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.

Thanks for the picture. Your concerns are valid. The concerns as a plastic surgeon would be development of wounds especially at the inverted T junction.  The general surgeon will make a vertical incision with wide exposure and the panniculectomy requires a horizontal incision. 

Hello and thank you for your question.  I do believe having a panniculectomy at the same time as hernia repair is a great idea.  You will heal quicker and having the excess weight removed will allow you to move better and maybe exercise better.  Remember, weight loss occurs more with diet than exercise.  Having the panniculectomy when your hernias are repaired will not guarantee that the hernias will reoccur.  Good luck.

I am sorry to hear that you have three hernias. I don't know that having a panniculectomy at the time of your hernia surgery will have much impact on whether your hernias recur. The greatest risk with any hernia surgery is recurrent hernia. You may benefit from having your hernia repaired with internal mesh then tightening the abdominal muscles on top of the mesh. People with a heavy panniculus may have less wound healing problems from having the pannus removed, but it won't impact the hernia repair much. Your pannus after your weight loss is probably fairly thin so the weight factor may not come into play. I would definitely explore the options for repairing the hernia as this will have the biggest impact on how well you will do.

The hernia has a 20% chance of recurrence statistically.  The hernia recurrence rate will not change much with or without a panniculectomy.  Performing a panniculectomy at the same time allows the incision to be made transverse.  This provides one advantage to healing.  It decreased the risk of the weight of your flanks creating undo tension at the midline incision and potentially exposing mesh (if needed) when the wound breaks down.  I have used this approach in several large abdominal wall reconstructions and I find it provides superior exposure during the surgery and healing after the surgery.  Best of luck.   

I agree with your written plan of weight loss first before any more surgery. Have you discussed this with all the surgeons involved? 

Thank you for your question. I do not think that you have a higher chance of recurrence of your hernia if you have a panniculectomy at the same time. If you feel that you have another 125 lbs. you want to lose prior to surgery then the bigger issue is whether you should wait before having your cosmetic surgery until after you have lost the extra weight. You will also expect to have a lower chance or recurrent hernia if you are closer to your goal weight. Good luck!

It is wise to consider a panniculectomy at the same time as your hernia repair so that the excess tissue does not pull on the abdominal wall.  You have done a great job losing weight, but don't stop now! When you are overweight with hernias, every pound you can lose toward your ideal body weight goal will help to prevent recurrence.  If you are considering a "tummy tuck" later, remember the differences between panniculectomy and tummy tuck:  with a panniculectomy there is no umbilical (belly button) work and no rectus muscle plication.  Make sure you discuss your long term plan with your board certified plastic surgeon so you are both clear and on the same page.