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Is Abdominoplasty and Hernia Repair Without Mesh Suggestible?

My Mom is 60 and already had 4 surgeries, her last surgery hernia repair with mesh has failed now. Doctor has advised us to go for Abdominoplasty and hernia repair without mesh. Kindly let us know if is it safe, hernia repair without mesh.

Doctor Answers (7)

Component Separation for Hernia Repair

+1

   Sometimes mesh with hernia repair fails and component separation can be a useful tool.  It can repair up to a 20 cm defect in the midline.  It uses your abdominal wall like an accordion to get this extra length.


Los Angeles Plastic Surgeon
5.0 out of 5 stars 237 reviews

Is Abdominoplasty and Hernia Repair Without Mesh Suggestible

+1

Not enough info to answer this one. Much will depend upon the nature of her previous surgeries, her size, her general health. 

In my practice, though I have fixed many hernias, for a patient with this history I would have her evaluated by a general surgeon with much hernia experience to participate. 

Historically, mesh is used because it has a lower failure rate than using a patient's own tissue. 

Thank you for your question, best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 34 reviews

Hernia

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A primary repair of the hernia with release and realoignment of the muscles is always the best way to go. Your mother needs to be evaluated and needs to be medically cleared and safe for this type of surgery

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 13 reviews

Repairing Recurrent Incisional Hernia at the time of an abdominoplasty

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If your mother has had 4 surgical procedures to correct an incisional hernia of the abdomen then there are obviously several problems present.  You did not mention your mother's weight or overall medical condition but these are factors to consider.  Also you need to consider the quality of the anterior abdominal wall fascia.  It it is of poor quality then it makes little sense to repeat the same type of operations again.  Also you did not mention if the previous surgery was done by a plastic surgeon.  General surgeons and plastic surgeons have different approaches to this problem.  A procedure such as a component separation has been used successfully to repair difficult incisional hernias.  Another consideration is to use a material such as Alloderm to repair and re-enforce the hernia repair.  This is an acellular dermal matrix and is a biologic material and not a foreign material such as mesh.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 10 reviews

Abdominoplasty & Hernia Repair Can Be Safely Combined

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Hernia repair is often combined with abdominoplasty safely.  A history of 4 surgeries and the use of mesh makes this a more complicated question that can be fully addressed online.  Physical examination and evaluation of the results of a CT scan would be necessary.  Further, the size, location of the hernia defect and type of mesh are also important.  Component separation of the abdominal wall muscles to reduce the tension on the repair is a very effective procedure but may or may not be indicated.  You should discuss these details further with your mother's surgeon.  Best of luck!

Robert F. Centeno, MD, FACS
Fairfax Plastic Surgeon
5.0 out of 5 stars 39 reviews

Abdominoplasty and Recurrent Hernia Repair without Mesh

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This is a good question. Without knowing the complete hernia history and location, I can give a general answer but it may not apply to all cases.

Hernias that  are repaired and fail are common. Instead of using mesh again, the medical studies show that a procedure called Component Separation (or Separation of Parts) has a higher success rate then mesh used alone. This procedure was developed by a plastic surgeon and is now considered the best hernia repair technique for most central recurrent abdominal wall hernias. 

Ask the plastic surgeon about this method to see if it is appropriate for your mother as not all hernias are the same. More information is in the link below.

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
5.0 out of 5 stars 20 reviews

Abdominoplasty with hernia repair

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Great question. I hear this question often as many tummy tuck patients have hernias when they present for consultation. Mesh has been used safely for years and most general surgeons are very familiar with its use. As a result, many patients have already heard about mesh hernia repairs and wish to know if it is needed for them.  The answer is usually no when a full tummy tuck is being performed along with the repair.  This approach is the most aggressive surgical dissection of a hernia allowing for the best repair.  The midline plication of the belly muscles adds a secondary repair as well as a tight cosmetic result.  No mesh is usually needed. Every patient is, of course, different, but a tummy tuck and repair with no mesh is safe and effective. Good Luck

Neil Gottlieb, MD
Philadelphia Plastic Surgeon
5.0 out of 5 stars 12 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.