Postpartum patients often present to the office complaining that their tummy is not as flat as it was before pregnancy. This is very common in patients who have maintained their weight but have not maintained their shape. They often experience a central bulge in their abdominal area when exercising. This is even more common with twin pregnancies. This is easily diagnosed with an abdominal exam with the clinical designation of a rectus diastasis.
With a significant muscle separation like in the patient above, a rectus plication is needed. This involves the use of a permanent suture to correct the muscle separation in the midline. This is done at the time of the tummy tuck. This is often the most uncomfortable part of a tummy tuck after surgery. The use of Exparel, a long lasting local anesthetic, injected into the abdominal wall at the time of the tummy tuck allows for better postoperative pain control.
