I had two children within 18 months and my first was a big baby, so now my tummy muscles have separated and I have a 4cm x 4.5cm umbilical hernia ,as well as looking about six months pregnant still. My surgeon has recommended I have an abdominoplasty at the same time as the hernia is repaired, as he says if I don't do this I'll always have a weakness in my stomach muscles and will be prone to further hernias. Would there be any medical benefits to having the tummy tuck or just cosmetic?
My Surgeon Has Recommended I Have an Abdominoplasty Alongside Hernia Repair. Is This Necessary?
Doctor Answers 6
From your letter it sound like your hernia is pretty large. From a medical standpoint, the abdominoplasty is not absolutely necessary during the hernia repair, but would likely give you a better cosmetic result. Just don't expect your insurance to cover the cost of the abdominoplasty. They rarely do, although they should cover the cost of the hernia repair which will help defray some of the costs of the procedure.
Abdominoplasty " Necessary” to Prevent Hernias?
Thank you for the question.
Generally speaking, tummy tuck surgery is not “medically necessary”; there is no evidence that shows that tummy tuck surgery will prevent the recurrence of abdominal wall hernias in the future. Tummy tuck surgery is indicated if you wish to have excess skin/adipose tissue removed and/or abdominal wall muscle plication performed.
I hope this helps.
Tuumy tuck along with hernia repair
What you describe is fairly common. I have operated on two patients in the last month with this combination. While I agree that you will always have the weakness that your surgeon referred to in the abdominal muscles if you don't have anything done, I don't agree that you will be prone to more hernias, assuming this one is properly fixed. Usually insurance companies treat repair of a diastasis (separation) as cosmetic, unless it is very severe and can be shown to be contributing to functional problems.
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Umbilical hernia repair vs. hernia repair with abdominoplasty
It sounds like you have a pretty good sized umbilical hernia- because hernias represent a hole in the muscle layer of your body, and because your intestines can become trapped in these holes, and if this happens your health and safety can be at risk, it is a good idea (that is, it is medically wise) to have this hernia repaired.
On the other hand, a tummy tuck is always a cosmetic procedure- whether you are having the hernia repaired at the same time or not. In other words, as long as you are confident that you are not going to have any more babies, the choice of whether or not to have an abdominoplasty is totally up to you.
Any reputable and well-trained, Board Certified Plastic Surgeon should be able to complete this for you- don't be fooled into thinking that your situation means that there is some "special" technique that you must have in order to be happy.
Hernia repair and abdominoplasty at the same time
Your hernia repair can be easily approached through an abdominoplasty incision. As a matter of fact, your PS will have better access and visibility of your entire abdominal wall to best correct your hernia defect. In addition to that, from your description of 'still looking 6 months pregnant', you obviously need your entire lower abdomen re-inforced with mesh. I encourage you to read a couple of published articles on my profile so that you can better understand the pathology behind hernias after pregnancy and the benefits of having them repaired using an abdominoplasty approach. Best wishes,
Hernia repair is medically necessary; tummy tuck is cosmetic.
A tummy tuck is not a medically necessary procedure. It is a cosmetic procedure.
The umbilical hernia repair is considered medically necessary because there is a risk that your bowels will become incarcerated or strangulated.
The tummy tuck is not mandatory but might do an excellent job of tightening your tummy muscles and keeping you from "looking about six months pregnant still" to use your words.
I hope this helps.
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