Can I Get Lipo with a Hernia or Will I Need a Tummy Tuck?

I am a mother of two, a 4 year old & a 3 year old. I had 2 c-sections. I went to a consultation for lipo an I was told by the surgeon that I had a hernia (as you can see) but he assured me he could work around it. I've also been doing some research on diastsis Recti and I even did the self check (just to make sure, I'm paranoid like that) and I honestly couldn't feel a gap between my abdomen. I am also not a MD so I'm not sure. I just want to be safe and get my money's worth. Help?

Doctor Answers 7

Tummy Muscle Separation (Diastasis) is NOT necessarily a Hernia

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For pregnancy to continue and allow the fetus to grow the abdomen has to be able to expand and can only do so by a controlled separation of the tummy 6 pack (Rectus Abdominis) muscles. The separation, or Diastasis, is commonly seen the vast majority of women who have had children andisthe prime cause of the dreaded "pooch" women complain of. Because exercise can tone the muscles but cannot bring them together, the pooch is exercise resistant. A HERNIA describes an incursion of one structure from its normal location into another location where it does not normally belong (such as inguinal hernia, femoral hernia, ventral hernia, paraesophageal hernia etc). A tummy (ventral) hernia is a contraindication to the performance of liposuction. Having intestines protruding outside the belly in a hernial protrusion puts them at danger of being punctured by the liposuction suction tubes. As a result, Plastic surgeons carefully examine their patients before deciding on liposuction to make sure hernias are NOT present. BOTH muscle separation and tummy hernias can be nicely repaired during the performance of a Tummy Tuck.

Memphis Plastic Surgeon

Sounds like a second opinion might be warranted.

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You best bet here is a second opinion with a general surgeon (not a general plastic surgeon) who is in the business of hernia repair.  Your internist or gynecologist can most likely refer you to someone in the DC area.  If this surgeon say you have a hernia-there is you answer.  Regarding what to do, this is a circumstance where it pays to have surgery with a board certified general plastic surgeon.  There is undoubtedly and increase risk when liposuction is performed in the setting of abdominal wall herniation.  

It is common for general plastic surgeons to do both tummy tuck and a durable repair of the abdominal wall weakness.  This is an instance where it makes sense to seek out a double boarded plastic surgeon, one who has completed an entire residency in general surgeon and a second residency in general plastic surgery.  Because of the way graduate medical education is funded, it is now very unusual for new to practice general plastic surgeons to be double boarded in this fashion.  You will need to find someone in their mid-forties or beyond for this level of training.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Tummy tuck more often a better choice than lipo after pregnancies and C-sections

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Since pregnancy stretches out the abdominal skin, there is usually some residual laxity that cannot be corrected with exercise or with lipo. Also, the muscle separation does not respond to exercise for anatomic reasons. A hernia is a separate issue, and it could be repaired as part of the tummy tuck. Make sure you are consulting a board certified plastic surgeon who does both tummy tucks and liposuction so they can recommend which is best.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

An abdominal hernia should be fixed

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1. If you have a hernia of the abdomen liposuction around it will only make the bulge of the hernia worse.  This probably won't look good.....But beauty is in the eye of the beholder.

2.  It is generally considered good practice to fix abdominal hernias.  Often times they can be fixed during a tummy tuck procedure.

3.  Doing liposuction in the area of a hernia could be risky because of the risk of poking a hole in the hernia contents which could be your intestines.

Dev Wali, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 58 reviews

Tummy tuck candidate

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If you have excess skin and fullness of your abdomen,it bulges out, then you are a candidate for a tummy tuck. If you just have excess fat without much excess skin, then lipo would be the answer. The latter is much easier to have with a very small scar compared to a tummy tuck. I am offering a temporary price reduction and excellent financing to make cosmetic surgery much more affordable. Watch my videos on my website.

Edward J. Domanskis, MD
Newport Beach Plastic Surgeon
4.5 out of 5 stars 28 reviews

Hernia or muscle laxity?

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If you have a true hernia, than liposuction is contraindicated because of the risks of perforation of bowel. If it is just a diastasis (not a true hernia), then it should not be a problem.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Muscle laxity, hernia and excess fat

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As you have several issues possibly such as diastasis rectus (weak fascial support for the abdominal muscles), excess fat in the abdomen and a hernia, I would suggest you seek consultation with a board-certified plastic surgeon who should examine you and make suggestions about the repair of the hernia and whether a tummy tuck is needed in addition to the liposuction.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 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.