Hernia Repair w/ Tummy Tuck - More Painful?

Since you are planning on having the hernia repair done it is a great idea to add tummy tuck at the same time. The recovery time and the pain level are similar for both procedures. Many patients that need hernia repair often combine this procedure with full or mini abdominoplasty depending on their needs. The recovery time takes on average about 3-5 weeks. It varies from patient to patient but most patients can drive a car and go back to work after one week

Properly performed, most all tummy tucks will include muscle plication (repair of the rectus abdominis muscle sheath that is stretched by pregnancy or obesity) from breast bone to pubis. This includes the umbilical area, so if there is a small hernia here, it can and should be fixed at the same time as your tummy tuck. Since this area is sutured with or without a hernia repair, the pain should be absolutely no different in either case.

I inject the muscles beneath the sutured rectus sheath (after hernia repair and plication, or plication alone) with Marcaine and epinephrine (a long-acting local anesthetic) for every tummy tuck--this helps to reduce post-operative pain and muscle spasm for hours and often as long as a day after surgery.

Generally umbilical hernias are relatively small and are repaired in conjunction with the abdominal wall plication. The plication contributes most to the pain after tummy tuck and the addition of an umbilical hernia repair should not add significantly more pain.

Thank you for the question.

In my opinion, the best time to repair the umbilical hernia is at the same time that you're having a tummy tuck done. At that time, the hernia is easily  exposed and repaired,  negating the need for further surgery. Care must be taken during the performance umbilical hernia repair to avoid compromise of blood flow to the overlying skin. Repair of the umbilical hernia will not necessarily increase your discomfort postoperatively.

 Please make sure you are working with a well experienced board-certified plastic surgeon.

I hope this helps.

A hernia at the time of abdominoplasty will not add to the pain.

Abdominoplasty which usually includes tightening the abdominal muscles is a painful procedure. The pain can be controlled by medication. Any pain associated with the hernia repair will not be noticed in the context of the normal pain felt after abdominoplasty.

G. Gregory Gallico, III, MD, FACS
Associate Professor, Plastic Surgery
Massachusetts General Hospital
Harvard Medical School
170 Commonwealth Avenue
Boston, MA 02116
Tel: 617-267-5553
Fax: 617-267-5507
 

MANY women who undergo tummy tucks need to have an umbilical hernia repair performed at the same time.  The reason for this is that pregnancy is generally what brings about the need for a tummy tuck and muscle plication.  Pregnancy is also a common cause of an umbilical hernia.  The reason is very simple-- there is only so much stretch that your abdominal wall can take before it gives a bit.  A tummy tuck usually involves plication of the anterior abdominal wall from right below where your ribs meet all the way down to your pubic bone.  To do this, the tissue overlying your rectus muscles, which is known as fascia, is sutured together.  To repair an umbilical hernia, the fascia beneath your belly button needs to be repaired.  Because both of these are fascial repairs, and the umbilical suturing is really very minor compared to the repair of your entire abdominal wall, the umbilical hernia repair really shouldn't cause you anymore pain.  Also, most surgeons will inject you with a long acting local anesthetic at the time of surgery which should help you get through the first night without too much pain.  I wouldn't worry about it too much.  

This is a common scenario and should not add to increased pain.  If your hernia is large, it may require a general surgeon to repair it at the time of the tummy tuck but again, this should not contribute to your postop pain.  Good luck!

It is a prudent choice to undergo the hernia repair at the same time as your tummy tuck as you will consolidate your procedures into one operative session rather than two - and the associated benefits from that. Virtually all if not all the pain that you will experience will be related to the plication (repair) of the muscle and the skin repair issues as opposed to the hernia repair itself.

Most of the pain is from the tummy tuck and muscle plication. It is bearable, and usually a pain pump or medication by mouth is enough.

Umbilical hernias may occur after pregnancy and are commonly repaired  at the same time as a  tummy tuck. It does not add any pain  or discomfort to the recovery, and is covered by your insurance.