3 Incisional Hernias from Abdominal Surgery - What Options Besides Mesh? (photo)

I read that the reoccurence rates after hernia repair are high without mesh, but would rather not have mesh. Would repairing my 3.5" diastasis lower those odds? Any other suggestions? (I'm slim, athletic..if it matters).

Doctor Answers 4

Recurrent incisional hernias can be problematic even with tummy tuck

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Yes, muscle tightening and repair of diastasis recti can lower the odds of hernia recurrence but it doesn't take it to zero.

No one can give you a 100% reliable answer online.  You need to go in and see at least two or more board-certied plastic surgeons for recommendations.

If you are not satisfied, you can see a third but be careful about trying to find a surgeon that tells you what you want to hear.

If you you repeatedly get the answer that you need mesh, then you probably need mesh.

I hope this helps.

Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews

Complex abdominal wall issues

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Your question cannot be adequately answered on line.  You need to meet with well qualified plastic surgeons to assess the laxity of the muscles.  Sometimes, the hernia can be repaired without mesh and tightening the muscles and repairing the diastasis over the top can support the hernia repair and take tension off it.

Repair of Incisional Hernias and Diastasis Recti?

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Thank you for the question pictures.

Based on your description and pictures  your abdominal wall has been through a lot;  the best way to reconstruct the abdominal wall will need to be determined after careful physical examination. If at all possible, I also would prefer to avoid the use of mesh (assuming the abdominal wall can be reconstructed adequately without it).

I would suggest that you meet with well experienced board certified plastic surgeons who can demonstrate experience with patient's presenting with a similar situation. I have attached a case presentation that may be helpful to you.

Best wishes.

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Repair the rectus diastasis, repair the hernia

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You are on target with your statement - repairing the diastasis lowers the odds of recurrence. I have seen many patients from other physicians with multiple repairs, both with and without mesh, who have recurred because the diastasis was not fixed. One poor patient had seven prior repairs. We repaired her wide diastasis, from the xyphoid (that's at your ribs) to the pubis bones (all the way at the bottom) and without mesh. Fixed.

For your case, you also have some loose skin, and since you have that long vertical scar, you should consider having some skin removed at the same time you have your diastasis and your hernias fixed. Ask your surgeon to do Marcaine injections (it's local numbing injections) into your rectus sheath before they close - it make the procedure much less painful.

Lisa Cassileth, MD, FACS
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 16 reviews

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.