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