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Where Would a Ventral Hernia Appear After C-Sections? What About Repair Options?

IF a person were to have an abdominoplasty and a umbilical and ventral hernia repaired at the same time, would the hernias be done laproscoically and where would a ventral hernia appear after a couple c sections?

Doctor Answers (10)

Hernia repair and tummy tuck

+1

OIften, the hernias can be repaired after the plastic surgeon elevates the adominal flap and then the surgeon has full access to what he needs to do.


Manhattan Plastic Surgeon
4.5 out of 5 stars 16 reviews

Repair of Ventral Hernias at SAME Time as Tummy Tuck

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Regarding: "Where Would a Ventral Hernia Appear After C-Sections? What About Repair Options?
IF a person were to have an abdominoplasty and a umbilical and ventral hernia repaired at the same time, would the hernias be done laproscoically and where would a ventral hernia appear after a couple c sections
?"

Ventral hernias are much more common after mid line surgical incisions than after C-section incisions.

A Full Tummy Tuck involves lifting the abdominal skin off the abdominal muscle wall. Depending on the size of the hernia and the quality of the adjacent tissues, such hernias may be repaired either directly or with the use of meshes which in turn can be placed either just under the muscle (Preperitoneal plane) or over the muscle (onlay).

Dr. Peter Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 59 reviews

Abdominoplasty combined with a hernia repair: Belly button beware

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Abdominoplasty combined with a ventral or umbilical hernia repair are common because during pregnancy the abdominal muscles can stretch out leaving a mid-abdominal bulge and sometimes an umbilical hernia. Excess abdominal skin and stretch marks are the common presenting complaint to plastic surgeons and hernias are the common complaints to general surgeons. Good news is that they can be repaired at the same time with the exposure provided with the lower abdominoplasty incision. There is no need for a separate laparoscopic approach, and the for most small hernias, a board certified plastic surgeon should be able to repair them. For larger hernias or hernias associated with pervious incisions, a general surgeon may be consulted before hand to assist in the repair of the hernia. In most abdominoplasty procedures the midline fascia is brought together or plicated, so this can act as a repair of the hernia. Umbilical hernias are straight forward to repair, though can compromise the blood supply to the belly button leading to necrosis of the skin necessitating a delayed reconstruction.

I hope this helps. 

Andrew P. Trussler, MD
Austin Plastic Surgeon
4.5 out of 5 stars 11 reviews

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Need to talk to your surgeon

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Ventral hernia usually refer to a hernia located in the midline of the abdomen, usually are a complication of and appear at the site of the scar resulting, from the previous surgery. C-sections are usually performed with a lower horizontal incision (cut), most of the OB surgeons will cut the rectus muscles horizontally as well, others (mainly older surgeons) will cut the line alba (midline) in between the muscles. It is rare to have a ventral hernia as a consequence of your c-section, but possible. There is no question, reviewing hernia literature, that recurrence of hernias is more common when primary repair is used, this is why, most general surgeons used some form of mesh with their repair. The most important factor in a sucessful repair of your hernias, and decreased the chances of recurrences, its  to determine what factors are involved in the development of your hernias (i.e infection, obesity, wound healing problems, etc), you may be a better candidate for repair with mesh or you may be a candidate for repair primarily. If mesh is decided, you may have more chances of complications (specially infections) if done with the open approach through the abdominoplasty incision. Hence, an indication for preperitoneal laparoscopic placement, however chances of complications are increased. At the end it depends on your particular findings, I recommend you check the credentials of your surgeon, and most importantly have a second or/and maybe a third opinion with other surgeons. Also remember, all board certified plastic surgeons have training in general surgery, but we do not perform hernia surgery, routinely. Small defect with no bowel involvement, very easy and safe to repair by us. Larger hernias with bowel involvement or potential for adhesions a lot more risky.

A final point, if your  plastic surgeon repair a large hernia, primarily along with the abdominoplasty; and you developed a recurrence of the hernia, later, most likely he will refer you to a general surgeon and you may end up with a vertical scar in the midline of your abdomen. So be sure you ask all of these questions in your consult.

Good luck

Victor M. Perez, MD, FACS
Kansas City Plastic Surgeon
5.0 out of 5 stars 7 reviews

Hernia and tummy tuck

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There is no need for a laproscopic approach.  The abdominoplasty provides more than ample exposure to repair the hernias.  In my practice, I will fix small ones, and have a general surgeon repair the larger ones.  They should not recur.

David A. Lickstein, MD
Miami Plastic Surgeon
5.0 out of 5 stars 3 reviews

Hernia Repair and Tummy Tuck

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I frequently repair hernias at the time of tummy tuck as I am trained in general surgery as well.  I have avoided the laparoscopic approach simply becuse full exposure of the hernia will already be done during the tummy tuck.  I also avoid using mesh in nearly every case since using your own tissue is far superior.

 

John LoMonaco, MD, FACS
Houston Plastic Surgeon
5.0 out of 5 stars 168 reviews

Ventral Hernia Appear After C-Sections? What About Repair Options

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To directly answer your question No the hernias will be repaired after elevation of the skin flap so the GS can directly repair the defects. Than the tummy tuck can be completed. From MIAMI Dr. Darryl J. Blinski, 305 598 0091

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 61 reviews

Umbilical hernia repair and

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I have done this in combination with general surgeons who have each used a variety of approaches. Some have selected laparoscopic placement of mesh, others have used pre-peritoneal mesh placement while others have used suture repair.  Discuss the approach with your surgeons and their specific recommendations for your condition/

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 43 reviews

Ventral hernia after C-section

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The vast majority of C-sections performed in the US is through a low transverse incision called a Fanensteil incision. This incision is without splitting the muscles in the abdomen and the rate of hernia formation is exceedingly low, even after repeat C-sections. I would be skeptical you have one without  evidence such as a CT scan. Umbilical hernias are common after pregnancy though they often close on their own after delivery. An umbilical hernia can be repaired laparoscopically, though repair through the umbilicus produces an effective repair with even less scar than a laparoscopic procedure.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 26 reviews

Hernia Repair during Abdominoplasty

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If you are having hernia repair during abdominoplasty, it most likely will be done "open" and not laparoscopically.  The main reason for laparoscopic hernia repair is to avoid incisions.  If you already have an incision because of your abdominoplasty, then it is best to just directly repair the hernia.  Some plastic surgeons are board certified in both general surgery and plastic surgery, so they may be able to do both procedures for you.  Good luck.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 55 reviews

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