Diastasis recti is usually linked to pregnancy, but men have it too. In our clinic we see it mainly in two situations: men with a belly caused by internal abdominal fat, and men who have lost weight and are left with loose skin and a lax abdominal wall. Dr. Jorge Aso has performed tummy tucks on more than 100 men. Here we explain what can be corrected, when it is better to wait and what is different from surgery in women.
Can men have diastasis recti?
Yes. Diastasis does not depend on pregnancy. In men, the most common cause is central obesity: visceral fat pushes the abdominal wall from the inside and separates the rectus muscles. It is repaired during a tummy tuck, but surgery does not remove the internal fat, so it is best to lose weight first and have surgery once your weight is stable.
- Most common cause: visceral fat
- Before surgery: lose weight
- Stable weight for about 2 months
- More than 100 men operated on
Diastasis recti in men
Diastasis is the separation of the two rectus abdominis muscles caused by the widening of the midline that joins them. It appears whenever the abdominal wall is stretched by pressure for years, and that happens in men too.
In men, the most common cause we see is central obesity: visceral fat, the fat inside the abdomen around the organs, pushes the wall from the inside and separates the muscles. That is why many men with diastasis do not know they have it: they put the bulge down to fat alone.
Internal fat comes first
A tummy tuck repairs the wall and removes the skin and fat outside the muscle, but it cannot remove visceral fat.
If the belly is mainly caused by that internal fat, operating before losing weight gives a poor result: the repaired wall is put under the same pressure again. So, in men with central obesity, we recommend this order:
Lose weight
With diet and exercise, or with medical treatment with GLP‑1 analogues such as semaglutide (Ozempic) or tirzepatide (Mounjaro), always prescribed and monitored by a doctor.
Keep your weight stable
About two months at a stable weight is usually enough before surgery.
Assessment
At the consultation we assess the diastasis, the loose skin and the fat on the flanks, and explain which technique you need.
Surgery
If you are taking semaglutide or tirzepatide, tell us: the anaesthetist will tell you when to stop it before the operation.
After weight loss: loose skin and a lax wall
After losing weight, whether a large amount (for example, after bariatric surgery) or a moderate amount, it is common to be left with:
- loose skin on the abdomen, sometimes with a fold hanging over the pubic area;
- diastasis that exercise does not correct;
- localised fat on the flanks.
A tummy tuck removes the loose skin and repairs the diastasis. If there is also fat on the flanks, liposuction can be done at the same time (lipoabdominoplasty). When the weight loss has been very large and the loose skin goes all the way round the waist, a circumferential tummy tuck may be needed.
What is different in men
Stronger plication
The male abdominal wall usually needs a stronger repair than in women. Sometimes central plication is not enough and several are needed to restore tension to the whole wall.
Tighter bleeding control
In our experience, men bleed somewhat more than women. That is why we carry out very thorough haemostasis, control blood pressure during the operation and use tranexamic acid during surgery.
Individual design
Markings and the scar are planned individually, as in women, aiming for a low scar.
How much does a tummy tuck for men cost?
The cost depends on the technique: mini tummy tuck from €4,500, full tummy tuck from €6,500 and lipoabdominoplasty around €9,500. Complex cases, such as a circumferential tummy tuck, cost more than €12,000. We give you a written quote after the assessment. Full details on our tummy tuck in Madrid page.
Can a man have surgery for diastasis recti?
Yes. It is repaired by plicating the abdominal wall during a tummy tuck. Men usually need a stronger plication than women, sometimes several in addition to the central one.
Should I have surgery before or after losing weight?
After. If the belly is mainly caused by visceral fat, surgery does not remove it: it is best to lose weight first and have surgery once your weight has been stable for about two months.
Can I have surgery if I lost weight with Ozempic or Mounjaro?
Yes, if your weight is stable. Tell us about the treatment: the anaesthetist will tell you when to stop it before surgery.
Is the surgery different in men?
In men the plication is usually stronger and bleeding somewhat greater, so we carry out very thorough haemostasis, control blood pressure during the operation and use tranexamic acid.
