Ask a doctor

I Have an Umbilical Hernia & Want 400cc Implants. 2 Big? Need a Tummy Tuck & All 3 Together? (Photo)

I am a 40 yr. old mother. I am 5’6” 110 lbs. I would like breast augmentation with 400 cc silicone. The implant width for Mentor high profile is 12.3cm. (My breast width is 11.5 cm) Would this implant size fit? I need an umbilical hernia repair (was approved by insurance with a general surgeon). I am considering a tummy tuck at the same time with a plastic surgeon in my network. Do I need a modified tummy tuck? The general surgeon wants to put in a mesh for the hernia.

Doctor Answers (10)

I have an umbilical hernia and want 400cc implants. Too big? Need a tummy tuck - all 3 together?

+1
Hello! Thank you for your question! These procedures can be effectively and safely performed in one setting.  Fading an umbilical hernia is also reasonable - it is already in the surgical field and will provide great access for repair, while not adding much additional time or risks to the procedure itself. The breasts and tummy tuck are commonly performed together, often referred to as the "mommy makeover". If you are healthy and your surgeon decides that s/he could perform the procedures in a safe time for you, these procedures certainly can be done in one stage. Staging the procedures to have them performed at various times will likely not have any cost benefit for you. When you combine procedures, there is often a discount that is provided by the surgeon for multiple procedures. Also, when having multiple procedures performed at the same time, you save on anesthesia and facility fees, which otherwise are paid for with each individual procedure. In addition, you may benefit by the single recovery time.

It is your decision as to whether you have your procedures performed in one or multiple stages, but your surgeon will give his/her recommendations. I would consult with a plastic surgeon well-versed in these procedures and discuss your concerns with your surgeon and see what your options are as well as have an examination. Your safety is ultimately the most important factor and is always on the mind of your surgeon when making such decisions. Hope that this helps! Best wishes for a wonderful result!


Scottsdale Plastic Surgeon
5.0 out of 5 stars 10 reviews

Umbilical Hernia In Combination With Breast Augmentation

+1

It’s not unusual to perform breast augmentation, tummy tuck, and umbilical hernia repair during the same operative procedure. This approach offers the patient significant advantages including lowered cost, improved results because of synergy and a single recovery.

 

         When this approach is utilized patients need to be done having children. They should also be in good health with no significant risk factors for surgery. It’s also important that the plastic surgeon and general surgeon have a good working relationship, so the procedure is well coordinated.

 

         It’s difficult to know what type of procedure you will ultimately need without performing a physical exam. Your pictures suggest that a full abdominoplasty would be appropriate, but a mini abdominoplasty might also be an option.

 

         Your choice of implant size and style doesn’t seem unreasonable but again it’s difficult to say without an examination. This decision is based on the patient’s anatomic findings and unique aesthetic goals.

 

         It’s important that you consult a board certified plastic surgeon. This surgeon should be able to make an appropriate recommendation. 

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 73 reviews

Umbilical Hernia Repair - Same time as TT and BA

+1
Breast implants/Breast Lift and Tummy Tuck as well as smaller procedures like an umbilical hernia repair are  Often Performed Together.
Different surgeons will recommend different procedures including doing more than one at a time. Some surgeons also differ in ability, time it takes to do the same procedure and general. It makes this a difficult choice for patients. Based on my own experience I would do all at once as long as it takes 4 or less hours. Surgeons should never perform elective operations that they are uncomfortable performing or feel unwise for them, nor should t)hey be faulted for doing so. However, for me, I typically perform a tummy tuck and breast augmentation  at the same time and usually takes about 3-4 hours so I recommend this be done in one surgery and this is what many refer to a Mommy Makeover.

Not only that,if you did not need a breast lift, I usually place breast implants through the Tummy Tuck incision but I prefer this technique. Tummy Tuck and Breast Augmentation Combination makes sense and is safe. Contrary to some of the answers I have found that the recovery time is not delayed and is the same as the tummy tuck procedure by itself. That is because you are healing simultaneously and not sequentially - both heal at the same time. The procedure only takes me about a half hour to 45 minutes longer than the tummy tuck alone. Best of all, I usually put in the breast implants through the tummy tuck incision so that there are no scars on the breasts.
I have performed many of these combination procedures over the past few decades and think it is a great idea without significant increased complications

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 38 reviews

You might also like...

Implants and tummy tuck can be performed together

+1

A tummy tuck with a hernia repair and breast implants can all be performed at the same setting if your health is good.  Make sure you are finished with child bearing before undergoing a tummy tuck, we want that result to keep forever!

The size of the implant you are choosing is fine, talk with your plastic surgeon about implant choice (saline vs silicone vs form stable silicone vs high profile vs ultra high profile, etc.)

Good Luck!

David Finkle, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 45 reviews

Breast augmentation, tummy tuck, and umbilical hernia repair

+1

Thanks for sharing your photos.  Based on your photos, you are a good candidate for breast augmentation and tummy tuck.  Hernia repair can be done at the same time as well.  In regards to picking the right implant size, it will depend on your body (anatomic measurement), thickness of your breast tissue, and your desired look/goal.  Although 400cc HF may fit in your body, I  don't know what your desired look is.  Please review and go over photos with your plastic surgeons to convey your desired look/goal. Best wishes for your surgery and recovery.

Sugene Kim, MD
Houston Plastic Surgeon
4.5 out of 5 stars 35 reviews

Appropriate breast implant size and

+1

I would recommend trying these implants on with your plastic surgeon to assess if this size reaches your goal.   If so, you may benefit for an ultra high profile implant, which can provide the 400cc range in a narrower base diameter.   

 

In regards to the tummy tuck, you have some loose skin and a fair amount of lax muscle.   You will likely befit from a full tummy tuck along with your hernia repair.    I am unsure of the reason for use of mesh, as the hernia defect appears rather small..  

 

I wish you a safe and healthy recovery.

 

Dr. GIll

Paul S. Gill, MD
Houston Plastic Surgeon
5.0 out of 5 stars 34 reviews

Breast Augmentation, Tummy Tuck, Hernia repair.

+1

Thanks for your question, and for attaching the photos.

  • Breast augmentation-As a general rule, I like to keep the width of the implant within the dimensions of the breast.Allergan makes a "full profile implant" implant of 400 cc which is within your breast width. The implant is a little rounder and more projecting, and may look less natural than some of the other profiles. Hopefully you have or will get to try these on in your surgeons office. You may find that they are a bit large for your frame, but this is a very subjective thing.
  • ?Breast lift-I can't quite tell from the photos, but it looks like your areola may be lower than your breast fold. Be certain to ask your surgeon if a breast lift is something you should consider. 
  • Hernia--it is typical to use mesh for many hernia repairs, as the chance of recurrence is lower. In addition to the hernia, it appears that you may have a diastasis-separation of the rectus muscles. Fixing that, which is a standard part of a tummy tuck, should give your a nice improvement in the bulge I see on the side view.
  • Tummy tuck--I don't see a lot of extra skin, but that can be deceptive on 2-D photos. One thing your surgeons will need to consider is that with a typical TT, the navel stays attached to the abdominal wall, and gets its blood supply which it needs to survive from its attachments to the abdominal wall. Those attachments are disrupted by hernia repair, and the planning of the tummy tuck must bear that in mind, as there are alternative techniques.

 

Good luck, and best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 30 reviews

Breast Augmentation and Tummy Tuck with Umbilical Hernia Repair

+1

Thank you for your question and pictures.

From the photos it does look like you would be a good candidate for breast augmentation surgery as well as tummy tuck surgery and hernia repair.

It would be in your best interests to be examined by well experienced board-certified plastic surgeons; you will receive the best advice after an examination and a full discussion of your goals, treatment options, and the pros/cons of each option.

A hernia by definition is a full thickness defect in the abdominal wall whereas a diathesis recti refers to a separation/spreading of the abdominal wall muscles.

The size and model of breast implant used may  make a  significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon.  in my practice I find the use of goal pictures to be very helpful.  in your case you could use your own before breast-feeding pictures as the goal. I have found that the use of words such as “natural” or “C cup” or "fake looking" or "top heavy" means different things to different people and therefore prove unhelpful. 


Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.

 

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 681 reviews

I Have an Umbilical Hernia & Want 400cc Implants. 2 Big? Need a Tummy Tuck & All 3 Together?

+1

Great posted photos but the questions are better answered in an in person evaluation. I believe 400 cc HP implant are OK. As for the TT I think you need a short scar full TT, but not sure. Seek additional in person consults, please. 

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

Choosing the size of your implants

+1

400cc looks like a good size for you.  As for your tummy, you'll most likely need a full tummy tuck to get rid of all of the excess skin and to tighten your abdominal muscles.

Jeffrey E. Schreiber, MD, FACS
Baltimore Plastic Surgeon
5.0 out of 5 stars 67 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.