Question:

Is it possible that a small umbilical hernia can be missed on CT scan and cursory examination? I had a hernia two years ago that was missed until it got bigger and I think it's happening again. Can a diastesis repair help with pain associated with condition?

Answer:

an umbilical hernia can be missed if it is a small and reducible hernia. A diastasis repair may not always correct that as they are concentrating on the linea alba and not the peri-umbilical area. If the patient knows that they have a small hernia, attention can be turned to that and have the hernia corrected at the same time as the diastasis. If the pain is from the hernia and the hernia is fixed, that should relieve the pain

Question:

Hi Dr. G,
 
Thanks for the response. I had a quick follow-up question. I was skinny before I got so overweight and had a six pack/and was in good shape. Due to depression, I stopped taking care of myself. Is it always the case that stretch marks predict loose skin. Or is it a confluence of factors? 
Superficially speaking, my stomach doesn't 'look' like it would leave me with loose skin. Is this something we can 'tell' with the naked eye or can someone's stomach look perfectly fine (just a little pudgy), and then they still end up with loose skin?
Can I do anything to counteract this? Ty

Answer:

I am afraid so, the stretch marks are essentially scars in the deeper layers of your skin where he skin stretched and tore the deeper layer. That means that in that area the skin will behave just like a torn ladies nylon stocking and will lack support and the ability to shrink back down. There is really not much you can do to counteract it or prevent it except losing the weight slowly and then stopping the weight loss when you start to see some worsening of the loose skin, but that might leave you heavier and more pudgy than you desire. Once the skin is loose there is not much prevention that works, liposuction will not cause the skin to shrink any better than weight loss alone, and there are no exercises that tighten skin, so it might mean surgery to remove the excess skin. But remember, surgery to remove skin does not change the quality of the remaining skin, it just removes the excess.

Question:

Hi, Dr. Garcia. I love the new website.
 
I am 29 yrs old, 6'0, 209 lbs and have a lanky build. I have always been skinny. But I gained a lot of weight from age 25 onwards. I have stretch marks now on my arms and even a few on my stomach.
 
If I lose 20-30 lbs, is it likely I will have loose skin and a changed belly button shape? At my highest weight, I was 249 lbs. Is it possible to lose weight without loose skin?
 
Thank you!
 
 

Answer:

losing weight and having skin shrink depends greatly on skin quality prior to the weight gain and also the length of time the weight is one, the longer the weight is there the less likely the skin will shrink. If you have areas of stretch marks that means you have lost skin retractability and that area will not shrink well. If the stretch marks on your abdomen are around your belly button now, and you lose more weight, there is a good chance that you will have some loose skin around the belly button I am afraid. Sorry.