I want a panniculectomy at the same time as the hernia surgery. Is there a chance that this will cause another hernia? (photo)

Unfortunately,
you have not told us your weight but from your photograph, it is hard to
believe that you could lose another 125 lbs. I recommend a technique called Abdominoplasty
with Mesh Reinforcement.A large piece
of mesh is used to reinforce the lower abdominal wall, which results in
increased mechanical strength, early satiety, weight loss and maintains the
reduced weight.This technique excises
the umbilicus so there will not be a recurrent umbilical hernia and the
previous site of the hysterectomy is reinforced.There are recent articles published in
Plastic and Reconstructive Journal describing this technique.Best Wishes,Gary Horndeski, M.D.

Both procedures may be done at the same time. It is imperative for you to lose weight, paniculectomy or not. The chances of a recurrent hernia are very high if you do not lose weight. Good luck

You have done a great job of losing weight and you seem well on your way to your goal.  I would definitely advise waiting until you are closer to your goal before having the hernia repair and the panniculectomy.  You have a great benefit with less tension on the hernia repair and more loose skin that can be removed to give you a better result.  I would combine the procedures and having a pre exisitng vertical scar allows removal of excess skin across the abdomen as well as down using a T incision while giving the general surgeons more than enough exposure for the hernia repair.Best of luck.