Hernia Repair with Tummy Tuck
Hernia repair with tummy tuck has become a common combo procedure. While these two surgeries have different goals, performing them simultaneously makes sense when the patient has loose abdominal skin and at the same time has intestine (or any organ) that “escapes” the fascia, leading to the appearance of a “sack.”
Because the abdominal organ, especially the intestine, breaks through the muscle and fascia it protrudes beneath the skin, which is the only anatomical layer that holds it. For this reason, patients with hernia may experience infection, blockage, and dysfunction in the organ.
Tummy tuck typically uses a hip-to-hip incision positioned very close to the bikini line for optimal concealment. I have demonstrated this a couple times in my Snapchat videos as part of my patient awareness advocacy.
The hip-to-hip incision not only allows me to remove the sagging skin and some excess fat. This technique also exposes the upper and lower abdominal muscle, which has become separated after pregnancy, drastic weight loss, or other factors.
To tighten the splayed or separated rectus muscle, internal sutures are utilized. However, hernia repair involves a more extensive approach in which a mesh is placed over or under the defect in the abdominal wall, with stitches holding it in place.
The mesh, which is usually made of polypropylene (a sterile, woven mesh made from a plastic-like material), will serve as scaffolding to prevent the intestine from escaping. Also, its structural design allows the patient’s own tissue to incorporate and grow into the surrounding area.
In one of my recent Snapchat videos, I presented one patient with a significant case of hernia in her upper abdomen further aggravated by the laxity in her tummy area.
After suturing the lower abdominal muscle in the midline to produce a narrower and more contoured appearance, the area above the navel where hernia presented itself had a mesh to reinforce it. This material is available in various measurements to accommodate the size of the “problem.”