Diastasis recti is a separation of the two long abdominal muscles that run down the front of the abdomen, most commonly caused by pregnancy. For many women the gap narrows in the months after birth, especially with physiotherapy. But once the connective tissue between the muscles (the linea alba) has stretched past a certain point, exercise cannot close it. In that situation, diastasis recti surgery, performed as part of an abdominoplasty, is the definitive treatment.

Medicare may contribute to the cost for eligible patients under MBS item 30175. This article explains what the condition is, when physiotherapy is enough, how surgical repair works, and exactly who qualifies for the Medicare rebate.

What is diastasis recti (abdominal muscle separation)?

Diastasis recti (also called rectus diastasis, or “split tummy muscles”) is a widening of the gap between the two “six-pack” muscles at the front of your abdomen. It is not a tear in the muscle itself. It happens because the tissue joining the muscles has stretched.

Your two rectus abdominis muscles run from your ribs to your pubic bone, one on each side of the midline. They are joined down the middle by a band of tough connective tissue called the linea alba. When the linea alba stretches and thins, the muscles drift apart and the midline loses its tension.

Why pregnancy causes it

Pregnancy causes diastasis recti through a mix of mechanical stretch and hormonal change. As your baby grows, the abdominal wall expands, while pregnancy hormones soften connective tissue to make room.

This is extremely common and it is not a sign that you did something wrong or were not fit enough. Pregnancy, Birth and Baby describes abdominal separation as a natural adaptation to a growing baby in later pregnancy. It tends to be more likely after more than one pregnancy, a multiple pregnancy or a larger baby.

How abdominal muscle separation is measured

You may have been shown the finger-width self-test. Lying on your back with your knees bent, you lift your head slightly and feel along the midline for a gap between the muscles. This is a useful way to notice a separation and track it over time.

For Medicare purposes, however, finger widths are not enough. MBS item 30175 requires the separation to be measured in centimetres by diagnostic imaging, such as an ultrasound, performed by a radiology provider. This distinction matters, and it is often blurred online.

Symptoms of diastasis recti that are not only cosmetic

Diastasis recti can affect how your body works, not only how your tummy looks. The midline is part of your core support system, so when it loses tension, other structures can take the strain.

Common symptoms include:

• a ridge, “doming” or “coning” down the middle of your abdomen when you sit up from lying down
• a persistent bulge that does not respond to exercise
• lower back pain
• core weakness and difficulty lifting, including lifting your children
• urinary symptoms, such as leaking when you cough, sneeze or exercise (stress incontinence)
• a feeling of strain on the pelvic floor
• in some cases, an associated hernia, such as an umbilical hernia

Many women also notice that their lower tummy stays rounded, sometimes looking months pregnant, even after returning to their pre-pregnancy weight. That is a very common reason for seeking advice.

Can diastasis recti close on its own, or with physiotherapy?

Yes, many separations narrow substantially on their own in the first 6 to 12 months after birth, and physiotherapy should always be the first step. Surgery is only considered when a significant gap and symptoms persist despite a proper trial of rehabilitation.

An article in the Australian Journal of General Practice reports that abdominal separation affects around 60% of women at 6 weeks after birth and about 33% at 12 months. The same article recommends a women’s health physiotherapist as the first line of management, with surgery reserved for cases where the separation limits function and quality of life.

So yes, diastasis recti can last for years. Where the linea alba has stretched beyond its ability to recoil, strengthening the muscles makes them stronger but does not draw them back together. This is the plateau many women reach despite doing everything right.

For support with rehabilitation, the Australian Physiotherapy Association and the Continence Foundation of Australia both offer helpful information.

How abdominal muscle separation is repaired surgically

Diastasis recti surgery repairs the separation by stitching the stretched midline back together, usually during a full abdominoplasty. The loose skin and fat of the lower abdomen are removed at the same time.

Rectus plication

The repair is called rectus plication. Through a low incision, the surgeon exposes the abdominal wall and draws the firm layer covering the muscles (the fascia) together down the midline, from below the breastbone to the pubic bone. It is then stitched, re-creating the central seam.

A useful way to picture it is re-lacing the front of a corset. The muscles themselves are not cut; they are brought back towards the middle where they belong.

Why muscle repair is combined with skin removal

After pregnancy, the skin over the abdomen is usually stretched as well. Once the muscles are tightened, that skin does not shrink back, so repairing the muscles alone would leave a loose apron of skin. Removing it is why the operation is an abdominoplasty and not an isolated muscle procedure. The belly button stays attached to the abdominal wall and is brought out through a new opening in the tightened skin.

A mini abdominoplasty usually cannot repair a separation that runs above the belly button. Our article on mini vs full abdominoplasty explains the difference.

Is there a keyhole or non-surgical option?

Keyhole (endoscopic or laparoscopic) repair techniques exist, but they are used only in selected cases and do not remove loose skin. MBS item 30175 specifically excludes laparoscopic procedures. Non-surgical devices, such as muscle stimulators or skin-tightening treatments, have not been shown to close a true diastasis.

Medicare item 30175: who qualifies for a rebate for diastasis recti surgery

Medicare may contribute to diastasis recti surgery under MBS item 30175 if you meet every criterion. The item covers a radical abdominoplasty with repair of rectus diastasis, removal of skin and fatty tissue, and repositioning of the belly button. It was introduced on 1 July 2022.

To be eligible, all of the following must apply:

1. The abdominal wall defect is a consequence of pregnancy.
2. The separation measures at least 3 cm, measured by diagnostic imaging from a radiology provider before surgery.
3. You have at least moderately severe pain or discomfort at the site of the separation during functional use, and/or low back pain or urinary symptoms likely due to the separation, documented in your records.
4. Your symptoms have not responded to non-surgical conservative treatment, which must have included physiotherapy.
5. You have not been pregnant in the last 12 months.

A few other points are important:

• Medicare benefits are not payable for surgery performed for cosmetic purposes.
• Item 30175 can be claimed only once in a lifetime.
• The rebate is partial. It is calculated against the MBS schedule fee, not the surgeon’s fee, so out-of-pocket costs remain for the surgeon, anaesthetist and hospital.
• Private health insurance may contribute where an eligible item number applies, but the level of cover matters. Contact your fund with the item number to check.
• Additional liposuction for contouring is generally treated as cosmetic and is not covered.

These criteria were checked against MBS Online on 24 September 2026. For Medicare and abdominoplasty more broadly, including weight-loss items, see is abdominoplasty covered by Medicare.

When is the right time to have surgery after pregnancy?

The right time is when your body and your life are ready, which is often later than the 12-month minimum. That minimum is the Medicare requirement, not necessarily the ideal timing for you.

Things to consider include:

• Finishing breastfeeding: many surgeons prefer to wait until breastfeeding has finished and your body has settled.
• Stable weight: your weight should be stable for several months, so the repair is done on a settled abdominal wall.
• Completing your family: a future pregnancy can stretch the repair again.
• Support at home: you will need help with lifting children and household tasks for several weeks.

Recovery after abdominoplasty with muscle repair

Recovery after diastasis recti surgery takes longer than recovery after skin-only surgery, because the abdominal wall has been tightened. Most patients describe the first 1 to 2 weeks as tight and pulling rather than sharply painful, and pain relief is prescribed.

These timeframes are a general guide, not a promise. Drains may or may not be used, depending on the technique, and your own timeline will be set at your follow-up appointments.

Lifting your children. This is the question almost every mother asks. Lifting a toddler or a heavy baby capsule puts direct strain on the repair, so it is usually restricted for several weeks. Planning help with lifting, bathing and car seats before surgery makes a real difference.

For more practical advice, see our abdominoplasty recovery tips and our guide on how to sleep after abdominoplasty.

Will another pregnancy undo the repair?

Yes, another pregnancy can undo a diastasis recti repair. As the abdomen expands, the repaired midline can stretch and separate again, and the skin may loosen.

That is why surgeons generally recommend completing your family before surgery. It is your decision, though. If you do become pregnant after a repair, let your obstetric team know about your surgery.

Risks and complications

All surgery carries risk, and abdominoplasty with muscle repair is major surgery. Possible risks include:

• a build-up of fluid under the skin (seroma)
• bleeding, including a collection of blood under the skin (haematoma)
• infection
• wound healing problems, particularly where the skin is under the most tension
• visible or thickened scars
• numbness of the lower abdominal skin, which often improves over months but may not fully recover
• blood clots in the legs (deep vein thrombosis) or lungs (pulmonary embolism)
• recurrence of the separation, or the need for revision surgery
• risks related to anaesthetic

Smoking raises the risk of wound healing problems, and Dr Cope advises smokers to stop at least 6 weeks before surgery. You can read more about surgery risks and complications.

What happens at your consultation

Your consultation is where your separation, symptoms and eligibility are assessed properly. It usually includes:

• a referral from your GP, which is required
• a medical history, including pregnancies, births and your physiotherapy so far
• an examination of your abdomen, standing and lying down, including checks for a hernia
• a referral for diagnostic imaging where indicated
• a review of documentation of your symptoms and conservative treatment
• a discussion of whether MBS item 30175 is likely to apply
• an explanation of the surgery, the scar, the recovery and the risks

A mandatory cooling-off period applies before cosmetic surgery, and you may wish to seek a second opinion. Some women choose to combine abdominoplasty with breast surgery; see breast and abdominal surgery (postpartum surgery). Dr Cope consults in Mosman, Wahroonga and Gosford. You can find out more about your consultation.

Why choose Dr Cope for diastasis recti surgery (abdominoplasty with muscle repair) in Sydney, North Shore (Mosman & Wahroonga) and Central Coast (Gosford)

Dr Charles Cope is a Specialist Plastic Surgeon who takes an ethical, patient-focused approach to care. His AHPRA registration number is MED0001146826, which you can check on the public register.

• Specialist Plastic Surgeon, AHPRA registration MED0001146826
• Fellow of the Royal Australasian College of Surgeons (FRACS)
• Member of the Australian Society of Plastic Surgeons (ASPS)
• Member of the Australian Society of Aesthetic Plastic Surgeons (ASAPS)
• International member of the American Society of Plastic Surgeons

Specialist Plastic Surgeons are the only specialty accredited by the Australian Medical Council (AMC) to perform cosmetic surgery (as well as reconstructive plastic surgery).

Dr Cope offers abdominoplasty with abdominal muscle repair, as well as combined postpartum breast and abdominal surgery. Your consultation includes an assessment of your separation and symptoms, guidance on imaging and documentation, and a clear discussion of whether MBS item 30175 is likely to apply to you.

Patients from across Sydney, the North Shore (Mosman and Wahroonga) and Gosford on the Central Coast can see Dr Cope at three locations. He is also listed as a specialist with Sydney Adventist Hospital and Ramsay Health Care.

• Mosman: Level 1, 357 Military Rd, Mosman, Sydney NSW 2088 (Lower North Shore)
• Wahroonga: Suite 507, SAN Clinic, 185 Fox Valley Rd, Wahroonga, Sydney NSW 2076 (Upper North Shore)
• Gosford: 3 Hills St, Gosford NSW 2250 (Central Coast)

Verify Dr Cope’s credentials:

• Australian Society of Plastic Surgeons profile
• Australian Society of Aesthetic Plastic Surgeons profile
• Board Certified profile
• healthdirect listing: Mosman
• healthdirect listing: Gosford
• Sydney Adventist Hospital profile
• Ramsay Health Care profile
• RealSelf profile

To book a consultation, call (02) 9307 2888 or book online. A GP referral is required. All surgery carries risk; please read about surgery risks and complications before making a decision.

If you would like your separation assessed, you are welcome to book a consultation with Dr Cope in Mosman, Wahroonga or Gosford.

Further reading

• Abdominoplasty (Tummy Tuck)
• Breast & Abdominal Surgery (Postpartum Surgery)
• Mini vs Full Abdominoplasty: Which Type of Tummy Tuck Is Right for You?
• Is Abdominoplasty Covered by Medicare

Medical references

1. Australian Government Department of Health. MBS Online: Item 30175
2. Australian Government Department of Health. Factsheet: New MBS item 30175 for abdominoplasty
3. Pregnancy, Birth and Baby (healthdirect Australia). Abdominal separation (diastasis recti)
4. Inge P, Orchard JJ, Purdue R, Orchard JW. Exercise after pregnancy. Australian Journal of General Practice. 2022.
5. Australian Physiotherapy Association. Exercise and diastasis recti abdominis
6. Continence Foundation of Australia. Pregnancy and childbirth
7. healthdirect Australia. Abdominoplasty (tummy tuck)
8. Nahabedian MY. Management Strategies for Diastasis Recti. Seminars in Plastic Surgery. 2018.
9. Cleveland Clinic. Diastasis recti

Disclaimer

The information in this article is general in nature and is not a substitute for personalised medical advice. It does not replace a consultation with a qualified medical practitioner. Every patient is different, and the suitability, risks and outcomes of any procedure can only be assessed during an in-person consultation with a Specialist Plastic Surgeon. All surgical and invasive procedures carry risks; please read about surgery risks and complications before making a decision. Before proceeding, you may wish to seek a second opinion from another appropriately qualified health practitioner. A GP referral is required for consultation. Information was current at the time of publication (September 2026), and Medicare item details are subject to change; check MBS Online for current details.