Liposuction to Remove Fat During Hernia Repair?

Question

I have a huge ventral hernia with bowel involvement. This is the 3rd repair, due to weak abdominal wall and excess weight from inactivity. I can't wait to loss weight; it's painful and needs repair now.  Can Liposuction be done to take away some fat during surgery, to help lessen protrusion after the procedure?

Trevor M. Born, MD · Answer

Dear Carole, thank you for your question.  Combining surgeries is not uncommon and can be performed safely.  In your situation - with a 3rd surgery being performed for the same problem - which is now causing you discomfort- it would not be reasonable to combine the 2 procedures.  As well, liposuction does cause increased swelling post operatively, as well as numbness and this may interfere with the healing of your hernia repair.
Good luck with your surgery!
With Warm Regards,
Trevor M Born MD

Ricardo A. Meade, MD · Answer

In general, liposuction for excess weight is a bad idea. If you need to lose weight because of inactivity (as you said) then after your hernia repair you should try to piggy back off of the recovery period and try to become more active. Lipo is not a solution for being sedentary and it would complicate the wound healing process since it would cause fluid to collect in the area where the fat was taken. Go step by step, I'm sure your plastic surgeon would recommend the same.

Ricardo L. Rodriguez, MD · Answer

Liposuction is not a weight loss technique, it is a contouring technique. It is not likely to help a person whose problem is weight excess.
If the problem is intraabdominal fat, the solution is weight loss. 
If the problem is recurrent hernia, the problem may be that there are unrecognized defects in the fascia at the time of closure. You might benefit by having a good reconstructive plastic surgeon involved in the hernia repair. A wide undermining of the abdominal skin flaps will show clearly where the good fascia tissue is so that a good repair can be anchored to it.
To put it anmother way, even if your abdomen was emptied of fat, and a repair was not anchored to good fascia, your hernia would recur.

Shaun Parson, MD · Answer

Thanks very much for your question. Liposuction can certainly be done during a concomitant hernia repair. I think you will find two issues with this if you decide to have it done. One is finding a plastic surgeon who is board certified in both general surgery and plastic surgery who can perform both procedures. It will be much easier to have one person perform both than to try and find two surgeons to perform the two separate procedures. Second, if both is involved the surgeon will have to go over specific risks in your case to determine if this is a good idea or if the hernia should be addressed by itself and then have the second procedure done at a later time. Hope this helps.

Hisham Seify, MD, PhD, FACS · Answer

Reccurrent ventral hernia repair is a complex surgery that will require component separation plus or minus mesh repair. Component separation is a surgical technique that advances the different muscle layers of the abdominal wall separately. This technique is proven to provide longer lasting results. Use of a mesh might be required as a reinforcement or as part of the repair if the abdominal fscia is weak. Removal of fat via lipousction in the same procedure might be done for other areas. I would not perform liposuction of the abdomen in the same time. This could compromise the blood supply tp the advanced flaps.I recommend to have a stagged approach to this problem.If the hernia needs to be done ASAP, procede with this surgery followed by other procedure or weight loss. Best of luck!

Christopher L. Hess, MD · Answer

It's not uncommon to combine hernia surgery and cosmetic abdominal surgery. Depending on the incision used for the hernia repair, liposuction of the surrounding tissues is most likely possible. I think this is a good step for you if you continue to improve on your health following surgery by exercising etc. Best of luck.

Scott E. Kasden, MD, FACS · Answer

Although possible, it is likely that the surgeon will use mesh.  Performing lipo may or may not increase the risk of infection or perhaps other wound healing problems.  I would suggest that you get the hernia fixed, and correct the protrusion by diet and exercise after healed, under your doctors advice.
sek

Steven Wallach, MD · Answer

It sound like you have a significant hernia. I wouldn't ocombine the two. The repair of your hernia has enough variables to deal with that you should not throw in possible complications of liposuction to compound potential issues.

Elan B. Singer, MD · Answer

Not a good idea. Your hernia repair is a complicated procedure. Liposuction would not assist the hernia repair as liposuction is best used for contouring and not weight loss. It would just further complicate your surgery. I suggest fixing your hernia and wait a few months to heal. Also, if you can lose weight before liposuction you'll get a better result. Good luck!

Barry H. Dolich, MD (retired) · Answer

Don't take your eye off the ball! Your surgery is very involved, usually requiring the services of a plastic surgeon operating with a general surgeon and most probably involve muscle component seperation and the use off alloplast to strengthen the abdominal wall.
Once that is well healed ,do the lipo.

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