6-weeks: At my checkup, the surgeon cleared me to slowly begin exercising again.

Why my Diastasis Surgery was Worth the Cost

I feel better both:

How Long Does Recovery Take

Diastasis Recti Repair Options & Why I Chose Surgery

Plan on two to three weeks of downtime and about six weeks before youll healthy enough for strenuous activity or vigorous exercise.

You can expect bruising and swelling around the incisions, and painespecially for the first few days. Your doctor will likely prescribe pain medication. Dr. Tattelbaum points out that newer drugs such as Exparel can diminish the discomfort for a much longer period of time postoperatively and diminish the need for narcotics.

Dr. Rahban doesnt sugarcoat it: In terms of recovery, its painful, he says. Any type of muscle work, whether its a C-section, hernia repair, or diastasis repair, is uncomfortable because the muscle and fascia are involvedand they tend to have a lot of nerve sensation.

You also wont be able to stand up straight for a week or two, and its not healthy to force it while your incisions are healing.

You’re going to need support with daily activities, especially during the first five days, when youll have the most pain and difficulty moving. You might also need help getting out of your compression garment to shower and fastening it afterward. You’ll continue to need some help during week two, to avoid strain that could cause complications.

Your surgeon will probably recommend moving a few times a day to prevent blood clots, but most say youll need to avoid heavy lifting for four to six weeks after surgery.

You should be able to resume all of your normal activities within six weeks of your surgery.

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Diastasis Recti Surgery Procedure

The surgery will be performed in the surgery center. Following your awakening, you will spend two nights in the recovery center for routine checkups.

The first week is usually the worst, but by the second week, the discomfort has subsided significantly. The surgeon advised me not to lift anything for at least six weeks to avoid straining the muscle repair. You might require assistance with everyday tasks, like getting out of bed, during the first few weeks.

Before and after photos of diastasis recti surgery

Answer: Hernia Yes Diastasis Not Usually

Many years ago when insurance was less restricted than now I did try repeatedly to get approval for coverage for the worst diastasis I have ever seen. It was declined even with the help of her ob-gyn pleading her case. I doubt you can legitimately have this covered by your insurance. Hernias are different and can cause bowel obstruction therefore are typically covered. These are mostly taken care of by general surgeons. When hernias are repaired by the plastic surgeon during abdominoplasty, some may credit the reimbursement for the hernia towards your tummy tuck but typically it is a very small fraction of the cost of a tummy tuck by an experienced board certified plastic surgeon. In my practice I just repair the hernia free of charge since it only takes 5 minutes with the normal exposure with a tummy tuck. Patients are given the op report and codes and can try to get some reimbursement if they wish. I cannot speak for how others manage these cases but I’d say do not be optimistic that insurance will be much help with the repair of rectus diastasis.

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What Is Involved In Dr Surgery

Surgery for a diastasis recti is substantial and invasive. It is not one to take lightly. A diastasis correction surgery is commonly called a tummy tuck or an abdominoplasty. This surgery seeks to tighten the abdominal muscles and remove excess loose skin.

However, it is not a surgery that is approached the same way for every person. Because each body is unique and the severity differs with each individual, the procedure will look differently from person to person. Some people may only need their core muscles tightened through what is called an endoscopic-assisted modified abdominoplasty. This surgery is less invasive and can be accomplished through a bikini line incision with minimal skin removal.

Some surgeries are more complex. For women who may have more stretched skin along with a stomach bulge and a more severe rectus abdominis separation, the surgery can involve skin removal, a larger incision made around the belly button, and even belly button relocation along with skin grafts. Ultimately, the procedure is dictated by the anatomy of the person.

What Causes Diastasis Recti

How To Get Diastasis Recti Surgery Covered By Insurance

As the uterus grows during pregnancy, abdominal muscles stretch. In some cases, 2 large parallel bands of muscles that meet in the center of the abdomencalled rectus musclesget separated more than normal. This condition is called diastasis recti. Women who carry multiples or a large baby to term have a greater chance of developing this condition. Its also more likely to occur for smaller women or for women who are older than 35.

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Answer: Diastasis Rectus And Insurance Coverage

Our insurance companies in Massachusetts do not cover the repair of a diastasis rectus, which is caused by the pregnancy pushing the rectus muscles apart. Most insurance companies will cover the repair of a hernia at the time of an abdominoplasty so your board certified plastic surgeon will usually check for this during your exam. Some insurance companies will cover the panniculectomy portion of an abdominoplasty if the skin hanging down is severe and causing chronic rashes. But a panniculectomy alone only removes the extra skin that hangs down and does not correct the muscle wall looseness- it is not an aesthetic procedure and is usually only done by itself in severe cases when patients are having significant rashes.

What Are The Alternatives To Diastasis Recti Repair

When your rectus muscles are separated, the only solution is repairing that separation and bringing the muscles together, Dr. Rahban says. This means there are no treatment options, outside of surgery, to fully resolve diastasis recti.

However, patients with mild ab separation can consider Emsculpt Neo. Emsculpt technology uses electromagnetic energy that triggers supramaximal contraction20,000 in a 30-minute periodto build new muscle and tighten diastasis recti, explains New York City dermatologist Dr. Bruce Katz. Studies have shown that the treatment can help improve by about 19%.

Another option for milder cases of ab separation is a mini tummy tuck, which doesnt involve as big an incision as a full abdominoplasty. It tightens only the lower belly though, so a full tuck is usually the best option for severe diastasis recti.

Doctors say that most patients get the best result from a full tummy tuck, which removes excess fat and sagging skin from above and below your belly button. It may also include liposuction to sculpt the waist and flanks.

It is very unusual for someone to need repair of diastasis but not the removal of excess skin, says New York City plastic surgeon Dr. Tracy Pfeifer. If you do have excess skin, in my experience, you will be much happier with a full abdominoplasty. Make sure you discuss the pros and cons of each option with your surgeon so that you can make the best choice for you that fits your goals.

Interested in diastasis recti repair?

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Choose A Surgeon And Schedule An Official Consultation

A general surgeon or a plastic surgeon can correct diastasis recti. When insurance is unlikely to fund your procedure, you might narrow your search to plastic surgeons because:

The majority of diastasis recti operations require a big hip-to-hip incision. A huge scar will be unpleasant and undermine your confidence, thus it is best to find a professional doctor so that the scar is as little as possible or not at all after you recover.

What To Expect In Recovery

6 MONTH UPDATE! Diastasis Recti Repair & Tummy Tuck

If you have pursued surgery under the advice of your doctor, there are a few things to expect and to consider regarding recovery and time. Depending on the severity of your procedure, the time it takes to recover and go through physical therapy to restore your core strength safely can be rather lengthy. Expect to be out of commission for at the very least a week before you are out of bed and trying to readjust to your usual routine. However, some people may experience a healing period of 6 12 months before recovering fully.

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What Is Diastasis Recti

Diastasis rectus is a condition in which a gap appears in the middle of your abdominal muscles. If youre pregnant, these muscles separate in the later stages of pregnancy. The illness can affect babies as well as the elderly.

Diastasis recti is a separation between the abdominal muscles that is the breadth of two fingers or more in an adult.

If you have the problem, youre more likely to develop a hernia, have difficulty managing your urine , and suffer from low back pain.

Diastasis recti can sometimes improve on its own. If you do activities that work your abdominal muscles, it might help.

If it doesnt get better, youll need to have surgery to fix the problem. A surgeon can close the space and reconnect the muscles. This can be done by itself or as part of an abdominoplasty. This is also called a tummy tuck.

Many people feel better after they have surgery to fix diastasis recti. However, there are some things that you should know if you are considering it.

How To Get Medicaid To Cover Tummy Tuck

Medicaid covers life-sustaining operations, such as removing malignant tumors. It usually doesnt cover elective surgeries, like tummy tuck, unless theyre medically necessary.

If you need a tummy tuck and want Medicaid to cover it, you have to prove that it addresses a health condition or have it performed together with a covered procedure, such as panniculectomy, hernia repair, or hysterectomy.

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