Who Do I See to Get a Possible Incisional Hernia and Tummy Tuck Evaluated?

I am 34 years old and have had 3 c-sections. Over the past five years since my last c-section I sometimes experience a charley horse type pain along with a bulge on the right side of where my incisional scar is and have been told by my OB and internist that it's probably just scar tissue. It happens mostly when I am straining that side of my abdominal muscles and think it may be more than just scar tissue causing the pain. The pain stops when I lie down, relax, and press on it slightly. Help!

Doctor Answers 9

Who Should fix a hernia at the same time as a Tummy Tuck?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

  If you want a tummy tuck, then starting our with a board certified Plastic Surgeon may be the best way to go here.  That is because most Plastic Surgeons in the United States have some training as general surgeons, in fact, some like myself, are board certified in both specialties.  I don't usually perform general surgery procedures anymore, but the background training is important in that we can offer our patients a critical evaluation of the problem, and be able to determine whether we could fix the hernia (usually small ones) at the time of tummy tuck. 

   Some hernias are larger or more complex and I may decide to involve a general surgeon that I work with often for cases such as this.  The important thing is that your plastic surgeon decides which general surgeon to send you to because we often know who in our community would perform this procedure best.  If you went to a general surgeon first, the recommendation may be to have the hernia repaired first then have the tummy tuck performed later, after you heal.  While this may be reasonable, it is not always necessary and you may be able to save some time, money, and avoid an extra surgery.

   That said, if you don't need the tummy tuck surgery, then just find a well qualified general surgeon who performs many hernia repairs.  Especially, if they can safely fix your hernia laparoscopically.  Final bit of advice, have your OB order a CT scan meanwhile to evaluate the presence and size of your hernia. Hope this helps your decision, Erez Sternberg, MD.

Jacksonville Plastic Surgeon
4.9 out of 5 stars 33 reviews

Incisional hernia from C-sections; also considering tummy tuck.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

With due respect to your Internist and OB, it sounds as if your diagnostic skills are "better" than the professional advice given, though they have the advantage of having examined you, so their input must not be dismissed lightly. Still, you give diagnostic information absolutely accurate for incisional hernia, and if a loop of intestine becomes strangulated in the hernia (the bulge that does NOT go away when you "lie down, relax, and press on it slightly"), you could become seriously ill and require emergency surgery.

Thus, you absolutely should be seen by a general surgeon who can diagnose this correctly and proceed with the appropriate surgical repair . . .

UNLESS you are considering a tummy tuck for treatment of loose skin, widened or stretched muscles, as well as an incisional hernia, in which case you should be seen promptly by an American Board of Plastic Surgery certified plastic surgeon (perhaps one who has also completed full training in General Surgery and is or was certified by the American Board of Surgery). Many ABPS-certified plastic surgeons have competed training and certification in General Surgery prior to their plastic surgical fellowships, but all ABPS-certified plastic surgeons are capable and skilled in this type of abdominal wall repair at the same time as tummy tuck.

If you are not yet ready for a tummy tuck, please see an American Board of Surgery-certified General Surgeon as soon as possible! Having to physically reduce your protruding hernia contents yourself is NOT good. Best wishes!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Tummy tuck and hernia

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Your symptoms are pointing to having an incisional hernia , which is not uncommon after multiple pregnancies and having C sections for giving child birth . If you do have excecc skin hanging down or if it covers your groin and pubic are ,  when you seat down , the best person to address your condition is a board certified plastic surgeon. He/she would be able to fix your hernia while doing your tommy tuck 

Incisional hernia repair at time of Tummy Tuck

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I does sound like an incisional hernia. This can be repaired at the same time as the abdominoplasty and your plastic surgeon can perform both procedures. If you decide to not undergo a Tummy Tuck but would like to have the hernia repaired, then a general surgeon would be the logical choice.

William H. Gorman, MD
Austin Plastic Surgeon
4.0 out of 5 stars 19 reviews

Tummy tucks are for plastic surgeons!

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Find a good plastic surgeon in your area. many are doubly trained in general surgery, so they have experience in hernia diagnosis and treatment. They will be best suited to determine your needs.

Many plastic surgeons will involve a general surgeon in the hernia treatment. This is something I routinely do.

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 34 reviews

A board certified plastic surgeon

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Your board certified plastic surgeon has a back ground in general surgery, so he/she should be very capable at repairing the incisional hernia at the same time as the TT.

E. Anthony Musarra II, MD
Atlanta Plastic Surgeon

Who Do I See to Get a Possible Incisional Hernia and Tummy Tuck Evaluated?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I recommend a team approach. See both boarded PS and GS to determine if by physical examination you may have an incisional hernia. Than a scan or ultrasound of the lower abdomen can aid in the pre operative diagnosis. After and if it determined you do have an incisional hernia than discuss with your chosen PS the treatment approach. That is to say, the GS does the hernia repair and the PS does the TT. or can the PS do both? Best of luck. 

Possible hernia and tummy tuck

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

If you have a possible hernia and were not considering a tummy tuck (as you did not have loose skin), then a general surgeon would be able to evaluate and repair this. If you have loose skin and you are considering a tummy tuck, see a plastic surgeon who would evaluate you for the tummy tuck and the hernia, and either repair the hernia at the time of the tummy tuck or work with a general surgeon to repair the hernia at the same time.

Incisional scar pain

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It certainly sounds like it could be an incisional hernia. Although a general surgeon could treat this, if you are also considering a tummy tuck, I would recommend seeing a board-certified plastic surgeon instead.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.