Hernias post tummy tuck - could these be caused by my tummy tuck? (Photo)

Thank you for your question regarding recurrent hernias following your tummy tuck with muscle repair. I’m sorry to hear that you’ve been dealing with multiple hernias and repeat repairs — that can be frustrating and uncomfortable, especially when you're doing everything right.

It is possible that your tummy tuck contributed to the development of hernias. During a tummy tuck, especially when muscle plication (diastasis recti repair) is performed, the abdominal wall is sutured together to tighten loose or separated muscles. While this can dramatically improve core strength and contour, the repair can also place tension on already weakened or thinned areas of the abdominal wall. This tension may predispose some patients to hernia formation, particularly if there is a pre-existing weakness near the belly button (umbilical hernia) or along the midline (ventral hernia).

Additionally, since your initial hernia repairs were done without mesh, the strength of those repairs may have been insufficient to withstand pressure over time — especially during events like a prolonged or forceful cough, which can sharply increase intra-abdominal pressure. When repairs are done without mesh, there’s a higher risk of recurrence, particularly in patients who’ve had previous abdominal surgery or muscle tightening.

The fact that you're not overweight, don't lift excessively, and haven’t had recent pregnancies suggests that there may be an underlying weakness in your fascia (the connective tissue layer of the abdominal wall), or even a collagen-related issue that makes you more prone to recurrence.

To reduce the risk of future hernias and recurrences, you may consider the following:

Comprehensive abdominal wall reconstruction with a board-certified plastic surgeon or general surgeon who specializes in complex or recurrent hernia repair. This may involve reinforced mesh placed in a layered fashion for stronger support.

Imaging studies (such as a CT scan) to evaluate the extent of the abdominal wall weakness and plan a more permanent repair strategy.

Genetic or connective tissue evaluation (if recommended by your physician) to rule out any predisposition to fascial or collagen laxity.

Postoperative abdominal binders or support garments and gradual return to activity to avoid placing excess strain on the healing tissue.

You’ve done the right thing by working with a skilled surgeon and asking questions. Sometimes, it takes a team approach to fully solve complex cases like yours. A consultation with a hernia specialist who routinely handles abdominal wall reconstructions could be the next helpful step.

Sincerely,
Dr. Katzen

Dear Exuberant351510,

it is unlikely that your previous tummy tuck surgery has caused hernias. During a tummy tuck, the surgeon will remove excess skin and tighten your abdominal muscles if there is separation.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Most likely your hernia is not caused by the tummy tuck but weakening of the fascia of your midline. When repairs are made, often times a piece of mesh is used. The technique I use is using a large piece of mesh that extends from side to side, approximately 1-2 inches above the umbilicus and all the way down to the pubic bone. This large mesh is incorporated into the body and hernias will not reoccur.

Best Wishes,

Gary Horndeski, M.D.

With a standard tuck, your fascia is not violated, but is tightened. Also, you may not have needed tightening all the way up to your chest. You might want to discuss this with your plastic surgeon, but I suspect your hernias are related to your tissue and being stretched and thinned with pregnancy, especially since they continue to reoccur.

Hernias are weakened areas through which tissue can come through. What you are describing is unusual as the muscle tightening portion of a tummy tuck should actually reduce the risk of a hernia. Sometimes a plastic surgeon will even repair an existing hernia during a tummy tuck. You may need to speak to your general surgeon about the recurrence. Mesh is sometimes needed to reinforce these weak areas.

Would you describe is pretty rare and unusual.
Muscle tightening as part of a tummy tuck should pretty much prevent someone from ever getting an eventual hernia in the future, and most likely the same issue for an umbilical hernia.
Muscle tightening as part of a tummy tuck should pretty much prevent someone from ever getting ventral hernia in the future, and most likely the same issue for an umbilical hernia.
In many ways, muscle tightening is an extreme definitive hernia repair from stern to stem.
I’m curious what the plastic surgeon who did your tummy tuck has to say about this.
I suggest you get a copy of their operative report and have a couple of other plastic surgeons review that operative report with your before and after pictures.
It really should be the other way around. We’re having had a full tummy attack should prevent you from ever getting an eventual hernia in the future.
It really should be the other way around. We’re having had a full tummy attack should prevent you from ever getting ventral hernia in the future.
If you had multiple hernias after the tummy tuck, I would’ve probably lifted the skin from your tummy, tuck incision and repair the hernias without adding new scars.
This would’ve given an opportunity to reinforce the abdominal wall, either with sutures and or mesh and would not have given you new scars.
It’s difficult to make a good assessment without quality information.
Get copies of all of your operative reports, and all before and after pictures from those who took them and consult with other plastic surgeons.
Something doesn’t seem right.
Best,
Mats Hagstrom MD