Is Open Surgery with Mesh Using Vertical Incision the Only Way to Repair Hernias and Diastasis?

Physically fit, 27 year old athlete and mom of 1 with physically demanding profession. I have 2 hernias, one 3 inches beneath sternum approx. 3 cm the second a <2 cm umbilical hernia. Diastasis recti was cited as underlying issue. Surgeon wants to make vertical cut, correct diastasis and use mesh to repair.Obviously want problems fixed to continue athletic and coaching careers, but want to make sure there's not a more aesthetically pleasing procedure that can correct the musculature and hernias.

Doctor Answers 5

Vertical incision and mesh for hernia repair is not needed.

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By your description you do not need a vertical incision. This is the easiest access, but most obtrusive in scarring as it is difficult to hide. Also, mesh is highly likely NOT needed for these smaller size hernias. Both can be easily repaired through a low transverse incision hidden by your panties or bikini. Please get a second opinion from a plastic surgeon with extensive experience, preferably a double board certified (General Surgery and Plastic Surgery).

Fort Wayne Plastic Surgeon
5.0 out of 5 stars 13 reviews

Repair all hernia through a lower, tummy tuck incision

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Please, don't let someone use a vertical incision for this. I and clearly the other docs replying to this post routinely repair these through tummy tuck incision. The surgeon can absolutely reach all the way up to the lower sternum through even a mini-tummy tuck incision and you will have a great looking repair! Even big hernias with bowel sticking out of them! Find someone else! Mesh is overkill, I would not normally use it in this kind of case.

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

Vertical scar

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Dear RacerMom,

   I am a board certified plastic surgeon for over 25 years and I have never used a vertical scar in over 1000 tummy tucks.  It is absolutly un-necessary !  A horizontal  incision , low in the abdomen in the natural crease, will give you a nice and easy hidden scar. Through that approach , the diasthesis recti and and hernias can be repaired with no difficulty.  A mash is absolutly un-necessary. I used it only once in an old lady with very weak fascia. The standard tummy tuck approach will help you also with the skin laxity that is probably there due to your pregnancy. It sounds like your surgeon is a general surgeon  and not a plastic surgeon. Be sure to get a 2nd opinion by a board certified plastic surgeon.

             Best of luck,

                                         Dr Widder 

As bigger herniae as best mesh graft/ mientras mas grande la hernia mayor posibilidad de malla sintetica

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you should  choose a certified plastic aesthetic  reconstructive surgeon  to repair this problem avoiding a vertical incition.

the incistion could be  like a cesarea or better by endoscopy, avoiding  also the type  cesarean incition, as you are an athlet perhaps the  mesh utilization be avoided, repairing directly the defect, but  that will depend of herniae seize.

tu debeerias de  escojer un  cirujano plastico estetico y reconstructivo que pertenezca a la ASAPS.

la incision podria  realizarse ´pór abajo como si fuera una cesarea o bien  por  endoscopia  evitando ambas incisiones  ya sea la vertical o la horizontal

Ramon Navarro, MD
Mexico Plastic Surgeon

Incisions to repair diastasis and hernias

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You should seek consultation from a double board certified surgeon (Am Board of Surgery and Am Board of Plastic Surgery) as they will have the ability to repair both issues perhaps with a more creative incision that just cutting down the middle on top of the hernias and diastasis.  Perhaps a lower abdominal horizontal incision would work.  Perhaps skipping the diastasis and doing the hernias endoscopically?

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