Functional and psychological benefits of postpartum restoration surgery: A systematic review.

Summary

This PROSPERO-registered, PRISMA-compliant systematic review of five studies (498 physical, 314 psychological assessments) shows that postpartum body contouring (diastasis recti repair/abdominoplasty) yields at least 85% reductions in back pain and urinary incontinence, significant trunk function improvement, and marked gains in quality of life, self-esteem (99.5%), and sexual life (95.2%). The authors argue these procedures should be considered reconstructive rather than purely cosmetic.

Key Findings

• Screening identified 5 eligible studies among 1365; all involved diastasis recti repair and/or abdominoplasty (no breast procedures).
• Across 498 women assessed physically, back pain and urinary incontinence decreased by at least 85%, with significant trunk dysfunction reduction.
• Quality of life improved broadly; 99.5% reported positive change in self-esteem and 95.2% improvement in sexual life.
• Findings support classifying postpartum body contouring as reconstructive rather than purely cosmetic.

Clinical Implications

Supports classifying postpartum diastasis repair/abdominoplasty as reconstructive, guiding payer coverage, shared decision-making, and prioritizing standardized PROMs for postoperative rehabilitation.

Limitations

• Only five heterogeneous studies; no breast procedures included
• Likely predominance of non-randomized designs and potential publication/reporting bias

Future Directions

Prospective controlled studies with standardized PROMs, inclusion of breast procedures, longer-term outcomes, and cost-effectiveness analyses to inform coverage and rehabilitation pathways.