Most people think of abdominoplasty or tummy tuck only as a procedure that removes the stretched out belly skin and excess belly fat left behind after pregnancy. But abdominoplasty is actually more that just fixing the outside. This procedure is not just about looks, it is about health and strength too! Pregnancy stretches the whole belly wall including the muscle and connective tissue layers that give strength and stability to your 'core.' If you have remained loose and stretched out after delivery, the connective tissue or fascia has not rebounded because it is not elastic. As the fascia remains stretched out, the abdominal muscles are no longer anchored in the midline of the belly, but bow out to the side, creating a physical imbalance of all the muscles of the belly wall. The separation of these muscles in the midline is called rectus diastasis. Not only can rectus diastasis add to that post pregnancy belly pouch, it may cause weakness of your abdominal wall and make it difficult for your belly muscles to properly support your back.
Some women bounce back into shape after pregnancy. Others of us do not. We are not all made the same and our tissues may have different elasticity from one another. Also, some of us had bigger babies, some of us smaller ones. Whatever our differences, if you have rectus diastasis, no amount of exercising can permanently correct the stretched out fascia. Rigorous exercise may enable you to actively pull those muscles back into the middle but the loss of the anchor of the midline fascia means those muscles will move back out to the side when you relax them; their midline position cannot be maintained.
Abdominoplasty is a repair in two layers. The excess skin and fat of the lower belly are removed which makes you fit in your clothes and look better, AND the separated muscles are pulled back together which allows you to develop and maintain your core strength again.