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Can't Do Plication with Ventral Hernia Repair?

asked 5 months ago by BonneV
Latest answer by J. Jason Wendel, MD
Question viewed 169 times
Tags: diastasis recti, hernia repair

I have a ventral hernia, very wide diastasis recti, and extra skin due to pregnancies (one large baby then large twins). The general surgeon recommended having a plastic surgeon do a tummy tuck to remove extra skin during the procedure. I met with the plastic surgeon, and he told me that the general surgeon doesn't like to have any plication done during the hernia repair. Does this sound correct? I would really like to have plication done as well during this surgery, if possible.

16 answers to Can't Do Plication with Ventral Hernia Repair?

Hernia repair and diastasis recti repair

Tummy tuck with plication, muscle repair and tightening can be performed at the same time as a hernia repair. It is the best time to do it all at once.

J. Jason Wendel, MD
Nashville Plastic Surgeon

Abdominoplasty with a hernia

Great Q BonneV, if all hyou have is a diastasis then you absolutely need a plication of your rectus muscles, that is how you fix it. That's in fact the problem! Sometimes hernia repair needs mesh, if that's the case, it means you have much more than just a diastasis and a TT is not the best option at the same time because it can . This one needs to be done on a case by case basis. You should consider coming in for a free conslutation since we're in the... more

Ricardo A. Meade, MD
Dallas Plastic Surgeon

www.DoctorMeade.com

Ventral hernia repair and plication of a diastasis

As evidence by the strong consensus on the issue, plication can and should be performed if needed during a tummy tuck when a ventral hernia is performed at the same time. There is no rational or medical reason not to.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon

www.turkeltaub.com

Diastasis

Perhaps your surgeons misunderstood you, i work with general surgeons frequently and plications are routinely performed. actually i think it can give an extra layer of strength to your hernia repair. maybe a second opinion is in order.

Jonathan Saunders, MD
Newark Plastic Surgeon

www.drjonathansaunders.com

Ventral hernia can be repaired during abdominoplasty

My background, as with most plastic surgeons, is in general surgery. And as such, I routinely repair ventral hernias while performing abdominoplasties. Plication does not interfere with hernia repair when it is being done simultaneously. It only becomes an issue if the hernia repair is done at a later time by laparascopy. If your PS does not have a background in general surgery or does not feel comfortable doing the repair; look for one that does. Having the hernia repaired at the same time... more

Gary M. Horndeski, MD
Houston Plastic Surgeon

Muscle plication and hernia repair during tummy tuck

There is no reason why a hernia repair can not be done with muscle plication. A hernia is an actual defect in the abdominal wall in which internal bowel contents can protrude. This can be dangerous if the bowel becomes trapped as it can die and cause serious issues. Such a hernia can be painful as well. Therefore a hernia needs to be repaired. Diastasis recti is a thinning of the abdominal wall with stretching and actual separation of the muscles but no actual defect in... more

Jay Burns, MD
Dallas Plastic Surgeon

Plication with Ventral Hernia Repair

A few comments to clear things up - The vast majority of Board-certified Plastic surgeons have fully trained in and are board certified in Surgery prior to training in Plastic Surgery. - a wide separation of the rectus muscles = a diastasis which is NOT necessarily a hernia. - There is NO reason why the muscle separation could not be repaired duting a Tummy Tuck. If you have a ventral hernia repair which was previously not been operated, the vast majority of such cases CAN be... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

Repairing hernias with a tummy tuck

Usually a Tummy Tuck involves plicating (or pulling together) the rectus muscles in the midline. This helps restore a straight core. If there is a hernia in the midline then that can usually be repaired at the same time and the repair reinforced with the plication.

Suresh Koneru, MD
San Antonio Plastic Surgeon

www.drkoneru.com

Ventral hernia and tummy tuck

A board certified plastic surgeon who has pre-requisite training in general surgery can perform the entire operation himself so perhaps this is why your general surgeon was apprehensive about a combined procedure or possibly the doctors are not on the same page. One area for confusion, in my area of the country, is that certain insurers will deny the ventral hernia if performed together with a cosmetic procedure and the hospitals will charge more for the cosmetic portion than what I pay my... more

Robert L. Kraft, MD
New York Plastic Surgeon

Ventral hernia repair and plication of muscles go together

Actually the repair of ventral and umbilical hernias go hand in hand with muscle plication during tummy tuck and one will not preclude the other. Perhaps there is a more experienced plastic surgeon in your area who can handle everything, as a second opinion might be helpful. We are with you, kind of a red flag here. Best of luck, peterejohnsonmd.com

Peter E. Johnson, MD
Chicago Plastic Surgeon

Hernia Repair and Tummy Tuck

Dear BonneV, In most cases where there is a ventral hernia and a tummy tuck is also being considered, the two can be performed at the same time including plicating the abdominal muscles. However, this is a generalization and not true for every patient. Even if mesh is used in the repair, if it is small enough in size, this can be incorporated into the muscle placation which actually makes the repair stronger. Given the confusion that appears to be occurring... more

Herluf G. Lund, Jr, MD
Saint Louis Plastic Surgeon

www.stlcosmeticsurgery.com

Plication and hernia repair can be done together.

Having your TT done at the same time as the hernia repair is a good idea as it lets you recover from both at the same time. If your hernia is small and right in the midline where your diastasis is, the hernia repair can then be incorporated into the plication and makes the repair stronger. If the hernia is large and requires a mesh to closed the hole, the plication is still possible. Get a second opinion to clarify where these can be combined in your case safely. more

Jeffrey M. Darrow, MD
Boston Plastic Surgeon

Abdominal Wall Plication During Hernia Repair

In most cases with a small hernia a plication can be done but it depends on the specific case. If you have a large hernia the requires a mesh, plication may not be possible. You may consider a second opinion.

Karol A. Gutowski, MD
Chicago Plastic Surgeon

Ventral hernia and tummy tuck

A small ventral hernia can usually be closed at the same time as a tummy tuck. The nice thing is that the lax muscles (rectus diastasis) can also be plicated and tightened over the hernia repair making it even stronger. This is like a belt and suspenders. Sometimes a hernia is more complicated and may even need a mesh repair. This may need to be done before the TT and healed. Also, some plastic surgeons are double Board Certified in surgery and plastic surgery and are... more

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Ventral hernia repair and muscle plication can be done together.

It may be true that the general surgeon doesn't like to have the muscle plication done, but that may just be his or her preference. Hernia repair and muscle plication are closely related and are commonly done together. Check with both of your surgeons and make sure there is not some special circumstance in your case.

Michael S. Hopkins, MD
Albuquerque Plastic Surgeon

www.hopkinsplasticsurgery.com

Plication of Muscle and Repair of Hernia Together?

Thank you for the question. I wonder if there has been some type of miscommunication; most ventral hernias can be prepared at the same time as tummy tuck surgery ( including the plication of the abdominal wall muscles). You may want to confirm your understanding with the plastic surgeon; if there has been no miscommunication, you may want to seek a second opinion. Best wishes. see video