Can Plastic Surgeon Do Diastasis Recti Repair with a Hernia in One Surgery?
- Asked by bellyblob in Boston
- 3 years ago
I had three children and have a Diastasis Recti along with umbilical hernia. I was told I needed to have a surgeon and plastic surgeon work on my belly. Is it possible for one surgeon do it all?
I had one consult by a plastic surgeon that told me my belly button is completely detached (photo) - i would need to have one created. I am really confused on what is considered medically necessary, i don't want to look like an alien after they fix my hernia. What are my options here?
An umbilical hernia can be fixed during tummy tuck surgery
Umbilical hernia is a relatively common problem associated with the stretching of the belly wall that can occur with pregnancy. If it is an uncomplicated hernia, it can be fixed at the same time as the rectus diastasis repair, if your plastic surgeon is comfortable doing this. I am fully trained in general surgery in addition to plastic surgery and so do this procedure when indicated. I am not sure that I understand what a "detached" belly button is, but reconstructing a pretty belly button is usually part of a tummy tuck. A general surgeon fixing the hernia only might not be as sensitive about the way the belly button looks after the surgery.
Umbilical hernia repair and TT
I would recommenda plastic surgeon who is boarded in both surgery and plastic surgery. An umbilical hernia repair is reconstructive and rectus diastasis repair is cosmetic. What you are essentially saying is that you want to have a tummy tuck and umbilical hernia repair if I understand you correctly. If so, remember that umbilical complications are much higher in this setting and you may lose your umbilicus.
Abdominal wall reconstruction is done both by General Surgeons and Plastic Surgeons
Abdominal wall reconstruction (hernias and diastasis recti) is done both by General Surgeons and Plastic Surgeons. Many plastic surgeons have had a minimum of 5 years general surgery training and are Board Certified. Others may have taken additional training in composite abdominal wall reconstruction and may specialize in this, working in tandem with trauma or oncological surgeons. Repair of a diastasis recti and umbilical hernia is routinely performed by all Plastic surgeons, during the course of an abdominoplasty; in some instances, biological or synthetic mesh may be included.
Hernias can be classified as reducible, incarcerated and/or strangulated. A careful review of the patient's history and physical will reveal whether the hernia is in the latter stages, at which time, it would be important to have a general surgeon on hand, in case a bowel resection is needed.
Simultaneous Repair of Umbilical Hernia and Abdominal Wall Laxity - Diastasis Recti
The vast majority of board certified Plastic surgeons were trained and certified in Surgery before training in and certifying in Plastic surgery. As such most of us are very comfortable repairing ventral and umbilical hernias.
We often CHOOSE not to do so and bring in a General Surgeon in these cases for a variety of reasons foremost of which is to allow the general surgeon to repair and bill for the often insurance covered part of the case (hernia repair) while deflecting potential liability for it. Had we not lived in such a sue-happy society, a lot more would be done for a lot less and we would all benefit.
As far as your options, you can choose to have nothing done. You can choose to have your umbilical hernia repair and stop or have your tummy tuck a few months later. Finally, you can have your hernia repaired at the same time as your umbilical hernia repair. Without any health risks you have not told us, that would be my preferred way of approaching most such cases.
In your case, you appear to be obese. Your risk for complications is higher including loss of the umbilicus (due to a poor blood supply to the umbilicus which would be poorer after the hernia repair). But, your potential functional and appearance benefits are far greater.
Plastic surgeons can do both diastasis recti repair and hernia
Most plastic surgeons are general surgery trained prior to entering a plastic surgery residency. I would check the credentials of the plastic surgeon you consulted with as there are other routes to plastic surgery. A plastic surgeon with Board certification in both General Surgery and Plastic surgery can do this operation for you. If they are uncomfortable with the case a general surgeon can be brought in to surgery to repair the umbilical hernia.
You should not need a complicated umbilical creation. Repair of the hernia and rectus diastasis will resolve this issue. There is a slightly higher chance of delayed wound healing or partial loss of skin of the belly button do to the need to enter the belly button to repair the hernia but the risk is low.
Hernia Repair and Abdominoplasty Combined
Most plastic surgeons are also board certified general surgeons. You need to find one that is comfortable performing both operations. There are surgeons out there that do both.
One note is that the is a likelihood that you will be left without a belly button if you desire to have a tummy tuck. It looks like the hernia has resulted in a detachment of the belly button. In a tummy tuck the incision is made all the way around the umbilicus and if there is not attachments to the underlying fascia then the umbilicus will not surrvive.
Tummy tuck and diastasis recti repair
Most patients to some extent have a diastasis and plastic surgeons routinely repair the fasica during a full abdominoplasty. In some cases, if you have a hernia or other internal abdominal issue, a general surgeon may be asked to assist during the surgery. However, many plastic surgeons are board certified in both General Surgery and Plastic Surgery and feel comfortable performing the entire procedure. Good luck.
Web reference: http://www.ShaferPlasticSurgery.com
I would get a second opinion on this. The hernia may be covered by insurance, but you need to check with them about it. Tummy tuck is never covered because it is cosmetic. A general surgeon may be needed to repair the hernia, as intestines may be involved.
Best to have hernia specialist together with tummy tuck surgeon.
In New York City, our policy is to bring in a surgeon who does a lot of hernias, when the hernia is complicated, like yours. If the hernia is tiny, then I repair it myself while doing the tummy tuck.
You need to find a plastic surgeon that has general surgery training also
Most plastic surgeon are double boarded in general surgery and plastic surgery. These plastic surgeon have done many hernia repairs and they should be able to do both procedures at the same time.The main concern is the blood supply of the umbilicus.The sever umbilical hernia thins out the skin and stretches the blood supply. Your board certified plastic surgeon can help you.
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.